The Affordable Care Act - What you need to know and were afraid to ask

Hi I’m Doctor Diane Cleverley PhD, founder of PHI, and thanks for joining me today. What is is Obamacare? It’s officially known as the Affordable Care Act it has a lot of different provisions, including the creation health care insurance marketplace That came into affect on October 2013 It mandates that all US citizens should have health insurance but that's easier said than done. Why did we need it? well did you know in 2010 15 million of our citizens were uninsured! Who were these people? There are some people that were unemployed that didn’t have COBRA, there were some small business employees is in part time employees including a lot young people ages 19 to 25. How could we do it? The federal government in Athens on this very question. the general idea from the administration was that we need to preserve the free market, we needed some government control and they came up with the idea of the creation of the health insurance market place. managed care organizations would bid to enter this market place and offer different levels bronze, silver, gold, and a higher level platinum. In order to get into this market place that would give the managed care organizations, you know, like a ready basket of customers, the government said they needed to provide 10 essentials like emergency room visit, doctor appointment, prescription drug coverage but the government also wanted them to provide some extras like preventive, well and chronic disease management and I was really happy to see that. Also mental health and substance abuse benefit including talks there which means that you're not going to treat mental health problems just giving them a pill, but letting people go to therapists. pediatric dental and vision are also covered in it really important thing. Parents who get insurance to the health marketplace can have their children covered up to age twenty-six. this will go a long way in helping to get that 50 million uninsured, the piece that was that children from 19 to 25 getting them coverage also people pre-existing get conditions who sometimes can get turned down by insurance company, or if your loved one, like a child has a condition like hemophilia which, is extremely expensive to treat they can sometimes get turned down or the insurance company will say , we will cover you but will only cover you up to maybe twenty thousand dollars a year. Well hemophilia can cost like two hundred thousand dollars a year to treat. in the government says no more that, we're going to put a cap on and we're going to only expect these people pay out of pocket to a certain amount. What if I still can't afford it, you might be asking yourself? well thought that'd some people this is the premiums that the managed care organizations still asking when they came back to the federal government their premiums still a little pricey, especially for people in the lower income bracket. The government came up with an idea to handle that. They would offer sliding scale reimbursement basically managed care organization is still going to get their premiums so they can operate at a profit still run their business but the government will reimburse people based on what their income is reported on thier tax form. So the less money you make, the more reimbursement you get back after you pay your premium. They also did something else that is leading to a lot of confusion. I get a lot of comments about people about this: they’ll go through the health care dot com website and then I'll get it back and the website will tell them, you’re not eligible for this, go fill out Medicaid. Now they’ve raised it to 133 percent of the Federal Poverty Level. It turns out that so over thirty thousand dollars a year on your AGI for family of four. 13 million people are now qualifying for Medicaid. That’s quite a bit remember the median income of the US is around fifty thousand dollars a year so this is a big bucket up people that are eligible now medicaid where do I sign up? well the government after they negotiating with the managed care and they set up the website they were all excited they went to the state and local governments, and they said “Hey we have this great website, tell everybody” Some of the states pushed back , like Massachusetts already had it’s own health website. It’s been running for years and had lots of people already signed up on it. Massachusetts Said “I like what I have , We’re running fine, don't bother us” So basically thirty-two states are using health care dot gov. these include New Jersey Pennsylvania Florida and some states are helping the government manage the website but there's somewhat involved. Nineteen states in one district, the district of Columbia Have their own website. These include New York, California and of course Massachusetts. Also remember that the territories are things like American Samoa and Guam Puerto Rico are not eligible to sign up for health insurance market place's so how does it work? You enroll. You enroll on health care dot gov or your alternate state’s website. the deadline been excited extended to March 2014 so you still have a few more months premiums may be higher than your employer-sponsored plans You might want to check it out even if you do have an employee's sponsoring a health care plan but remember your employer pays part of your premium the benefits might be better; there might be a special cases if a spouse on chemotherapy if you have a child with a chronic illness I'm you may find that you like the premiums better the network might be something that you like better Networks are limited, though. So do your research before signing up make sure your favorite doctor your hospital whatever in your plan really have severely limit the networks from what I've read in those plans in and what if I don't want health insurance is a question I get on my other friend who's a libertarian he just doesn't want to do it So, basically you're going to get taxed, and get civil tax assessed on in a monthly on a monthly basis a went without health insurance the end each year on your tax refund. It will be deducted from your tax refund 2014, the penalty is low and they're going to raise it each year . To give you an idea what the amount would be: ninety five dollars or 1 percent of your AGI so whichever is greater I'm using that fifty thousand dollars a year because that’s median gross income United States as an example it would be five hundred dollars. It's going to go up though, in 2016 be two-and-a-half times greater so that's it basically. Please enroll. Please practice preventive and well medicine. Care for your chronic conditions and remember you deserve to be well-treated and treated well If you have any questions just email me at personal health for you at gmail dot com and I’ll do my best to answer them. Thank you for listening for more information this business on the web at personal health info dot weebly dot com.