Health reform passed – now what?

There was a lot of hoopla last week when the Supreme Court ruled to allow health reform to move forward.  I work at a small shop – about 20 full-timers, and have group health insurance.  Will my plan be affected by health reform?

Thinking Ahead

Dear Thinking Ahead,

You are indeed thinking ahead – the major provisions of health reform do not kick off until 2014.  That’s when employers who have more than 50 full-time employees will be required to offer a plan, or pay a penalty – or should I say “tax”?

At 20 employees, your shop will not be required to offer you a health plan in 2014.  It might choose to continue offering a plan, but it might not.

If your employer keeps its plan, you will not be directly affected.  That is, you will stay covered by your employer’s plan and likely not see significant changes.  Your plan has already made several changes to comply with health reform – covering children up to age 26, covering preventive care without a co-pay, etc.

If your employer drops its plan, you will be in a new world of health insurance options.  You can buy your own health insurance at an “exchange”.  (Indeed, you will have to buy a plan or pay a tax, unless you qualify for one of the exceptions.  Without going into all the technical details, suffice it to say if you are a United States citizen, you have to buy a plan or pay the tax.)  You will get help buying a plan – a “subsidy” – if your income is less than 400 percent of federal poverty limits (FPL).

If your income is below 133 percent of FPL, you may qualify for Medicaid.  Not all states will choose to offer Medicaid to adults at this income level, however.

For now, there is no need to worry unless your employer drops its plan before 2014.  If so, write me back and I’ll help you come up with options.

Linda Riddell

About Linda Riddell

A published author and health policy analyst with 25 years’ experience, Linda Riddell's goal is to alleviate the widespread ailment of not knowing what your health plan can do for you.