Archive for Monday, September 30, 2013

What does the Affordable Care Act mean for you?

September 30, 2013


Obamacare is here.

A major piece of the 2010 Affordable Care Act will be rolled out Tuesday. But what does that mean for you, the Lawrence consumer? Here are answers to basic questions about the nation's new health care law.

What is the Affordable Care Act?

The 2010 health care law often called Obamacare, even by the president himself, aims to provide coverage to many of the estimated 48 million Americans without health insurance. It tries to accomplish that goal by expanding the Medicaid program for the poor, removing restrictions from who can buy insurance and requiring that all Americans carry some form of health coverage while subsidizing it for those who can't afford it.

Who will be affected?

The law will mainly impact people who don't currently have insurance through a job or government program (Medicare, Medicaid, Indian Health Service, Veterans Affairs). For instance, many of the 350,000 uninsured Kansans, including 15,200 in Douglas County, will now be eligible for tax credits to use toward purchasing coverage.

What starts Tuesday?

Beginning Tuesday, any Kansan, regardless of preexisting medical conditions, can obtain coverage on the insurance marketplace, at or by calling 800-318-2596. The open enrollment period lasts through March 31. The next open enrollment period is from Oct. 15, 2014, to Dec. 7, 2014. People can get insurance during closed enrollment only if they have a certain life-changing event, such as a marriage, birth of a child or loss of a job. The marketplace also lets you know if you qualify for Medicaid or the Children's Health Insurance Program.

Rosilyn Wells, right, discusses information regarding the Affordable Care Act with Lawrence Memorial Hospital personal care assistants Barbara Harris, left, and Debra Pacheco, center, during Saturday's LMH Health Fair. Wells will be the only full-time ACA navigator in Lawrence and will work out of Heartland Community Health Center. The online health-insurance marketplace — a major piece of the 2010 health care law — will be unveiled Tuesday.

Rosilyn Wells, right, discusses information regarding the Affordable Care Act with Lawrence Memorial Hospital personal care assistants Barbara Harris, left, and Debra Pacheco, center, during Saturday's LMH Health Fair. Wells will be the only full-time ACA navigator in Lawrence and will work out of Heartland Community Health Center. The online health-insurance marketplace — a major piece of the 2010 health care law — will be unveiled Tuesday.

But I thought Kansas wasn't participating in Obamacare?

The state has opted neither to expand Medicaid eligibility to 138 percent of federal poverty level nor create its own insurance marketplace. In the case of the latter, the federal government stepped in to design and operate Kansas' marketplace.

What kind of insurance can I buy on the marketplace?

The marketplace will offer a variety of plans from two insurers — Blue Cross Blue Shield and Coventry. The coverage options include bronze, silver, gold and platinum, ranging from the lowest premiums and coverage amounts (60 percent) to highest premiums and coverage amounts (90 percent). Catastrophic coverage will be available to Americans 30 and under or with low incomes.

Plans offered on the marketplace must cover 10 essential health benefits: outpatient care, emergency room visits, inpatient care, prescription drugs, maternity and newborn care, mental health and substance abuse treatment, preventive services and chronic disease management, lab testing, rehabilitation services, and pediatric dental and vision care.

The federal government has delayed for a month the rollout of a separate online marketplace on which small business owners can purchase subsidized coverage for their employees.

Who can buy insurance on the marketplace?

Any American citizen not in prison can shop for a plan on the marketplace. However, only people who make between 100 and 400 percent of the federal poverty level (between $11,490 and $45,960) will be eligible for tax credits, which can be used at the time of purchase, to offset the cost of the premiums. Also ineligible for the subsidies are those who are offered qualified insurance through their employer that doesn't exceed 9.5 percent of their income.

When am I required to have insurance under Obamacare?

Nearly every American will be required to have health insurance on Jan. 1. Plans have to be bought on the marketplace by Dec. 15 to kick in the first of next year. People who go without coverage in 2014 will be levied fines of $95 or 1 percent of their income — whichever is greater — on their tax returns. The fine will increase to $325 or 2 percent of income in 2015 and $695 or 2.5 percent of income in 2016.

