TV-6 Investigates: Health Care Reform Basics - News and Weather For The Quad Cities -

TV-6 Investigates: Health Care Reform Basics


In less than a week, one of the main parts of the Affordable Health Care Act will open for business.

The health insurance exchanges will start open enrollment on Tuesday.

Providing an online health insurance store for millions needing coverage.

The options can be a bit daunting.

TV-6 will be investigating health care reform throughout this process.

Helping bring answers to your questions about a law that affects everyone.

Here are some of the most asked questions we get:

Does October first change anything for me?

Do I need to do anything?

What program will I fall under?

We're going to help answer those questions with a quick guide to the insurance situations many people will find themselves in.

First, let's talk about people who already have insurance through their job.

That's most people and for many, nothing changes. The open enrollment period for the health insurance marketplaces doesn't do anything to your insurance or your doctor.

On January first, when the mandate that people have insurance takes effect, you will be covered.

If however, your employer's insurance does not meet the minimum requirements for acceptable insurance, or is considered unaffordable, you can buy insurance through the marketplace and receive a federal subsidy.

You can also choose to buy insurance through the marketplace instead of taking your job's group health insurance coverage.

However if you do that, you do not qualify for any federal subsidies. You'll pay the entire sticker price.

The majority of the changes will affect people who are uninsured.

That affects several groups of people.

We're first going to talk about people who are poor.

Both Iowa and Illinois have expanded their Medicaid programs.

Before this expansion, Medicaid had gaps in it.

If you were single, or didn't have children, chances are you didn't qualify for Medicaid, leaving you with no health care.

Under this expansion, those gaps go away.

That means for anyone whose earnings are at the federal poverty line and below for their family size, so if you're single, that's $11,500, you'll be enrolled into Medicaid when you try to buy insurance on the exchange.

The expansion also includes people above the federal poverty line, up to 138 percent, so for a single person, $15,900 per year.

Here is where things get a little tricky depending on which state you're in.

In Illinois, everyone who earns 138 percent of the poverty line and below, goes on Medicaid.

In Iowa, that's not the case.

People who are above the original federal poverty line but below the new 138 percent limit will not be signed up for Medicaid.

Instead, Iowans in that category will buy insurance through the state marketplace.

Iowa will help pay for that insurance using the extra Medicaid dollars it's receiving from the federal government.

Providing those people with subsidies to pay for coverage.

Uninsured people who are not poor will be able to buy insurance through the marketplace beginning on October 1st, going through March 31st, like everyone else.

No one has to buy insurance through the marketplaces.

People can still go through insurance agents.

If you do buy off the exchange, you'll enter your information, your location and finances, nothing health related, which will pull up what plans are available to you.

They will be broken into different levels.

Bronze, silver, gold, or platinum.

The different metals represent plans with higher premiums, in exchange for lower deductibles and co-pays.

Any subsidies someone can get in the exchange is based on their silver plan.

The subsidy will be based on a person's income.

So, let's take a family of four, two adults and two children.

The parents are 35 years old and together they make 50-thousand dollars a year.

Their yearly health insurance premium would cost a little over $7,000.

The government would pick up about half that, $3,676.

You can take the subsidy and buy more expensive plans, gold and platinum, or buy a bronze plan, which is cheaper.

The subsidy amount doesn't change depending on what you buy.

People on Medicare don't have to do anything.

Everyone has to have insurance in 2014.

People who don't buy insurance but can afford it will be assessed the penalty on their 2014 taxes.

We'll continue digging as the exchanges and mandate take effect.

Please, send your questions to Mark,, or talk to us on our facebook page.

We'll also post regular updates to our website with more information.

Here's a link to the subsidy calculator we used to figure out a family of four's cost.

You can also follow this link to

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