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#WTF Does the Affordable Care Act Mean for You?

#WTF Does the Affordable Care Act Mean for You?
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It took a government shutdown for many of us to start paying attention, but there are big changes afoot in the U.S. health care system. Despite the shutdown, October 1 marked the beginning of open enrollment for insurance coverage under the Obama adminstration's new health care reform legislation, aka Obamacare, aka the Patient Protection and Affordable Care Act (ACA). The act aims to provide 27 million more Americans with health insurance over the next decade, and young adults are crucial to those efforts.
 
While America's elected leaders battle it out in Washington, it’s up to the rest of us to figure out just what the heck this legislation is actually about, and how it will affect Americans’ lives. We’ll be the first to admit it: Sorting through the ins and outs of the new health care legislation is confusing as all get out. But it’s also incredibly important, as the legislation will have a sweeping impact on the lives of millions of Americans, particularly those currently without health insurance.

To help navigate the madness, we’ve rounded up a bunch of resources from around the web that break down what the ACA is all about, how it will affect everyday people (and especially younger Americans aged 18 to 35), how to enroll in new insurance plans, why some people are opposed to the ACA, and what all of this has to do with the government being shut down in the first place.

Note: We'll be updating this post as more resources come in. As with any major piece of legislation or news event, the full facts will take some time to come to light. In the meantime, here are the resources we've found to be most useful.

1. #WTF is Obamacare?

Despite widespread ignorance to the contrary (see the video above) Obamacare and the Affordable Care Act are one and the same. The Act was signed into law in March 2010 with the goal of making preventative health care more accessible and affordable for more Americans. Some of the law’s provisions have already taken effect (like the ability to stay on a parent’s health insurance until age 26), and many more will be rolled out in the coming years. October 1, 2013 marked the beginning of the first open enrollment period (for the year 2014), which will end on March 31, 2014. For those who enroll during this time, coverage can begin as early as January 1, 2014.

Here are the basic provisions of the ACA:

In other words (slightly adapted from the Washington Post), the ACA will:

  • Require every American to have insurance. (The law includes discounts for people who can’t afford insurance on their own as well as penalties for people who refuse to buy coverage.)
  • Require that most employers contribute to employees’ coverage or pay into a health fund. (Small organizations would be exempt from this ruling, or receive tax credits to help shoulder the cost).
  • Expand the Medicaid health program for the poor (though some states have chosen not to do so).
  • Provide insurance discounts for lower-income citizens. (Individuals earning less than $45,960/year and families earning less than $94,200/year may be eligible.)
  • Impose new restrictions on insurance companies, such as prohibiting the denial of coverage based on preexisting conditions and getting rid of yearly or lifetime financial caps for coverage.
  • Create new health insurance marketplaces, aka "exchanges" or "gateways," that allow individuals and small businesses to comparison-shop for insurance. Any plan that's included in the marketplaces will need to provide a base minimum of "essential benefits." Beyond this baseline, required benefits will be determined at the state level. 

To learn more about the ACA, check out these resources:

  • The best way to learn more about the ACA is to go right to the source. Healthcare.gov has a wealth of resources related to what the ACA is all about and guides individuals, families, and small businesses through the process of enrollment. It also includes a health insurance marketplace (or “exchange”), where people can review and compare different plans and enroll in the plan of their choosing.
  • The White House also has a comprehensive resource at http://www.whitehouse.gov/healthreform, which spells out current health care stats, the goals of health care reform, and some of the myths circulating about the legislation.
  • Why is the ACA necessary in the first place? Check out this list of reasons from the American Public Health Association.
  • Want the facts in visual form? Check out these maps, charts, and graphics from the Christian Science Monitor.

2. What Does It Mean for Me?

Want to learn how the ACA will affect you with the help of tiny cartoon Americans? Then check out the Henry J. Kaiser Foundation's video below:

If you already have health insurance through your employer, relatively little will change (although premium costs could shift slightly, and it might end up saving you money in the long run). You will be allowed to enroll in a new plan through the new health insurance marketplaces (aka “exchanges,” which will be run by state or federal governments). However, you are not required to do so if your employer already offers insurance, and you wouldn’t qualify for any tax breaks.