Who is excluded from the mandate?

Those excluded from having to carry insurance are members of religious groups opposed to health insurance, undocumented immigrants, prisoners, Americans who either don't make enough money to file taxes or would have to spend more than 8 percent of their income on premiums, and American Indians eligible for care through the Indian Health Service.

Wasn't part of the law delayed?

The Obama administration pushed back for a year the provision of the law that required that businesses with more than 50 full-time employees provide them with health insurance.

Where can I get more information or help signing up for insurance?

Assistance will be available at various community agencies. Specially trained navigators, for instance, can provide information on and help people enroll in the marketplace.

Rosilyn Wells, a navigator based at Heartland Community Health Center, 1 Riverfront Plaza, Suite 100, can be reached at 785-841-7297, ext. 219, or Heartland also has certified application consultants (who, unlike navigators, cannot sign people up on the marketplace) available.

There will be three navigators at the Lawrence-Douglas County Health Department, 200 Maine St. For assistance, call 785-843-0721 or stop by the clinic between 8:30 a.m. and 5 p.m. on Mondays, Wednesdays, Thursdays and Fridays and 9:30 a.m. and 5 p.m. on Tuesdays. The clinic is closed daily between 11:30 a.m. and 1 p.m.

There are also several Affordable Care Act information forums planned, with dates and locations to be announced.


John Graham 6 months ago

Insurance premiums almost double. Deductible increases from $2650 per year to $6350 per year. Thank you President Obama and Democrats. ACA really makes healthcare affordable for me. By the way I do not qualify for any subsidy.


Richard Payton 6 months, 2 weeks ago

Free health care if you get thrown in prison. Granny said she doesn't have to worry about the cost of a nursing home now LOL!


gr 6 months, 2 weeks ago

"As for paying into the pool, the more people who pay in, the better it is for everyone, of course. Yes, even the person who wasn't participating before. Why? Because those people were still participating in health care. Everyone does. The risk that those nonparticipants, as you would call them, carry for the rest of us is huge. One nonparticipant gets hit by a bus and the rest of us are out the hundreds of thousands in emergent, essential health care costs. That's hardly fair to the rest of us. Sort of sounds like the nonparticipants are ok taking my money for their own use, to make themselves happy..."

Well, if it's about minimizing risk, then us healthy people should have something to say about those who take unnecessary risks. The burden is huge on all of us. This would mean no smoking, no drinking, no soft drinks, no sugar including no candy, no meat, no packaged foods.

Because.... people who do those things make it "hardly fair to the rest of us."

FORCE! Yes! Force people to do what certain ones want them to do!


gr 6 months, 2 weeks ago

Ah, from

Make $40,000 a year, 31 years old, premiums 199 / month = $2,388 per year.

Make $40,000 a year, 40 years old, premiums 219 / month = $2,628 per year.

make $40,000 a year, 46 years old, premiums 257/month = $3,084 per year.

Make $50,000 a year, 60 years old, premiums 466/month = $5,592 per year.

Make $35,000 a year, 60 years old, premiums 277/month (after subtracting a $188 tax credit later on) = $3,324 per year.

Talk about throwing grandma under the bus!

I also notice that different counties have different rates. Equal and fair is not what ObamaCare is.


gr 6 months, 2 weeks ago

"The coverage options include bronze, silver, gold and platinum, ranging from the lowest premiums and coverage amounts (60 percent) to highest premiums and coverage amounts (90 percent). Catastrophic coverage will be available to Americans 30 and under or with low incomes."

And how much will it cost?

$3,000+ and add another 40% if you need it?

What if all you want is Catastrophic coverage? Isn't that what the promoters were all talking about? That some incidence could wipe you out? Why would you need anything else?

FORCE is the name of the game.


