The 4 most basic health reform questions, answered

Public Health – Seattle & King County staff have identified the questions many people seem to have and the answers everyone should know:

1. What’s the Affordable Care Act (“Obamacare”)?
The Affordable Care Act gave each state the option of both expanding Medicaid and starting a “health benefit exchange” in order to reduce the number of uninsured.

2. Who’s paying for this?
The State of Washington opted to extend Medicaid benefits to all individuals who fall within 138% of the Federal Poverty Level (up to $15,865 in annual income). Currently, the state is responsible for covering 50% of the costs of the Medicaid program, but the full costs of the expanded Medicaid program will be covered by the federal government for its first three years. The federal government’s share will gradually decrease to 90% by 2020.

3. What’s an “exchange” and who can use it?
The State of Washington agreed to plan and implement a state-based health benefit exchange, which is a marketplace for individuals and small businesses to compare and purchase health insurance. Individuals and families with incomes that place them between 139 percent and 400 percent of the Federal Poverty Level will be eligible for subsidies (technically a tax credit, but available immediately) through the exchange, making insurance options more affordable. The state’s exchange, called the Washington Healthplanfinder, will begin enrollment on Oct. 1, 2013, and insurance coverage will begin on Jan. 1, 2014.

4. Who’s left out?
Some individuals will remain uninsured, even after Medicaid expands and the Health Benefit Exchange is in place. These populations include undocumented immigrants, who are not eligible to receive Medicaid or purchase insurance through the exchange, and individuals who choose to pay a fine in order to opt out of coverage.

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