The government shutdown did not prevent one of the centerpieces of the Affordable Care Act (ACA) from going into effect: health insurance marketplaces opened today.
Individuals and families can access their states’ marketplaces through Healthcare.gov. The marketplaces will allow consumers to shop for and compare healthcare plans available in their state, find out if they qualify for lower costs, and learn about coverage options. To qualify for coverage in 2014, individuals must enroll by March 31, 2014.
“At last, 50 million Americans without health insurance, most of whom are women, will have access to low-cost health insurance plans,” said Feminist Majority Foundation President Eleanor Smeal. “Don’t be fooled by the scare tactics. If you have insurance, you won’t lose it, but for the 50 million who do not, this is a great deal.”
Insurance plans will be offered in four categories that reflect the level of coverage and price: bronze, silver, gold, and platinum. Most eligible individuals will be able to purchase a plan for $100 or less per month. The federal government will subsidize plans by offering tax credits to individuals and families within 100 percent and 400 percent of the federal poverty level- $11,490 and $45,960 for an individual and $31,322 and $94,200 for a household of four. Twenty states have also decided to expand Medicaid eligibility under the ACA. People with incomes below 133 percent of the federal poverty level and able-bodied adults will no longer be excluded from the program as long as they meet income eligibility.
Young adults and those in need of lower-cost options will be able to choose catastrophic plans, which are designed to help cover unexpected, high medical costs, and have higher deductibles but lower monthly premiums. Adults under 26 may also remain on their parents’ insurance plan.
Under the Affordable Care Act, plans offered must cover ten essential benefits, including ambulatory patient services, maternity and newborn care, mental health and substance use disorder services, prescription drugs, and pediatric services including vision and dental care, among others. Plans must also cover the cost of preventive services without copays, coinsurance, or deductibles, including annual well-woman visits, contraceptives, HPV testing, HIV counseling and screening, domestic violence screenings, and mammograms, among others. Dental and vision coverage are included in some plans, but may also be purchased as separate stand-alone plans.
Media Resources: Healthcare.gov; Feminist Newswire 9/17/13, 9/27/13