March 19, 2014 -- The big deadline -- the final, no-more-extensions, we-mean-business-this-time deadline -- is almost here. After March 31, Americans -- with a few exceptions -- won't be able to buy health insurance for 2014.
And unlike the previous deadlines, there seems to be no chance of a last-minute reprieve.
It's a good time to take a look at the state of health care reform. Here are seven things we know now about it.
1. The March 31 Deadline Is Firm
Don't expect this enrollment deadline to get extended. Most uninsured people will need to buy insurance by then to avoid facing a penalty.
How come they mean it this time? There have been lots of extensions and delays to the law, partly because of the botched launch of Healthcare.gov.
"But if you continuously push [the deadline] back, it will look like the policy is a failure, and you're not doing what the law intended, which is to force people to buy coverage,” says John Bowblis. He's an assistant professor of economics at Miami University of Ohio who studies health insurance.
Could there be one more delay? Possibly. If there are technical glitches in the final days of enrollment, federal officials are working on a plan to approve sign-ups for everyone who tries to enroll before the deadline.
People with low income can apply at any time for Medicaid or the Children’s Health Insurance Program, though.
2. You May Be an Exception to the Rules
What if you want to get insurance after the March 31 deadline? You’ll only be able to if you have what's known as a “life event.” That includes getting married or divorced, giving birth to or adopting a child, or losing your job. A life event qualifies you for a special enrollment period.
If you didn't have a life event, will have to wait until the fall -- Nov. 15 in almost all states -- when enrollment opens for coverage that takes effect in 2015.
There are exceptions to tax penalties, too.
You’ll be penalized if you don’t have health coverage this year, unless you fall in certain exempted groups of people like most prisoners, those who were uninsured for fewer than 3 months of 2014, and those in certain religious groups. People who have faced hardships like bankruptcy, homelessness, and domestic violence (among several other types of hardship) may also be exempt. You’re also exempt if you were found to be ineligible for Medicaid because your state didn’t expand the program, or if you can’t find a plan that costs less than 8% of your income.
3. Can You Keep Your Old Insurance? Maybe Not
After an outcry from people who feared cancellation of their insurance would force them to lose their doctors or pay higher rates for a health plan, the Obama administration said it would allow people to keep the policies for 1 year -- even though they might not meet the law’s minimum coverage standards. Earlier this month, officials extended that another 2 years for a total of 3.
But there's still one catch: States don't have to allow those extensions, and insurance companies don’t have to offer them. Washington state, for example won't allow those policies that don't meet "Obamacare" standards to be offered.