If you are a self-employed artist and need to buy health insurance, it’s a mess. There isn’t one place to compare all the available plans, and if you don’t make much money you’re stuck with a crappy plan or no insurance at all. If you have a pre-existing condition you’re out of luck, and if you get seriously ill, your insurance company will go through your medical records looking for any excuse to drop your coverage. The Affordable Care Act aka Obamacare addresses the most glaring problems.
Exchanges: Starting in 2014, every state will have its own insurance exchange – an independent agency that will connect people to insurance. You’ll be able to look on one website or call one phone number to compare every plan available in your area.
New rules for insurance plans:
- Insurance companies can no longer discriminate against people with pre-existing coverage and can’t drop your coverage if you get sick.
- Lifetime and annual limits are eliminated– plans can no longer cap how much they will pay out over the course of a year (or your lifetime) if you get sick.
- Limits on how much plans can charge.
- Plans have to cover preventive care without a copay or deductible.
Help paying for insurance, based on income:
- If you make less than 400% of the poverty line (i.e. less than $43,320 for an individual; $88,200 for a family of 4) you pay on a sliding scale. If insurance costs more than a certain percentage of your income, the government will pay the difference.
- If you make less than $14,400 (or less than $29,327 for a family of four), you’ll be covered under Medicaid.
Limits out of pocket expenses: The most a plan could have you pay out of pocket in a year will be $5,950 for an individual, $11,900 for a family. And if you make less than 400% of the poverty line, the limits on out of pocket expenses are lower (also based on a sliding scale).
For the small arts business:
- The law also creates exchanges where small businesses can shop for coverage.
- Businesses with more than 50 employees will have to pay a tax penalty if they don’t offer health care.
- Businesses with fewer than 25 full-time (or 50 part-time) employees who make less than $50,000 per year on average are eligible for tax credits to help provide insurance to their employees. These credits are already in effect, and will increase starting in 2014.
For young people:
- You can stay on your parents’ insurance until you’re 26.
- If you’re under 30, you’ll have the option to purchase “catastrophic” insurance through the exchanges. This is coverage with a high deductible, but low premiums– it’s only meant to kick in if something serious happens to you. However the first three primary care visits every year will be free.
Remember to vote in November like your health depends on it.
Rob Cullen, a professional health care blogger at Whatifpost.com, presented this at our last event, “The Future of Health Care”. Whatifpost.com is a fantastic resource that demystifies the health care system and makes the reform movement easier to understand.