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Individual Mandate

Individual Mandate Delayed

Zinser · November 3, 2013 · Leave a Comment

Individual mandate penalty delayed

October 30, 2013

The part of the Affordable Care Act (ACA or health care reform law) with the biggest impact – the individual mandate – is getting a lot of attention lately. Under the law and regulation as written, people who buy health insurance as individuals (an individual plan) can go three months without health insurance and not have to pay the individual mandate penalty. Now that individual market open enrollment goes until March 31, 2014, coverage can start as late as May 1. The Obama Administration felt like it needed to fix the problem where someone who buys insurance in the last 45 days of open enrollment still would have ended up paying part of the penalty. Because of a change to the regulation this week, this will no longer be the case in 2014. As long as people buying individual plans are signed up for insurance by March 31, 2014, they will not get hit with the penalty.

The Centers for Medicare and Medicaid Services put out guidance on October 28 that gives more information on the “hardship exemptions” for the individual mandate penalty. The Department of Health and Human Services is putting such an exemption in place for people who sign up for insurance before the open enrollment period ends on March 31, 2014. Without this exemption, individuals would have had to be covered by health insurance by March 31, meaning they would have had to sign up for it by February 15, 2014. Now, people who have signed up by March 31 will be able to claim a “hardship exemption” (without asking for it from the marketplace) on their taxes and not pay the penalty for the months in 2014 that they did not have health insurance.

A regulation with more detail should be released very soon. We will share more news when we have it.

PPACA Rollout

Zinser · May 13, 2013 · Leave a Comment

On Friday President Obama held an event to tout the benefits of ACA, specifically to a large group of women.   The New York Times is also reporting that the administration confirmed that Kathleen Sebelius, the head of the health and human services, has been trying to raise money from the private sector to promote an education and outreach program raising the awareness of the benefits of PPACA.  Congress has repeatedly refused to fund this outreach program, and that’s why Ms. Sebelius is going to the private sector.

http://www.nytimes.com/2013/05/11/us/politics/obama-to-makes-new-pitch-on-health-care-law.html?ref=us

Speaking just for Kentuckians, I’m really skeptical that we’re going to see a decrease in premiums.  Just taking into account what the new policies are going to have to cover, that in and of itself will cause an increase in premiums.  For instance, maternity.  All policies (even men) will have maternity coverage. Right now, that costs about $100/mo more than a policy that doesn’t cover it.

The second factor that’s going to cause premiums to rise is the guaranteed issue aspect of the law.  When underwriting is taken away from the insurance companies, healthy individuals are going to be penalized even more than they are today because insurance companies can’t offset the amount on the older and/or sicker population.  So the older individuals more than likely have their premiums staying roughly the same, it’s the younger generation that’s going to see an increase.  The same young people that the President is targeting to enroll in this law.

I will give the President this, the individuals and families that receive a subsidy, may see a decrease in what they pay.  However, I think the insurance will still cost more.

We’re going to just have to wait and see in October when the premiums are made public just how much it will cost.

 

 

 

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