Obamacare takes effect: What it means for Colorado
DENVER — Major portions of the Patient Protection and Affordable Care Act, also referred to as “Obamacare,” are set to take effect this week. While some congressional Republicans continue to battle the law, odds are quite high that the set changes will happen more or less as scheduled.
All this week, FOX31 Denver is answering your questions about Obamacare and clearing up confusion on both sides of the issue.
On Tuesday health insurance marketplaces, are scheduled to open for business. Think of it as the beginning of the holiday shopping season, said Dede De Percin of the Colorado Consumer Health Initiative.
Millions of Americans can go online to compare health plans, find out if they are eligible for federal help and buy coverage.
The Affordable Care Act requires all Americans to get some form of health insurance or pay an annual fine of $95. The fine increases to $695, or 2.5 percent of income, in 2016.
Each state will have an exchange. In Colorado it will be called Connect for Health Colorado. Some states are running their own exchanges, while others will rely on the federal government to operate it.
The exchanges for people who either don’t have health care insurance or whose employer provided insurance is too expensive or lacks important benefits.
Most workers at big companies that already provide health insurance won’t use the exchange.
For companies with 50 employees or less, the federal exchange and most states will have a Small Business Health Options program. This program is called SHOP.
All of the plans in the exchange will offer essential benefits including hospitalization, emergency care, maternity and pediatric care, mental-health care and prescription drug coverage.
Plans must cover preventive care — including flu shots, routine vaccinations and mammograms — at no cost. Insurers will offer four tiers of plans, based on deductibles, co-payments and other costs to consumers: bronze, silver, gold and platinum. Bronze plans have the lowest monthly premiums but higher out-of-pocket costs.
All the plans must cover people with preexisting conditions. In Colorado that’s means an estimated 2 million people can no longer be turned away.
How does the process work?
You can create an account at healthcare.gov or with the Colorado run exchange.
The exchange first determines if you are eligible for Medicaid. Through Medicaid, you can begin to have coverage and benefits.
If you are not eligible for Medicaid, the exchange will tell you how much of a subsidy you can get from the government to help pay for a private plan. In most cases, the government will pay the subsidy directly to insurance companies.
The exchange will show a variety of plans you can sign up for depending on your needs.
There are a variety of subsidies available depending on your income. People who receive subsidies will be required to pay 2 to 9.5 percent of their incomes, depending on how much money they make.