If you happen to be reading this on Tuesday, Oct. 1, know that today is historic.
I say that because open enrollment starts today as part of the Affordable Care Act
(ACA) and will end March 31, 2014. Insurance coverage for those who obtain it during
open enrollment can start as soon as Jan. 1, 2014. If we had been around in 1940,
when the first Social Security checks were issued, or in 1965, when the first Medicare
card was issued (it went to President Harry Truman) then we would have some idea of
today’s significance.
You can tell your grandchildren you remember the “real” start of the ACA — the day
the exchanges (also now called marketplace) started. Remember the idea behind the
exchanges — it is that most of the 45 million Americans without health care coverage
can obtain coverage either by qualifying for Medicaid or through purchasing insurance
on the exchange. Insurers selling plans on exchanges will have to provide a set of
essential benefits and many who get their insurance through an exchange will receive
a subsidy based on their income. For example, a family of four with income between
$23,550 and $31,400, will pay 2 percent of that income for coverage, while a family
of four with income between $70,650 and $94,200, will pay 9.5 percent.
Here are two more examples from Texas: after subsidies, a 27-year-old with an income
of $25,000 would pay $145 per month for the benchmark second-lowest-cost silver plan,
$133 for the lowest-cost silver plan, and $83 for the lowest-cost bronze plan. A family
of four with an income of $50,000, again, after subsidies, could expect to pay $282,
$239 and $57, for the same plans.
And, it is the law that we (all of us) either have to have health care coverage or
pay a fine.
How is this going to work out? That remains to be seen.