Healthcare Reform and Young Professionals

Feb 13, 2015

As young professionals, we are energetic, enthusiastic and focused on either getting our careers started or taking our careers to the next level, amongst of course other things. We are taking charge of our careers and while we are doing this the Affordable Care Act has given us the opportunity to take charge of our health care. A general consensus for years has been youthfulness means a certain level of good health. That is true to an extent. Certain illnesses are associated with age, but with the dawn of the information revolution and the availability of increase health information, we realize that even young professionals need healthcare options and should be concerned about their health. We recognize the importance of healthcare and want to provide some information on the Affordable Care Act (ACA) especially given the fact that the deadline for signing up on the Health Insurance Exchange is February 15th. 
 
What is the Affordable Care Act
The Affordable Care Act (ACA) comprises of two separate legislation: the Patient Protection and Affordable Care Act; and the Health Care and Education Reconciliation Act. Together these legislation have expanded Medicaid coverage to millions of low-income Americans. This has resulted in a reform of both Medicaid and the Children’s Heath Insurance Program (CHIP). Under the law a new Patient’s Bill of Rights gives us the stability and flexibility to make educated decisions in regards to our health care.
 
Changes to our healthcare coverage and costs
  • Children under 19 can no longer be denied or be provided with limited healthcare coverage due to a pre-existing condition
  • If you are under 26 years old you can opt to stay on your Parent's health plan
  • Insurance companies can no longer arbitrarily withdraw your insurance coverage because you made an honest mistake
  • You now have the right to appeal a payment that was denied by your health plan
  • All new health insurance plans are banned from placing a lifetime limit on most of our benefits
  • Unreasonable rate hikes must now be publicly justified
  • Premium dollars must be spent primarily on heath care and not administrative costs
 
An important aspect to understand and keep in mind when you think of the health care reform is the belief that prevention is better than cure. As such you may be eligible for certain recommended  preventative care services at no cost to you, and emergencies are covered at any hospital whether it's inside or outside of your health plan’s network.
Healthcare options available
  • The most obvious option is through our employers who might require you to follow the requirements of the Health Enhancement Program (HEP). HEP requires us to complete all our preventative exams/screenings by a certain time
  • If you are under 26 you can stay on your Parent’s health coverage as mentioned above
  • You can apply through the Connecticut Health Insurance Exchange: Access Health Connecticut (ahCT). Depending on your Adjustable Gross Income and your tax dependents you could be qualified for Medicaid, CHIP (if you have children whom you are applying) or a Qualified Health Plan (QHP) through insurance companies such as Connecticare and United Healthcare. You will pay a fee for CHIP and might have to pay a monthly fee for a QHP. 
  • Consolidated Omnibus Budget Reconciliation Act (COBRA) is a federal legislation that requires your former employer to offer you job-based health coverage if you have lost your job. If you have lost your job and received an offer for this overage you know it is very expensive.

                                   
How the Affordable Care Act affects your taxes

With the implementation of the Affordable Care Act (ACA), qualifying health care coverage is now a requirement for the entire nation. Taxpayers who do not possess a qualifying health care plan will face a penalty when filing their 2014 taxes unless you qualify for one or more of the following exemptions:
  • Uninsured for 1 or 2 consecutive months for the year.
  • Enrollment in a health plan that started later than 05/01/14 but were uninsured any number of months before that in 2014
  • The lowest price health insurance available to you would cost more than 8 per cent of your household income
  • You are below the level of income required to file a tax return
  • Members of a federally recognized tribe or eligible Indian Service Provider
  • Members of a recognized health care sharing Ministry
  • Members of a religious Sec
  • Not a lawful permanent resident
  • US citizen living abroad
  • Hardship exemption  
If you do not have qualifying health care coverage or a qualifying exemption be prepared to pay a penalty of $95 per person for the 2014 tax year ($47.5 per child under 18), or 1 per cent of your yearly income, the higher of the two. For the 2015 tax year the penalty will increase to the higher of $325 per person for the year ($162.50 per child under 18) or 2 per cent of your household income. If you apply for health insurance coverage through the new Health Insurance Exchange ‘Access Health Connecticut’ you can elect to utilize the tax credit subsidy, which serves to lower your monthly payments if you qualify for a subsidy and elect a Qualifying Health Plan (QHP) through specific insurance providers. If you did not have health insurance for more than 2 months in 2014 be prepared to pay the above penalties unless you fall under the exemptions above.      
 
In conclusion, there are limits to our careers if our health is not good. Having health coverage and utilizing it, especially for preventative care, is helpful and can prevent or detect illnesses early. Do understand that it is always your choice whether or not to have health coverage, but my hope is if you do decide to enroll you have this valuable information to refer to. February 15th is the final day to sign up on the CT Health Insurance exchange; April 15th is the final date to file your taxes.

Information provided in this document is not intended as an in-depth analysis of the ACA or other laws stated above neither is this a substitute for a formal opinion or advice on the ACA. This is also not to be used to solely determine your eligibility for the programs or health coverage above, this is basic general information on the topic.  If you have specific questions pertaining to ACA or health care coverage please consult with a lawyer or State Agencies providing this service.   

Thank you Mishka Nembhard for this informative blog on healthcare! Mishka works at the Department of Social Services for the State of Connecticut. Comment below with further questions or comments, and we will be sure to direct you to the right person for answers.

3 Comments

  1. 3 Kevin Nembhard 21 Feb
    Hi Mishka,

    Thanks very much this valuable information on ACA. I am now very informed about healthcare and my choices

    Kevin
  2. 2 Shanica 21 Feb
    This is good information which I can utilize in my field as we get patients on a daily basis who do not seek health care as a result of concerns re insurance. This info is invaluable . I will definitely share. 
  3. 1 Terry Ann Naembhard-Hemmings 03 Mar
    Thank you Mishka. Your blog was very informative and educational. This is valuable information which will assist me in  educating employees on their choices for healthcare. 

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