A Quickie Guide to Obamacare: Four Big Changes You Need to Understand

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Afraid of—or just confused about—the changes Obamacare may bring? Not to worry: Here's a truly quick, bottom-line guide to what's happening when, including what you need to do and what you don't need to worry about. All the big changes you need to be aware of will happen in January 2014, and while that may seem a long time from now, you'll start hearing about the changes this summer and possibly earlier, depending on where you live.

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Big Change: Most Americans will be required to have health insurance.

What It Means for You: Under the ACA, most people who can afford it will have to have basic health coverage through their employer or through insurance marketplaces in their state—or pay a penalty if they don’t. Subsidies will be available for many people who meet financial criteria.

Do I Need to Do Anything? Not yet. Every state will open an information call center on July 1 (don’t worry; you won’t miss it—the centers will be heavily advertised). You can start signing up for insurance starting on October 1, and your coverage should begin on January 1, 2014.

More Info: Many people, including individuals earning about $45,00 and families earning close to $90,000, may be eligible for tax credits and cost-sharing for premiums, co-pays, and other health expenses. Find out more at Heathcare.gov

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Big Change: You can’t be discriminated against because you have a pre-existing condition.

What It Means for You: Insurance companies can no longer refuse to sell coverage or renew policies because of an individual’s pre-existing medical conditions, from asthma to cancer.

Do I Need to Do Anything? Not yet. Starting on October 1 you can sign up for coverage through a health insurance marketplace or your employer.

For More Info: Check out this fact-sheet at Heathcare.gov that’s specifically for people with pre-existing conditions.

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Big Change: There are no more limits on lifetime benefit or on annual coverage.

What It Means For You: Obamacare now prohibits new plans and existing group plans from imposing a limit on the amount of health insurance coverage an individual may receive in a year or over a lifetime.

Do I Need to Do Anything? Nope. Starting on October 1 you can sign up for coverage through a health insurance marketplace or your employer.

For More Info: Check out this fact-sheet at Heathcare.gov that’s specifically about annual and lifetime limits.

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Big Change: If you join a clinical trial you can’t have your insurance cut off.

What It Means for You: Insurers will now be prohibited from dropping or limiting coverage because an individual chooses to participate in a clinical trial. The new rule applies to all clinical trials that treat cancer or other life-threatening diseases. 

Do I Need to Do Anything? No.

For More Info: The American Cancer Society’s Cancer Action Network has a fact sheet on clinical trials and the ACA.

 

The best way to think about the switchover to the Affordable Care Act is—sorry—to think of it as you think about your taxes: Take some time to study the information, figure out what your particular situation is (your health, your current coverage, what you’re looking for in an insurance provider, etc.) and then, if you need it, ask for help.

You can also watch this fun, short animated video from the Minnesota Health Insurance Exchange to get a handle on the broad strokes of the law. (It’s aimed at Minnesotans, but much of the information is applicable no matter what state you live in.)

Are you concerned about the changes ahead for healthcare? Do you think Obamacare will help most Americans? Or do you think it will hurt them?

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Fran Kritz is a freelance writer specializing in health and health policy and lives in Silver Spring, Maryland. Takepart.com

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