Cherri Gregg, a KYW Newsradio reporter, is also an attorney admitted to the Pennsylvania Bar. She analyzes the historic ruling by the U.S. Supreme Court with the most commonly-asked questions.
In a 5-4 vote, the Supreme Court ruled that the individual mandate of President Obama’s Affordable Care Act, requiring virtually all Americans to buy health insurance, is constitutional. The court also addressed a provision requiring that states expand Medicaid coverage to include some non-elderly populations, such as low income residents, or lose federal Medicaid funding. On this issue, the Justices ruled that the provision is constitutional as long as states will only lose new funding if they refuse to comply with the expanded coverage requirements.
But what does this ruling mean for you and your health?
Here are answers to a few frequently asked questions.
1. Do I have to purchase health insurancee?
Yes. Beginning in 2014, if you can afford it and do not have a valid reason (such as religious beliefs) precluding insurance, you will be required to enroll in an insurance program. If you do not enroll, you may be required to pay a penalty in the form of a tax.
2. Will I get any help paying for health insurance?
Yes. The law will provide all Americans with access to affordable health care beginning in 2014. States are required to create healthcare exchanges, which are market places that will allow small businesses and individuals to compare costs of health plans. In addition, middle and low income families will be able to get tax credits that cover a portion of insurance costs.
3. If I decide not to get insurance, what will I have to pay?
Beginning in 2014, those who can afford insurance by choose not to buy it will have to pay a penalty, which will be collected when you file your yearly tax return. The penalty amount will vary based on your income.
4. Will I still be able to get insurance if I have a pre-existing condition?
Yes. Under the law, health insurance companies cannot deny coverage of children under age 19 based on a pre-existing condition. In addition, Americans who have been uninsured for at least six months because of a pre-existing condition now have access to health insurance through the Pre-Existing Health Insurance Plan or through the Department of Health and Human Services in their state. In Pennsylvania, those with pre-existing conditions have access to insurance through PA Fair Care. See http://www.healthcare.gov or www.pafaircare.com
5. Can my adult child stay on my insurance plan?
Yes. Under the Affordable Care Act, young adults will be allowed to stay on their parents’ health insurance until age 26. This does not apply if the young adult is offered health insurance at work.
6. What did the Supreme Court say about the states’ responsibility to continue to offer expanded Medicaid coverage for low-income consumers?
Under the law, states can receive additional matching federal funds when they cover some low-income individuals and families under Medicaid who were not previously covered. The Court ruled that states can choose not to provide this expanded Medicaid coverage without losing their original Medicaid funding.
7. I am a senior. Does the ruling change my Medicaid coverage?
No. Individuals under age 65 are still eligible for Medicaid in the same manner as before the ruling. The ruling only potentially impacts those under age 65.
8. Will the ruling affect the rates I pay for health insurance?
No. The ruling does not change what you are required to pay for health insurance under the new law.
For detailed information on the Affordable Care Act and a timeline of when the new provisions, go to http://www.healthcare.gov/law/timeline/index.html.
For more information on access to affordable healthcare in Pennylvania, go to http://www.portal.state.pa.us/portal/server.pt/community/health_insurance/9189
For more info on affordable access to healthcare in New Jersey, go to http://www.state.nj.us/dobi/division_insurance/ihcseh/index.html