The Affordable Care Act & You
The Affordable Care Act & Your New Health Care Options:
The Affordable Care Act was signed into law in 2010 and many of the key provisions of the critical legislation have already taken effect, while many more are to be implemented as 2014 approaches.
This means that New Yorkers will have more affordable health care options and will start receiving key health care services without going through red tape. Enrollment began on October 1, 2013. To learn more, apply for coverage, compare plans, and enroll, visit NYStateofHealth.NY.Gov or call 1-855-355-5777. The call center is open Monday through Friday, 8 a.m. to 8 p.m. EST. To stay up-to-date with the changes, sign up for email and text updates by clicking HERE.
Below are helpful resources that will help you navigate the new changes and help you get the answers you need as we continue to transition towards a fair and efficient health care health system that is affordable for people on all income levels.
How does the Affordable Care Act Protect You?
- Creates the Health Insurance Marketplace, a new way for individuals, families, and small businesses to get health coverage
- Requires insurance companies to cover people with pre-existing health conditions
- Helps you understand the coverage you’re getting
- Holds insurance companies accountable for rate increases
- Makes it illegal for health insurance companies to arbitrarily cancel your health insurance just because you get sick
- Protects your choice of doctors
- Covers young adults under 26
- Provides free preventive care
- Ends lifetime and yearly dollar limits on coverage of essential health benefits
- Guarantees your right to appeal
Timeline of the Affordable Care Act:
Reforms included in the Affordable Care Act will be implemented through 2014 and beyond. This timeline shows when key features will be implemented:
October 1, 2013: Enrollment begins for individuals in the Health Insurance Marketplaces and for small businesses in the SHOPs.
January 1, 2014: - Coverage begins for individuals in the Health Insurance Marketplaces and for small businesses in the SHOPs.
- To make coverage affordable in the Marketplaces, premium tax credits become available for those with incomes between 100% to 400% of the poverty level (between $23,500 to $94,200 for a family of four in 2013).
- For those states that choose, Medicaid is expanded to cover all those with incomes up to 138% of the poverty level, with the federal government paying 100% of the cost for first three years, phasing down to 90% of the cost by 2020 and beyond.
- A prohibition on all discrimination by insurance companies against Americans due to pre-existing conditions begins.
- The elimination of all annual limits on insurance coverage begins.
- The small business health insurance tax credit increases from covering 35% of a business’s premium costs to 50% of a business’s premium costs.
March 31, 2014: The enrollment period ends for calendar year 2014 for individuals enrolling in Individual Health Marketplaces and for small businesses enrolling in SHOPs.
Your Insurance Company & Cost of Coverage:
The Affordable Care Act includes features that promote transparency and hold insurers accountable for how they spend your premium dollars and rate increases. Insurers must now spend 80% or 85% of the premium dollars they take in on health care costs and health care improvement activities. If they do not, they must provide rebates or premium reductions to policy holders. Click here to find out where your insurance company is spending your dollars, and check out their "Rate Review" profile to find out if they plan to increase rates in any way.
But I’m happy with my health care, what does this change for me?
More information on keeping your current plan can be found at HealthCare.gov's "Grandfathered" Health Plan website.
New York’s Health Insurance Marketplace:
New York State has partnered with the U.S. Department of Health and Human Services (HHS) to establish a state-operated Health Insurance Marketplace that will let you choose the plan that works for you, at a cost you can afford. Whether you’re uninsured or just want to explore new options, the state Marketplace gives you more choice and control over your health insurance options.
- About the Marketplace
The Marketplace is designed to help you find health insurance that will cover your needs and fit your budget. Here in New York, our state has partnered with HHS to ensure a well-run Marketplace is a top priority. You can find more updates here.
- Preparing to Enroll
There's a helpful checklist for individuals and families preparing to enroll in the NY Health Exchange and a thorough resource for small businesses. Click HERE to see what you will need to do to prepare to enroll.
- Get a Break on Costs
Since the Affordable Care Act has been implemented, we have seen the growing costs of health care coverage shrink. Further, more and more New York residents will be eligible for the affordable care they need as we head into 2014. In the meantime, you and your family might be eligible to find cost-cutting savings now.
Where can I find a navigator to help me enroll in person?
The following locations are official local New York State navigators in the community that are able to help you understand and enroll in new affordable health care options:
Locations in the 8th Congressional District:
For ACA navigator locations where you can enroll in person, click here: Guide to Affordable Care Act Navigators in NY-8
What if I have job-based insurance?
If you have job-based health insurance, you're considered covered. You may be able to change to Marketplace coverage if you prefer.
Any job-based health plan you currently have qualifies as minimum essential coverage. You don't need to change to a Marketplace plan in order to avoid the fee that uninsured people may have to pay for 2014. If you'd like to explore Marketplace coverage options, there are several important things to consider.
I am a small business owner. How will the Affordable Care Act affect me?
The Small Business Health Options Program (SHOP) simplifies the process of buying health insurance for your small business. Open enrollment for SHOP will begin on time on October 1 and businesses will have plenty of time to enroll for coverage that begins January 1.
- SHOP is different than normal enrollment – enrollment is year round and you can enroll on a monthly basis.
- In the Federal SHOP, businesses can apply and learn about options starting in October.
Call now to get your SHOP and small business questions answered by a customer service representative at 1-855-355-5777. The call center is open Monday through Friday, 8 a.m. to 8 p.m. EST. To stay up-to-date with the changes, sign up for email and text updates by clicking HERE.