How the Affordable Care Act affects Mass. residents
Submitted by South Cove Community Health Center
As the federal government rolled out the Affordable Care Act on Oct. 1, it is aimed at middle-class households earning $20,000 to $90,000 each year. To ease their medical insurance costs, the act offers more affordable insurance and related advantages. The ACA requires Americans to purchase medical insurance, but many people are unfamiliar with the legislation. Under ACA, insurance companies cannot refuse to cover individuals with preexisting health conditions, such as cancer, long-term illness, pregnancy or other cases. Individuals 26 and under can remain dependents in their parents’ insurance plans. Those under 30 can choose to buy medical insurance just for accidents or major illness.
All state residents can choose a medical insurance plan best suited for their health needs and finances from their state’s health insurance marketplace. ACA is designed for individuals who do not qualify for state Medicaid because their income exceeds the limit, but cannot afford medical insurance. This legislation gives nearly 50 million people access to more affordable medical insurance. Families with annual incomes under $90,000 qualify for tax premiums, to ease the financial burden of purchasing medical insurance.
Chinese Americans should understand how ACA affects them and ignore hype about how complicated the process is. Individuals who are uninsured in 2014 will be penalized. The fee in 2014 is 1 percent of your yearly income or $95 per person for the year, whichever is higher. The fee increases every year. In 2016 it is 2.5 percent of income or $695 per person, whichever is higher.
The health insurance exchanges started operating on Oct. 1 and are expected to serve more than 7 million uninsured individuals, who will be covered by 2014. ACA has four categories of personal medical insurance: Bronze, silver, gold and platinum. Bronze plans cover 60 percent of medical costs, while silver covers 70 percent of medical costs, gold covers 80 percent and platinum covers 90 percent. Bronze plans have the lowest premiums, which scale up to the platinum plans. The mid-range silver plan is considered the standard, because tax credits are based on silver medical insurance plans. Individuals can select the right plan for their needs. ACA requires insurance providers to cover many basic health benefits, such as colonoscopies and mammograms.
Health exchanges face an unprecedented level of complexity, as they must integrate multiple state and federal databases. Troubleshooting time was cut short because of the tight deadline, so parts of the system are imperfect.
During testing, individuals were able to go online to compare insurance plans, but were unable to register at the last minute, requiring technical support before they could finish the process.
The Kaiser Family Foundation offers a subsidy calculator (http://kff.org/interactive/subsidy-calculator/http://kff.org/interactive/subsidy-calculator) for families with different settings. It found a family of four — two children and no smokers — with an annual income of $50,000 would pay about $9,800 for silver medical insurance that requires individuals to pay 30 percent of medical costs. However, because the household qualifies for ACA premium tax credits, they could apply a tax credit of about $6,500. In other words, the household would pay just $3,300 per year or $275 per person for medical insurance. Currently, most online calculators only tally tax subsidy amounts. As the health exchanges went online on Oct. 1, people can have a better idea of the exact cost of medical insurance and how much tax benefit they qualify for.
State insurance changes
ACA is a national health care reform. Mass. residents can purchase insurance from the Health Insurance Exchange, with bronze, silver, gold and platinum plans. They can also enjoy tax credits.
Massachusetts is complying with health care reform by providing Qualified Health Plans which fulfill ACA requirements and are approved by the Massachusetts Health Connector. These plans can be chosen from the online Health Insurance Exchange by individuals over age 19, low-income residents, green cardholders, individuals who do not qualify for Medicare and those who are ineligible for health insurance plans offered by their employers. Among the Qualified Health Plans, individuals must select a Connector Care Plan to qualify for monthly federal subsidies.
For low-income Mass. residents who are green cardholders with five years of residency, MassHealth requirements will be changed. First, MassHealth coverage will expand and there will be fewer restrictions. Second, Commonwealth Care will end after 2013.
The Qualified Health Plans will be rolled out in 2014. Before the end of 2013, Commonwealth Care low-income residents in some plan types will qualify for Mass Health. These two categories include individuals whose annual income falls under 133 percent of the federal poverty line.
Legal permanent residents who have not resided in the United States for five years and are using Commonwealth Care will be notified to switch to health care plans starting Oct. 1. To apply for a Qualified Health Plan, they must visit the online Health Insurance Exchange at www.MAhealthconnector.org. On the website, they must select a Connector Care Plan from the Qualified Health Plans to qualify for monthly federal subsidies.
An email address is required to successfully log into the Health Insurance Exchange. Once in the website, individuals can reapply, register, compare insurance rates and buy insurance. However, the online exchange is difficult to navigate, as different states and federal agencies combine their databases. For users to register successfully without contacting technical support, you must prepare the following information before logging into www.MAhealthconnector.org:
- An email address
- ID: U.S. passport number, citizenship document, naturalization document, birth certificate, green card, foreign passport or work permit (original documents, not copies)
- Social Security cards for your whole family (original documents, not copies)
- Two recent consecutive paychecks or an employment letter verifying one’s salary, tips and employer’s contact information
- Most recent tax return, including the 1040 form, W-2, schedules and other forms
If individuals have any other forms of medical insurance, please prepare your insurance cards. Some people may need to pay on a monthly basis, so please remember to bring personal checks.
If you log into the Health Insurance Exchange successfully, be sure to remember your login ID and passport, so you can update your information online in the future.
This post is also available in: Chinese