Will Health Reform Cost Me More?
Seniors and People With Pre-existing Conditions
People with health conditions or older adults may get a break on their health insurance costs.
Starting in 2014, insurers will no longer be allowed to turn people away or charge them more because of a pre-existing health condition.
Older adults also can't be charged more than three times what a younger person pays for the same health plan.
People With Low Incomes
As many as 17 million people nationwide could be eligible for Medicaid coverage, the federal and state-funded program that provides insurance to low-income people. The law this year increases coverage to individuals with an annual income of about $15,415.
It may not apply to everyone who qualifies, however. The Supreme Court's ruling from earlier this year gives states the option of whether they want to participate in this program.
The law calls for the development of the Small Business Health Options Program (SHOP) Exchanges, where businesses with up to 100 employees can purchase insurance coverage.
Small businesses with fewer than 25 employees may also qualify for a tax credit of up to 35% to offset the cost of premiums between 2010 and 2013, and up to 50% in 2014.
People with Medicare coverage, in some instances, have already seen their costs go down. The prescription drug "donut hole" is set to close by 2020 so seniors have reduced out-of-pocket costs for medications. In addition, preventive services such as annual doctor visits and screening tests are now available without a co-payment or deductible.
People with incomes of $85,000 or more have paid higher Medicare Part B premiums since 2007 and higher Part D premiums since 2011. Those rates have been frozen, says David Lipschutz, policy attorney with the Center for Medicare Advocacy, Inc. "Over time, as cost of living adjustments increase, it will apply to more people," he says.
The law requires nearly everyone to have insurance in 2014 or pay a fine on their income tax. The individual penalty is up to 1% of income or $95, whichever is higher, and rises to 2.5% in 2016. For families the penalty starts at 2.5% of household income or $2,085, whichever is greater. Some people may still find insurance too expensive and opt to pay the fines instead.
"At the end of the day there will be people who will decide they'd rather pay 1% or 2% of their income to the IRS than 5% or 8% for [insurance] coverage," says Anthony Wright, executive director of the health care consumer advocacy coalition Health Access.