If you’re one of the nearly 50 million Americans who don’t have health insurance — the population this really affects big time — you're eligible to buy a plan from the health insurance marketplaces. Insurance won't necessarily be cheap, but it'll be less expensive than going without care and having to pay all unexpected costs out of pocket. The government will also offer some tax breaks for low-income families to help pay for insurance. To enroll, use one of the state or federal marketplaces. You can also research and compare plans (but not enroll) on independent sources such as ZocDoc

Check out these resources to learn more about how the ACA will affect Americans in general

  • For a very basic breakdown of how the new law might affect you, check out this infographic.
  • For more comprehensive information, read “20 Questions You Have About Obamacare But Are Too Afraid to Ask” by Think Progress.
  • To learn more about how the changes are being handled in your state, check out this interactive map from the U.S. Department of Health and Human Services.
  • To see if you qualify for a premium tax credit to help pay for health insurance, check out NBC’s cost calculator.
  • If you’re a woman, check out the Henry J. Kaiser Foundations’ brief on how the reforms will specifically affect coverage, benefits, reproductive care, and long-term care for women. For more on what new services will be covered, check out this resource from the National Women’s Law Center. Want it in infographic form? Check out the visual at Womenshealth.gov. (Sorry, fellas — we tried to find a similar resource for men but came up short.)
  • Here's the bad news: If you're a single mother, a poor black person, or a low-wage worker, there's still a chance you could go uninsured (even though the bill was designed specifically to help out people in lower socio-economic positions). That's because access to insurance, for these populations, generally hinges on the expansion of Medicaid, which many states refused to pass. 

Check out these resources to learn more about how the law will affect 18-to-30somethings, specifically

  • First, check out the general resources, above: They apply to young folks, too. Then read the next few bullet points. 
  • Good news for cash-strapped young'uns: Certain preventative care procedures, such as some immunizations and screenings for STIs and diabetes, will now be free of charge (and even free of copays) for any plan offered through the marketplaces and many other plans outside of the marketplaces. 
  • More good news: Young adults (both married and unmarried) can remain on a parent's plan up until the age of 26. 
  • Birth control of all types will now be available without a copay, so there are fewer excuses than ever not to practice safe sex
  • It may be more difficult to acquire low-premium, high-deductible plans (aka "emergency only" or "catastrophic coverage" plans) under the ACA. This is because the Obama administration and health insurance companies are counting on more young people to enroll (specifically 18-to-35 year olds, and especially young males and people of color) in new coverage to balance out increased insurance company costs in the face of new consumer protections, which include the prohibition of lifetime and annual coverage caps. But don't panic: There's still a lot of debate as to whether the premium hikes will cause fewer young adults to enroll in any plan. Any rate changes will likely depend on where you live
  • You cannot be denied coverage even if you have a preexisting condition (This is true for the general public as well.).
  • Young women can't be charged more than young men. Sadly, this has not been the case in many states. But under the new law, this practice will be illegal. 
  • If your state passed the Medicaid expansion, then you might qualify for Medicaid, which helps low-wage workers (including underpaid young folks) obtain health insurance coverage. To find out if you qualify, check out this resource

3. Where Can I Sign Up?

People who elect to enroll in new health insurance plans will do so through the new health insurance marketplaces, or "exchanges." To learn more about these exchanges, check out the White House's video below:

While the ACA gives unprecedented choice to consumers looking to buy health care coverage, information needed to compare all those plans hasn't been readily available until the past couple of months. That could create some complications as the administrative side of things catches up, especially since some states are handling the exchanges themselves and some are relying on the federal government to organize them. Still, don’t let that stop you from enrolling if you’re in need of insurance.

4. What are Some Criticisms of the ACA?

It’s no surprise some people are opposed to the ACA: It’s why the government is shut down right now. It’s difficult to narrow down the criticisms into a few bullet points, but we’ve given it a try:

5. What Does This Have to Do with the Federal Government Shutdown?

Many Republicans in Congress aren't too happy about Obama's new health care plan, so House of Representatives Republicans tied continued government funding to measures that would undermine the ACA. Democrats, who currently control the Senate, rejected those efforts, and so a federal budget couldn't be agreed upon before the October 1st deadline. Congress must approve a budget  before the start of the new fiscal year (which begins on October 1st) in order for the government to keep functioning. Since they haven't done so yet, all government services considered non-essential are closed (and their employees told not to report to work).

Written and compiled by Laura Newcomer. Research assistance by David Tao

Got any other resources to add? What are your thoughts on the ACA? Share in the comments below or tweet us @greatist.

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