AUSTIN, Texas â€“ As major portions of the Patient Protection and
Affordable Care Actâ€”commonly referred to as Obamacareâ€”are set to roll
out beginning this fall, it's an important time to understand how these
changes will affect a significant number of currently uninsured
Unless Congress takes action to delay the implementation of the
“individual mandate,” Americans who fail to purchase insurance coverage
by Jan. 1, 2014 are subject to a fine of $95 per uninsured person or 1
percent of the household income. Fines will increase in 2015, eventually
maxing out at $695 per uninsured person or 2.5 percent of household
income in 2016.
To assist consumers in avoiding fines for non-compliance with the
individual mandate, the department of Health and Human Services is
launching a national Health Insurance Marketplace, also known as a
“health insurance exchange,” on Oct. 1 of this year (more information at
The Marketplace will provide consumers with a central point to apply
for health insurance and view a variety of options for purchase. It will
also alert you if you qualify for free or low-cost coverage available
through Medicaid or the Children's Health Insurance Program.
If you live in the United States, are a U.S. Citizen or national (or
lawfully present), and are not currently incarcerated, you qualify to
enroll in program.
The new insurance programs offered through the Health Insurance
Marketplace are different from what you might have experienced in the
past. Many consumers who have been denied insurance coverage previously
due to preexisting conditions will notice the biggest change.
Beginning in 2014, health insurance plans can't refuse to cover you
or charge you more just because you are currently sick. Further, all
plans offered through the Marketplace must cover many preventative care
services at no out-of-pocket cost to you, including blood pressure,
cholesterol, depression, diabetes and HIV screening, as well as
immunization vaccines, among others.
Preventative care services for children, including autism screening
and behavioral assessments, will also be offered without cost to the
If you are a small business owner (50 or fewer full-time employees)
and are interested in offering or changing your employees' health
insurance coverage to a plan in the Health Insurance Marketplace, you
can enroll through the Small Business Health Options Program (SHOP).
If you secure employee coverage through the SHOP marketplace and pay
at least 50-percent of your full-time employees' premium cost, you could
qualify for the Small Business Health Care Tax Credit, which can add up
to 50-percent of your contribution to employees' premium costs
(35-percent for tax-exempt employers).
It's important to note that, as all of these changes are currently
underway, now is an ideal time for scammers to capitalize on the
If you receive a phone call from anyone claiming to represent a
government agency, do not give out your social security number or
banking information. Doing so will not enroll you in the Health
Insurance Marketplace or allow you to purchase insurance and could
jeopardize your personal financial information.
When enrollment begins on Oct. 1, please visit www.healthcare.gov,
call 1-800-318-2596 or contact a health insurance broker for more