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Affordable Care Act: A Healthy Understanding Part 1

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LAWTON Okla_ The Affordable Care Act, Obamacare, or Universal Health Care: no matter what you call it, for now, it's here to stay.

While it's what everyone is talking about, very few understand how it will affect them. Whether you like it or not the Affordable Care Act is probably affecting your life in some way. Over the next three days, 7News will cut through the politics and get to the point by explaining just how this new legislation affects your life, and you'll hear from experts who work closely with the new law every single day.

To most of us, the daily chatter we hear about the Affordable Care Act just sounds like noise. It's riddled with politics, numbers and jargon no lay person could understand. So when it gets right down to it, what do we really know about how the ACA works?

Let's start with some basics. Who does it affect? In short, everyone. It will have the most dramatic impact on the 48 million Americans who don't have or haven't been able to get insurance. So if that's you, that's when the fabled HealtCare.gov comes in.

Other than hearing how it doesn't work, there are some actual facts about the website you really need to know. For one, there is a lot of useful information on the site, and it is the only confirmed source you should be getting it from. Once signing up, you can scroll through, look at different plans and figure out what exactly works for you, just like if you were shopping for an insurance plan anywhere else.

Lynnette Wallace is a certified application coordinator for the Affordable Care Act. She's seen HealthCare.gov through good and bad, but she said despite its many problems, it lays out the details of health coverage in basic terms.

"It's very simple to look at," Wallace said. "I've looked at it several times. They're very easy to compare. It pretty much shows you in plain language."

You should also find out if you qualify for the premium tax credit. That means you could get money from the government.

"The premium tax credit is on a sliding scale," Wallace said. "So, if they're 100% to 400% of the federal poverty limit, you'll get assistance. How much depends on the type of plan you choose."

There are some definite groups who really benefit, CEO of Southwestern Medical Center Steve Hyde recognizes that.

"Kids can still be on their parents' plan until age 26," Hyde said. "I think it's wonderful that people will not lose health insurance because of a pre-existing condition."

There are some places where it falls short, though. Those getting hit the hardest are part-time workers or the unemployed who don't make enough to receive governmental assistance. That means if you don't make the minimum $11,490 per year to qualify for the premium tax credit, you must pay full price for a health care plan, which is not affordable for some.

Now, let's talk about deadlines. Despite the chatter, we've heard about the low numbers of enrollment. As of now, there's not much rush. The earliest an insurance plan bought off the marketplace will take effect is Jan. 1, and open enrollment has only just begun. 

"The insurance isn't going to start until Jan. 1, so they've still got until Dec. 15 to enroll in a plan that begins Jan. 1. They still have until March 31 to enroll before they'll start to get penalties."

Oh, the penalties. One of the most widely scrutinized aspects of the plan is how much will the penalties be? What does it mean if you're penalized?

"Individual penalties range from around $95 on the low end," Wallace said. "It's based on income, so it can be higher than that."

If you choose not to enroll in a plan and/or you do not enroll by March 15, that's when you'll be looking at facing a penalty. There's still question as to how the IRS will track and asses those penalties. Most experts estimate they probably won't even be collected until you're filing taxes in the year 2015.

The final major concern most have is, "If I have my plan, will I get to keep it?" If you were listening to the president, you've heard this now infamous promise:

"If you like your plan, you can keep your plan!"

That's no longer ringing true. Even with the new so called "administrative fix" the president has issued, in the end everyone who has a plan from the individual market will have to give it up.

At the end of the day, it's important to remember, health care is not one-size-fits-all. Take the time to look on the website and do your research, just like you would with any other health care plan. 

"It really depends on your situation," Wallace said. "There are a lot of people it can help."

Now, if you're a business owner concerned about what changes, you'll have to make concerning the new health care law, .you won't want to miss Part 2 of A Healthy Understanding. We'll explore how it relates to all things in the workplace.

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