This month, the centerpiece of the three-year-old health insurance law begins to take shape here in Queens and across the United States.
As of Oct. 1, millions of Americans, including all residents of the borough, have begun to have access to quality health coverage under the Affordable Care Act.
The law provides individuals, families and small businesses — both uninsured and insured — with the opportunity to shop for and enroll in affordable healthcare plans through new competitive, state-run marketplaces called health insurance exchanges.
Obtaining coverage is easy. Just log onto the user-friendly website at healthbenefitexchange.ny.gov/ and browse and compare all the different insurance options that are available in New York. Then purchase a plan that best suits your needs and budget. It’s that simple.
All you need to do is make a choice by the deadline, which is March 31, 2014. Coverage purchased by Dec. 15 will take effect on Jan. 1.
Anybody can purchase healthcare polices through the new state exchanges. This includes those without coverage or individuals unhappy with their current plan. If you like the insurance you have now, you can keep it. The same applies to people who qualify for Medicare and Medicaid.
For borough residents and other Americans unable to afford health insurance, tax credits are available to help offset the cost. To qualify for such a credit, annual household income must be between $11,490 and $45,960 for an individual and between $23,550 and $94,200 for a family of four. If eligible, the online exchange will make it easy to see which tax credit applies to you.
Don’t forget that under the ACA, all Americans will be required to secure health insurance.
If you would like to obtain more information on seeking coverage, there are trained “navigators” throughout Queens who are available to help you understand all of your options and assist with filling out your application, both in person and over the phone. Just call 1 (800) 318-2596. The phone line is open 24 hours a day, seven days a week.
In addition to enrolling in the exchanges, insurance companies must still provide all policyholders with the landmark protections that took effect shortly after the ACA was enacted in 2010. These include provisions such as prohibiting insurance companies from dropping coverage when people get sick; banning lifetime limits or caps on coverage; allowing young people to remain on their parent’s policy until age 26 and barring health insurers from denying coverage to those with pre-existing conditions.
Other improvements required to continue are more screenings for cancer, diabetes and other conditions; maternity and newborn care; improved coverage for immunizations; strengthening Medicare by extending yearly wellness visits; closing the drug coverage “donut hole”; implementing better preventative care, improving nursing home care and many more benefits.
There is also coverage extended to businesses.
Starting in 2015, employers with 50 or more full-time staff must offer affordable medical coverage to their employees.
Small businesses with two to 50 employees are not mandated to provide insurance but may at this time select health plans through the Small Business Health Options Program Exchange, a one-stop shop to compare and buy coverage. In 2016, SHOP will be open to businesses with 100 or fewer employees. The exchange will lower the cost of health insurance for small businesses because it will spread administrative costs across more employers and will offer tax credits to eligible employers.
Additional information for employers is available by calling 1 (800) 706-7893.
There are many other benefits too numerous to list here, but you can learn more about them by visiting the federal government’s healthcare law website at healthcare.gov.
At long last, affordable, quality health insurance has finally arrived for all Americans, and whether you support or oppose the ACA, it is the law of the land and will be for the future. So make sure you and your family are covered before the deadline kicks in.
I look forward to our country benefiting from the ACA for many years to come.
Grace Meng is U.S. Congresswoman for the 6th District, in northern, central and southwestern Queens.