Mike Ford 6 months, 2 weeks ago

my father went by train from Kenora, Ontario, Canada, to Quebec City, Quebec, last summer. Canada has had a health system like this for five decades. It allows companies to leave the employee health care issues to someone else so that they can concentrate on business. General Motors plants in Ontario which I've visited in Oshawa, Ontario, didn't have any of the legacy healthcare costs that the GM plants in the US had because they have government healthcare in Canada. On this train trip my father had to convince many of the riders he talked with as a retired minister that this country wasn't entirely populated with adults acting like children that there were rational people who understood the premise that if more product is sold than the product becomes cheaper. After all, why do people shop at Wal-Mart? because they sell more products and the price becomes cheaper. DUH. As someone who has a minor pre existing condition I welcome the ACA. When my company healthcare was ended in February 2011, I was paying $273 a month. When I first enrolled in company provided healthcare my healthcare insurance was $136 a month. This was in late 1997-early 1998. I had to take on two jobs to pay for my health insurance and keep my overall budget functioning during the Bush years. I've always paid my way and I make less than $10 an hour. I'm a Democrat. I work hard and I call balderdash on the people who keep repeating the nonsense about hard working people like me who've paid taxes since my teens taking a handout. If anything I'm now paying taxes for something serving a humane purpose. No un-needed wars or no bid contracts to friends of W anymore getting my tax money. We have friends who are Canadian-Americans. They've gone back to either Toronto or Vancouver for healthcare from Lawrence prior to the passage of this bill in the last two years. Hopefully they don't have to do this anymore. Maybe the US can catch up with the rest of the world and stop looking like a bunch of people watching out for the people in the tv or black helicopters coming after them with their tin foil hats on in a shelter in their back yard. I can only hope.


Centerville 6 months, 2 weeks ago

For me it means that I can continue my health isurance that will be accepted by my long-time family doctor,but in 2014 it will cost $2,500 less than this year. . That's the pomise but my navigator says such a thing doesn't exist. I think they need to educate these navigators. President Obama would never lie to me /hahahahahahahahahahah!


Wally 6 months, 2 weeks ago

To quote the erudite philosopher: “Aunt Bea, call the man!”

state website:
phone number for Kansas residents that was supplied at the meeting in Topeka on Monday was 1-800-432-2482.

article in the LJW on Sept 30, about woman located in Lawrence who can answer questions:

article in LJW on Sept 28, that includes a brief synopsis of the ACA:


akt2 6 months, 2 weeks ago

My daughter and I both have existing individual policies. I recently found out that some ACA benefits won't be allowed on an existing policy. Those policies are considered "grandfathered in" and if you have had the policy for years, certain benefits may not apply. So basically the insurance companies are still doing what they want to and finding loopholes wherever they can.


In_God_we_trust 6 months, 2 weeks ago

Obamacare means:

10,000 pages of regulation

Will push about 7 million people out of their job based insurance

Signing up for Obamacare also affords the opportunity to sign up to vote

After expending $1.8 trillion for Obamacare, 30,000,000 people (by CBO projections), will still be uninsured

Young people may experience a doubling of cost on their policy - urban institute

Obamacare mostly supported by democrats

Source: Lou Dobbs


geekin_topekan 6 months, 2 weeks ago

you are all paying for others healthcare in a broken system anyway.! fortunately, Indian Health Services exempts me from the tax. Tax i tell ya!


Shardwurm 6 months, 2 weeks ago

Since this is so good I'm looking forward to Obama Auto, Home, and Life Insurance.

Seriously. Think about it. We're giving everyone medical coverage. Why not help them out and pay for all forms of insurance? Between that and Welfare we'd have the richest and most well-provided for bums on the planet.

Surely the rich people who make more than $50,000 a year can give up more money in order to provide their neighbors with the same comforts they've earned. Why should someone pay for their car insurance? If we can get that covered then they could drive to the welfare office instead of walking!

Then, once we have the insurance in place, we can buy them all cars!

