In 2010, the federal government enacted the Patient Protection and Affordable Care Act, which aims to increase the number of Americans with insurance and cut the overall costs of health care. The Affordable Care Act puts in place strong consumer protections, provides new coverage options and gives individuals the tools needed to make informed choices about their health. One of the primary components of the ACA is the introduction of Health Care Marketplaces. California’s Health Care Marketplace is known as Covered California.
The first round of open enrollment for Covered California began on October 1st and continues through March 31st, 2014. The provisions of the Affordable Care Act can be confusing, here are some key points impacting students and educators:
|Federal Poverty Level||Up to 150%||200%||250%||400%|
|Percent of Income||4%||6.3%||8.05||9.5%|
|Maximum Monthly Portion||Up to $57||Up to $121||Up to $193||Up to $364|
Premium assistance is available for individuals and families who make less than a certain amount a year and who do not have other options for obtaining affordable health insurance that meets certain coverage requirements, such as health coverage offered through their employer or another government program.
The amount of premium assistance depends on an individual’s income, age and where the person lives. The Patient Protection and Affordable Care Act sets a monthly maximum that people will pay for health care, based on where their income falls in the federal poverty
level scale. In general, the less income someone makes, the less he or she will have to pay for health insurance and the more the federal government will help.
For example, individuals who make up to $45,960 and families of four that make up to $94,200 may qualify for financial assistance.Here are some key facts about premium assistance:
While premium assistance can help reduce premium payments, cost-sharing subsidies protect lower-income people from high out-of-pocket costs at the time of service. Those with incomes that are less than about $28,725 for a single person and less than about $58,875 for a family of four in 2013 may be eligible for those subsidies. Anyone who qualifies for cost-sharing subsidies will pay less for health care expenses, including costs incurred when they receive medical care.