Outreach

 

Affordable Care Act Repeal Efforts:

What it Means for Consumers
It’s critically important to know that as of now, nothing about the Affordable Care Act (also known as Obamacare) and the Health Insurance Marketplace has changed. Consumers who enroll by the January 31, 2017 deadline will have coverage starting March 1.

If anything were to change about coverage options for 2017, community health center staff will be available to help consumers understand what that means for them.

Q. I heard that Congress already voted to repeal the Affordable Care Act. Is that true? If so, that means I can’t enroll in coverage, right?

  • While Congress has started a process that could eventually repeal the Affordable Care Act, as of now, nothing has changed and open enrollment continues.
  • Congress voted on a budget resolution that kicks off a multi-step budget process that could result in the repeal of parts of the Affordable Care Act, but a budget resolution is not law, and it does not go to the President for a signature.
  • As of now, nothing has changed about the Affordable Care Act – not plans, not prices, and not enrollment deadlines.
  • While repeal is not a certainty, even if repeal does take place, it’s likely that most consumers who are already enrolled with an insurer for a 2017 plan will be able to keep their coverage.
  • Consumers can enroll in coverage right now, pay their premium, and begin using their insurance on March 1. Consumers who apply and are eligible for Medicaid can still enroll at any time.

Q. What do you think President Trump and the Republican Congress will do about the Affordable Care Act moving forward?

  • We do not know what the President or Congress might do in the future, but as of now, nothing has changed about the fourth enrollment period – not dates, not plans, and not prices.
  • It’s likely that 2017 plans will remain in place, and both insurance companies and Members of Congress have expressed a desire to avoid disruptions and do no harm to consumers already in the system.
  • That means free, expert assistance will continue to be available to consumers throughout the enrollment period and beyond.

What about the recent executive order? Did that repeal the mandate, or change things for people who need to enroll?

  • No, the executive order did not change anything for people who want to enroll. The deadline is still January 31, financial assistance is still available, and consumers can still find quality, affordable plans through the Health Insurance Marketplace.
  • The executive order just restated what the Trump Administration has already said about what they want to do with the Affordable Care Act.
  • Changing the law will require Congressional action, and as of now, nothing has changed.

About the Affordable Care Act:

  • On 3/23/2010 President Obama signed the Affordable Care Act into law. The U.S. Supreme Court ruled to uphold the law on 6/28/2012.
  • As of January 1, 2014 ALL individuals will be required to have qualifying health coverage or pay a tax penalty if they are not insured.

 There are exemptions to this requirement:

  • Religious Exemptions
  • You a member of an Indian tribe
  • You are incarcerated
  • You are an undocumented immigrant
  • Your income is below the tax filing threshold.
  • 8% of your income goes to pay health insurance.

For more information go to: HealthCare.gov


Why should I have health coverage?

  • Health insurance covers unexpected medical care and protects you from high expenses.
  • A benefit of health insurance is the free preventative care, like vaccines, screenings, and checkups. They also cover the costs of some prescription drugs.

What does the affordable care act mean for you?

Improved Coverage:

  • Under the law, young adults are able to be covered under their parents plan until age 26 if the plan offers coverage to dependents.
  • The law ends pre-existing exclusions for children under age 19.
  • Your insurance cannot cancel your coverage if you make an honest mistake during application.
  • You are guaranteed the right to appeal.

Improved Care:

  • Insurance companies/plans must offer preventative health services.
  • You can choose the doctor/provider you want from your plans network.
  • If you require emergency care out of network; you are no longer subject to higher costs or pre-approval.

Limits Costs:

  • There are no longer lifetime limits on coverage.
  • Your insurance premium dollars must go towards healthcare costs, not administration costs.
  • Insurance companies must be able to justify an increase in your rates.

For more information go to: HealthCare.gov

What is the Health Insurance Marketplace?

  • It is a new way to find health insurance coverage that fits your budget and meets your needs.
  • The Affordable Care Act makes provision for people to receive reduced premiums and out of pocket costs on their insurance through the health insurance marketplace if they meet eligibility requirements.

For more information go to: HealthCare.gov


What does Marketplace health insurance cover?

  • Essential health services include the following minimum requirements:
  • Ambulatory patient services (outpatient care without being admitted to the hospital);
  • Emergency services;
  • Hospitalization;
  • Maternity and newborn care (before and after baby is born);
  • Mental health and substance use disorder services, including behavioral health treatment;
  • Prescription drugs;
  • Rehabilitative and habilitative services and devices;
  • Laboratory services;
  • Preventive and wellness services and chronic disease management;
  • Pediatric services.

For more information go to: HealthCare.gov


What if someone doesn't have health coverage?

  • If someone who can afford health insurance doesn't have coverage, they will have to pay a fee. They also have to pay for all of their health care.
  • Visit the website for questions about:
  • What are the fees?
  • What is the minimum essential coverage?
  • What kinds of health insurance don't qualify as coverage?

For more information go to: HealthCare.gov


What if I'm self-employed?

  • If you're self-employed with no employees, you're not considered an employer. You can use the individual Marketplace to find coverage that fits your needs.
  • If you have employees, you can get coverage for yourself and employees through the Small Business Health Options Program (SHOP) Marketplace.

For more information go to: HealthCare.gov


What are my health coverage options if I'm unemployed?

  • If you're unemployed, you may qualify for Medicaid, the Children's Health Insurance Program, or lower costs on Marketplace insurance based on your income.
  • Your options depend on your household income.

For more information go to: HealthCare.gov

What if I'm a part-time employee without health coverage?

  • If you're a part-time worker without job-based coverage, you may be able to buy health insurance in the Marketplace and get lower costs based on your income.
  • If you're offered coverage through an employer, you may buy insurance through the Marketplace instead. But, in most cases, you won't be able to get lower costs based on your income.

For more information go to: HealthCare.gov

United Community Health Center Can Help

  • United Community Health Center is a Certified Application Counselor Organization with trained staff available to answer any questions you may have about enrolling in Medicaid, Children's Health Insurance Program (CHIP known as Hawk-I in Iowa), or the Marketplace Insurance Exchange. Appointments are preferred. If you would like more information about the Affordable Care Act, go to healthcare.gov.

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To find out how much you are eligible for when you apply, you need to have the following information:

  • Social Security numbers (or document numbers for legal immigrants) for each member of your family
  • Birth dates for every member of your family
  • Pay stubs, W-2 forms, or "Wage and Tax Statements"
  • Policy numbers for any current health insurance
  • Information about any health insurance you or your family could get from your jobs


To apply for health coverage, create an account at HealthCare.gov

Additional Resources for Consumers:

  • Cuidadodesalud.gov – to apply for health coverage in Spanish Marketplace Call Center: 1-800-318-2596 (open 24/7)
  • TTY: 1-855-889-4325 (open 24/7)
  • SHOP Small Employer Contact Center: 1-800-706-7893 (Open Mon-Fri, 9 am – 7 pm)
  • Questions your CAC can't answer? Call your regional Navigator @ Planned Parenthood of the Heartland: Sioux City – 1-877-811-7526
  • Like Facebook.com/HealthCareGov
  • Follow @HealthCareGov on Twitter