‘Obamacare’ and you
On the first day of October, health insurance “marketplaces” opened across America. Three other key provisions of the health reform law, the Affordable Care Act, also went into effect that day, and will greatly benefit older Americans
The first of these provisions will benefit everyone who shops in the new marketplaces, but will be especially valuable to adults between the ages of 55 and 64. As of Oct. 1, people with pre-existing conditions, who may have previously faced denials of coverage or burdensome additional charges because of those conditions, will have the opportunity to buy health insurance that covers their conditions without having to pay additional costs.
This is more than a token change. In 2010, Families USA, a nonprofit advocacy organization, worked with one of the nation’s top healthcare and human services consulting firms to study the breadth of problems that people with pre-existing conditions face. We found that of approximately 57.2 million Americans under the age of 65, more than one-fifth of that age group (22.4 percent) had diagnosed pre-existing conditions that could lead to a denial of coverage in the individual health insurance market.
A second key provision of the law: States that have decided to expand Medicaid will have new opportunities to offer health coverage to all low-income adults. This could be particularly helpful to those below age 65 who aren’t yet eligible for Medicare. In these states, the income eligibility level will be raised and standardized at 138 percent of the federal poverty level (about $21,400 for a family of two), and other barriers to eligibility will be thrown out as well.
Medicaid, the largest payer for nursing home care in the United States, will continue to support seniors and people with disabilities who need long-term care, and cover the home and community based care that makes it possible for 2.8 million seniors and people with disabilities to remain in their communities.
The third big provision of the law will benefit everyone shopping for health coverage. Consumers are able to tap health care “premium tax credits” that can lower their health care premiums each month, making their health coverage much more affordable. Those with the lowest incomes will receive the greatest financial assistance and will pay the lowest premiums. Families with incomes as high as $62,400 for a household of two will be eligible for this assistance.
A bright new day in health coverage is about to dawn.
Ron Pollack is executive director, Families USA