Welcome to today's live chat on health care reform.
Now that the Supreme Court has upheld President Obama's sweeping health care reform law, what does this mean for you?
Kiplinger health editors Martha Craver and Kim Lankford will be taking your questions for the next hour.
Good afternoon. Happy to be here.
Thanks for participating, everyone. Looking forward to your questions.
To get started, let's take a look at what readers can expect to happen next.
Martha, we’re already hearing that Congressional Republicans are going to try to repeal and replace the law. What’s the likelihood of this happening?
And Kim, what are some key provisions that will take effect over the next two years?
That's right. The House GOP intends to vote to try and repeal the law in the next couple of weeks. It will pass the House but not the Senate. And, as long as President Obama is in the White House the law will not be overturned.
What about if Romney is elected?
However, if Gov. Romney is elected in November, all bets are off. Even if Senate Democrats are able to bottle up any "repeal and replace" legislation, Romney as chief executive could scuttle the law. The Accountable Care Act gives a lot of authority to the regulatory agencies and Romney could simply have the agencies delay rules or refuse to enforce those already on the books.
So, there are still a lot of unknowns out there about what could happen.
While we let Kim finish up her answer, let's get started with our first question from Ken.
Yes, the Court's decision ends some of the uncertainity, but it still faces a contentious political outlook.
Right now, young adults will continue to be able to stay on their parents' policies until age 26 (but it's a good idea to shop around to see if this really is the best deal, especially if you move far away from your parents and are healthy -- I wrote a column about that a few weeks ago). Next year, the maximum limit to put in medical FSAs will shrink down to $2,500, so it's a good idea to have any major medical procedures with big out-of-pocket expenses this year if you were able to set aside more than that in your FSA this year. Also, the doughnut hole for Medicare Part D prescription-drug coverage will continue to shrink in 2013, and you'll be able to switch Medicare Advantage plans anytime during the year -- rather than just during open-enrollment season -- if you live in an area that has a plan with a five-star quality rating (I did a column about that a few weeks ago, too). Then the big changes take place in 2014, when insurers must cover everyone regardless of their health and you must pay a penalty (or a tax) if you don't buy coverage, and the state health insurance exchanges should be up and running by then, although some had been waiting for the Supreme Court's decision to get started, and it will be interesting to see how quickly they can move to get implemented.
Martha and Kim, any insight into Ken's question about Medicaid?
Ken, I haven't read the entire decision yet but I don't think that's what the Court said. My understanding of the Medicaid issue is that the Court ruled that Congress acted constitutionally in offering states funds to expand coverage to millions of new individuals. States can agree to expand coverage in exchange for those new funds. If the state accepts the expansion funds, it must obey the new rules and expand coverage. A state can refuse to participate in the expansion without losing all of its Medicaid funds. Instead, the state will have the option of continuing its current unexpanded plan as is.
Here's our next question from MaryG
Mary, if you mean the temporary insurance for those with preexisting conditions, I believe those will continue until 2014 when the state insurance exchanges begin operating.
That makes sense, thanks Martha.
Here's a question from Sarah.
We also have a comment from Cascadia.
Karen, you will need to buy health insurance come 2014. By then the insurance exchange in your state will be up and running where you will be able to shop for the best plan for you. You may be eligible for a subsidy from Uncle Sam to help you buy health insurance.
If you're in relatively good health, you could get a policy now. In most states, healthy people in their 20s can generally find a policy for less than $200 a month, and you can lower your premiums by getting a high-deductible policy, which can also qualify you to contribute to a health savings account -- you can make tax-deductible contributions and use the money tax-free for medical expenses (such as to help pay the deductible). Starting in 2014, you'll be able to get coverage on a state health insurance exchange, regardless of your medical condition.
Cascadia, that is exactly the argument the Obama Administration made for requiring all to buy health insurance. By having everyone participating, the pool is bigger and the risk is spread out and the premiums are lower.
We have a question about the individual mandate from Jess
And to the writer who had the 15% premium increase -- it's a good idea to shop around and see if you can get a better deal with another company; the prices can vary a lot from insurer to insurer. You can see a list of companies offering coverage in your area at HealthCare.gov or eHealthInsurance.com. You can also save money by raising your deductible. Insurers must generally provide some preventive coverage now even for high-deductible policies.
Depending on your income you might be eligible for Medicaid. Beginning in 2014 anyone with an income at or lower than 133% of the federal poverty level (which currently would be $14,856 for an individual or $30,656 for a family of four) will be eligible for Medicaid.
You might be eligible for government subsidies to help you pay for private insurance sold in the state insurance marketplaces, These premium subsidies will be available for individauls and families with incomes between 133% and 400% of the poverty level, or $14,856 to $44,680 for individuals and $30,656 to $92,200 for a family of four.
Thanks, a lot of good information there Martha.
Alright, we have one more question in the queue. Then, we'll go ahead and wrap up.
Martha, this looks like a good one for you.
