Health care act covered
CRANBERRY TWP — A handful of residents turned out Wednesday afternoon at the Cranberry Public Library looking for information and even help signing up for the new federal health care program.
Leslie Bachurski, director of consumer navigation & organizational development for the Pittsburgh-based Consumer Health Coalition, discussed the program and assisted with sign-ups.
The Affordable Care Act, known as ObamaCare, was signed into law in March 2010.
According to Bachurski, the law is projected to help 48.6 million Americans who otherwise would not have health care coverage. About 3 million of those helped would be from Pennsylvania.
The public already benefits from this law in that insurance companies can no longer deny children and adults coverage based on pre-existing health conditions, Bachurski said.
Children also can stay on their parents’ health care plans up to age 26.
“Insurance companies can no longer cancel your coverage due to becoming sick,” Bachurski said.
She added there are no more insurance coverage caps, a new appeals process and future rate and premium insurance increases must be justified.
To get health care insurance, prospective buyers need to log onto the federal government’s health care marketplace, Bachurski said.
For Pennsylvania residents, she said all well-known regional insurance carriers, including UPMC, Health America and Highmark, are part of the marketplace.
“There are no ‘no name’ plans in the marketplace,” she said, adding that both mental health services and alcohol treatment must be a part of those plans.
The plans range from platinum, gold, silver and bronze levels, which based on each plan, will affect the out-of-pocket costs and the cost in each of those categories.
“Most people currently signing up are in the $10,000 to $40,000 income range,” she said.
Consumers can pay a reduced rate if their total household income is 100 to 400 percent of the federal poverty level. Those consumers will receive a tax credit that will be sent by the government directly to the insurance carrier to cover the cost of their premiums.
The insurer still will be responsible for a reduced premium based on the calculations, she said.
Those who choose not to be insured will pay a penalty of $95 or 1 percent of taxable income this year and that increases to $325 or 2 percent in 2015 and $695 or 2.5 percent in 2016, Bachurski explained.
Larger employers who do not offer insurance to their employees face fines of $2,000 to $3,000 per employee. Small companies are exempt.
But Bachurski said she expected the federal government to establish a penalty for small companies this year.
There are some exemptions from paying a penalty if an individual goes without health care insurance. Those include:
n Those who cannot afford coverage
n The household income falls below a certain threshold
n A short gap of three months or less in coverage
n Those who are a part of certain religious sects
n Those who are a part of a health care sharing ministry
n Prison inmates
n Those who are illegally in the United States
n Those who are a member of an American Indian tribe.
Those wanting to sign up can visit the ACA’s website at www.healthcare.gov or call 800-318-2596 to register over the telephone.
For questions about the Affordable Care Act, contact the Consumer Health Care Coalition at 412-456-1877 or visit its website: www.consumerhealthocalition.org.