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Jenny Gold Answers Your Questions On Health Care Exchanges

Jenny Gold, a reporter for Kaiser Health News, is as clear and straightforward a health care reporter as you can find. She responded to some of your online questions after our hour on the state health care exchange marketplaces. It’s not exhaustive, by any means, but it offers more simple, easy-to-understand information about the arrival and implementation of the Affordable Care Act.

 

Isn’t Obamacare going to be more expensive for young people who don’t qualify for subsidies?

The few young adults who are buying insurance on their own now may see their premiums go up. That’s because healthy people will no longer pay lower premiums than people with health problems. And the oldest people will pay a maximum of three times what the youngest people pay—that’s a much smaller difference than today

But it’s important to consider what you’ll be getting from those plans and make an apples-to-apples comparison. Young people today are often buying inexpensive “catastrophic” health plans that have very high deductibles and skimpy benefits. In contrast, all plans sold on the exchanges must include a comprehensive set of essential health benefits. So even though the plan might be more expensive, you might be getting more bang for your buck.

My understanding is most of the insurance offered under this new law has deductibles around $5,000. How can anyone that can’t afford health insurance now afford that kind of up front expense? And second, since when is health insurance health care?

Deductibles will vary from state to state. They also vary by plan. There are four levels of coverage available on the exchange—bronze, silver, gold and platinum.  The lower the grade of metal, the more you have to pay for your medical expenses (including the deductible), but the premium will be lower.  In California, for example, the bronze plan has a $5,000 deductible, but the gold and platinum plans have no deductible at all.

The Affordable Care Act also sets maximum out-of-pocket costs for health plans, which includes copays, coinsurance and deductibles. For people earning more than 250 percent of the federal poverty level, the maximum is $6,350 for an individual and $12,700 for a family. For people earning less than that, the maximum out-of-pocket spending is as low as $2,250.

Medicaid takes your assets into account after the age of 55, if you own your own house, has that changed????

The Affordable Care Act eliminates the Medicaid asset tests for people under age 65. As long as you earn less than 138 percent of the federal poverty level ($15,415 for an individual), and you live in a state that’s expanding Medicaid, you should qualify. Your eligibility for Medicaid will be based solely on your income, not your income + assets.

I hope you talk a little about what happens when states like mine (Wisconsin), who didn’t set-up their own exchanges, have to use the federal healthcare site instead. Does it have all of the same features? How does it compare to say, California or New York’s sites? If they can just do it on the federal site, why even have the states do their own?

The Wisconsin exchange, which is being run by the federal government, is expected to be fully functional byOct. 1. Just go to www.healthcare.gov, where you will put in your state and then provide your personal information to find out which plans are available to you. States running their own exchanges, including California and New York, will have sites that look different, but should have similar features. The people who drafted the law expected states to “make it their own” and built in a lot of flexibility for states to set their own rules and do their own branding – as states have done in the past with the CHIP program for children and Medicaid. But little about this law has gone the way the people who wrote it expected it to go.

I live in Baton Rouge, I have been unemployed for over a year & currently am covered under my husband’s policy. Because of Obamacare, they will be dropping spouses. I will not be able to afford insurance at all. Will I be penalized? Do I have any hope of getting coverage?

Your husband can stay on his employer plan, and you should be able to buy a health plan on the Louisiana exchange. You can access that site through www.healthcare.gov, beginning on Oct 1. You may qualify for a subsidy to help you buy coverage. If you have additional questions or need help picking a plan, you can call the toll-free federal hotline at 1-800-318-2596.

For more on the politics of the Affordable Care Act, or Obamacare, listen back to our hour on the political nature of the law’s implementation from this past August. You can also listen back to our lively on-the-road round table from Nashville, where we checked in with local leaders in the medical industry there on how they are getting ready for next month’s marketplace debut.

Have more questions for us on Obamacare in your state? Leave your comments below, or check in with us on Facebook and @OnPointRadio. Or, you can ask Jenny herself to answer your questions @JennyAGold.

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