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Barack Obama

HEALTH CARE REFORM: Obamacare Exchanges Start Enrolling Uninsured Next Week

COMPLETE COVERAGE:  How Exchanges Will Work | How Affordable Is Coverage | What It Means For Employers. | Exclusive WBEN Audio | Calculate Your Costs Can it Be Stopped? | Union Health Care Plans Not Subsidized

On Oct. 1, millions of people without access to job-based health care will be able to enroll online through new state insurance markets for coverage effective at the start of next year.  And while the Congressional Budget office has estimated that health care reform will cost  taxpayers about 
$938 billion over 10 years
, the measure will provide coverage to a huge number of people who aren't insured right now. 

About 55 percent of Americans get health insurance provided by an employer. Others have Medicaid, Medicare, Tricare for military families, and other government insurance. The CBO projects that 26 million people will buy health insurance on the new online marketplaces called  exchanges by 2022. And it predicts that 12 million people will become newly eligible for Medicaid in the states like New York that choose to expand their offerings by 2022.

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  Friday's vote by the House to defund the Affordable Health Care Act, or Obamacare, is fueling the fires of debate on the topic. One financial expert says everyone should have concerns.

"We've seen a lot of corporations that are starting to cancel their plans and move people off their retirement," says Glenn Wiggle of The Financial Guys. "On the affordability side, you'll have a whole slew of new taxes and regulations, and I think it will be a debacle." Wiggle adds states like California are increasing premiums by as much as 60 percent.

Employment is a concern too. "We're seeing a lot of companies cut hours to 30 hours or less to avoid paying fines or providing the necessary coverage," notes Wiggle.

Wiggle says President Obama's solution is not the answer. "What we need is more tort reform, we need more competition, we need to make the patient the consumer ultimately, and tell them what the cost is for these procedures," explains Wiggle.

He also notes a new form is added to your tax returns to note your health care, and "the more we find out what's in it, the more people and corporations don't like it."

1   The NYS Insurance Department estimates that on average, the policies offered in the exchange are about 50 percent less than ones currently on the market.

2. The online price tool,  based on your income and the level of coverage you select,  can show you the range of plans you qualify for, how much it will cost each month, and how much of an offset you can get from the federal government. The subsidy can be paid directly toward the insurance company up front if you want, or taken as a  tax credit at the end of the year.

 3. Some employers are entering the exchanges and subsidizing  your participation as a way to give lower  income or uninsured workers more options and to also possibly reduce their own employer costs.

4. Even though anyone individual or household  making under 90,000 a year is eligible for coverage, most higher income earners would probably lose out by entering an exchange.  Pricing is such that the employer contribution you now have, might be greater than the federal tax credit, and anyone individual or household who makes more than 4 times the federal poverty level gets no tax credit/federal subsidy.

5. Beginning next year, anyone who doesn't buy into an insurance plan, will pay a $95 monthly penalty.  The penalty will increase over the next several years.  Right now  the penalty  will probably be higher than the bottom line amount  most  lower or middle income earner will have to pay, but it rises to $695 byh 2016.

  - Source: WBEN Research, based on .....

Exclusive WBEN Audio
from Hardline, the WBEN Politics Program (Sunday 10a -12 noon)
Ann Monroe, Community Health Foundation of Western & Central NY

How Much Will It Cost?   Here's a few examples....

$20,000 A YEAR   $50,000 A YEAR
These 6  Providers:
  • Today's Options (American Progressive)
  • Health Now (Blue Cross/Blue Shield)
  • Fidelis Care
  • Health Republic (freelancers)
  • Independent Health
  • Univera
  These 6  Providers:
  • Today's Options (American Progressive)
  • Health Now (Blue Cross/Blue Shield)
  • Fidelis Care
  • Health Republic (freelancers)
  • Independent Health
  • Univera
$277- $148    $467 - $275
$190   $0 because $50,000 is more than 4  times the annual poverty level.
$87   $467

  Available policies vary from county to county, and prices change based on level of coverage bought. The above examples, taken from the state's online calculator below, are computed for individual (not family coverage)  purchased in Erie County at the Silver (mid level coverage) option.

Low-income workers on union health plans are not eligible for the same federal subsidies available to those who buy insurance in the new state health care marketplaces, the White House said Friday.

The decision is a disappointment for labor unions, coming shortly after top union officials met for more than an hour with President Barack Obama to press their case that subsidies could be extended to union-sponsored plans.

Labor leaders have complained for months that without the subsidies, the Affordable Care Act would drive up the cost of some union plans, leading employers to drop coverage and jeopardizing health coverage for millions of union members.  READ MORE

 From NYS Dept. of Health: 

The Tax Credit and Premium Estimator estimates the amount you would pay toward a health plan when you are eligible for tax credits.  Your estimated advanced tax credit is paid directly to your health plan by the federal government.  You only pay your portion of the premium. 

Click on the Tax Credit and Premium Estimator below, to estimate the amount of tax credit you may be eligible for and the amount you will have to pay toward coverage each month.  To get your estimate, just fill in the number of people in your household, your annual household taxable income, the county where you live, and the level of the health plan.     

Your actual Advanced Premium Tax Credit will be determined at the time you apply for coverage and by the plan option you choose.


Republican Sen. Rand Paul says President Barack Obama's health care law probably can't be defeated or gotten rid of. And he's suggesting there are few ways and little time for him and other congressional Republicans to stop it.

Speaking to reporters Saturday at a gathering of Michigan Republicans, the presidential prospect said Republicans in Congress could use votes on measures in the House and in the Senate to come up with compromise legislation that could make the law more palatable. Some provisions, Paul said, include removing caps on health savings account contributions or deductibles for health policies.

But the Kentucky Republican said time for that is running out before Oct. 1, the start of the 2014 fiscal year and the date that state insurance exchanges begin.

Paul said Republicans still expect members to fight the law, which national polls show only about a third of Americans support.

"I'm acknowledging we can't probably defeat or get rid of Obamacare," he said. "But by starting with our position of not funding it, maybe we get to a position where we make it less bad."

Some Senate Republicans, including would-be 2016 presidential rivals Ted Cruz of Texas and Marco Rubio of Florida, have said they would vote to refuse to pay for the health care law, even if it meant shutting down portions of the government. Paul has called closing down the government "a dumb idea."

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