This is a GREAT idea! Who's with me?!?! Very excited - all we have to do is pool our money together and give it to other people! There is no limit to the amount of dollars in the pockets of the fat-cats who make over $50,000 a year! BOTTOMLESS PIT OF MONEY!!!!


Silverhair 6 months, 2 weeks ago

I may have missed this in the article. Does anyone have the link to the Kansas Exchange website?

I know some folks without health insurance who do not have home internet access. I wonder if there Is a number that they can call to get a mailer that has the Kansas plans and enrollment information? I bet the health department isn't mailing anything out.


LJ Whirled 6 months, 2 weeks ago

Young people can pay the penalty cheaper, at least at first --- then they can always get a policy AFTER they get sick or hurt.


nwtransplant 6 months, 3 weeks ago

If the lowest premium is $100.00 per month that would be $1200.00 per year. The maximum penalty for someone earning $46000.00 would only be $460.00 ($95.00 for the smallest penalty). I can see a lot of healthy Americans deciding to take a chance, just pay the penalty and pocket the $740.00 or $1102.00 savings. Healthcare for everybody is a great idea but there has to be a better way. Will I now have to provide proof to the IRS that I have health insurance?


waitjustaminute 6 months, 3 weeks ago

I just heard a drone fly overhead, despite the "no drone rule" soon to come to Lawrence. Obamacare is now in effect. (Move to the line on the left, keep your head down and nobody get's hurt.) Might be an IRS drone making sure we're all gunna sign up for the exchanges, ... or the NSA, making sure we're all keeping our noses clean, ... or perhaps, a Department of State drone looking for answers to solve the Benghazi mystery, ... or just your plain 'ol EPA drone looking for evidence of global warming / climate change / green house gases / or someone smoking. That's a government I can trust in. (I wonder what color of star you have to sew onto your coat if you don't sign up for health care?) Sleep well Lawrence, sleep well.


ThePilgrim 6 months, 3 weeks ago

And here is what will happen somewhere between October and January - Scenario 1: The young people who are being courted by ACA marketing will get on the exchange, and they will be infuriated that they have to pay more than $100 a month for insurance. (Don't believe me? My young daughters thought $75/mo was too high and chose to go without insurance). ACA doesn't guarantee lower premiums. The insurance company can't charge you higher for your pre-existing conditions, but they aren't going to charge you lower either. They will charge everyone higher to make up for it. Scenario 2: If you are a poor person, adult male or adult non-PG female who are not currently covered by Medicaid in KS, and you fall between the Kansas very low Medicaid poverty level and the point where Obamacare kicks in, you will be paying the premium. They call that the "doughnut hole". Kansas didn't expand Medicaid and Obamacare didn't expand lower to cover them, so they are paying their own premiums, sometimes without the tax credits to offset.


Armstrong 6 months, 3 weeks ago

It means in one way or another I (and you) will be paying for someone else's insurance.


Fred Whitehead Jr. 6 months, 3 weeks ago

CNN is having a ball with this!! I don't think I have ever heard so many different ways to plot and twist statistics as they are showing tonight. What a show!!!.

Well, maybe this will show everyone what the tea party really is. I won't mention it, because it will probably get me deleated from this forum.


tomatogrower 6 months, 3 weeks ago

Hah!!! No all the deadbeats will have to buy insurance, instead of sponging off those of us who are responsible.


fmrl 6 months, 3 weeks ago

Watching a train wreck in slow motion.


Dont_Tread_On_Me 6 months, 3 weeks ago

It means I am forcibly kicked off the insurance I chose by our government and forced to buy what the government tells me is good for me.


JayhawkFan1985 6 months, 3 weeks ago

The GOP once understood that "good government" does not equal "no government." They have lost their way. The politics of destruction can't build a society.


JayhawkFan1985 6 months, 3 weeks ago

Obamacare means... 1) No pre existing conditions. 2) kids can stay on parents insurance until age 26. 3) lower costs to society as a whole because everyone in insured. 4) more GOP circus acts as their party self implodes.


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