COLUMN: Affordable Care Act on the horizon - what to expect

— The Affordable Care Act, or Obamacare, is on its way to becoming policy.

On June 28, the U.S. Supreme Court ruled that “individual mandate was a valid exercise of Congress’ ability to levy taxes.” While I oppose the very idea of requiring citizens to purchase a service, nevertheless, this law is upon us. Given that our federal and state governments are moving forward, I want to update you on a few deadlines and important changes that will affect health insurance as we know it.

One of the main changes Obamacare did was require states to offer a health exchange portal – a marketplace where people and small businesses may purchase health insurance. Some have said it might be something like Expedia, a service that enables you to shop for an airplane ticket through several different airlines. In this exchange, consumers can compare products and prices. Some states elected to have the federal government operate their exchanges. New York, however, is one of 19 states that elected to operate its own health insurance exchange. This was decided by the Governor, by executive order on April 12.

All residents must purchase or be enrolled in a health plan by Jan. 1, 2014. Failure to enroll in a plan by Jan. 1 will result in a penalty levied by the IRS. The state has until October of this year to develop its health insurance exchange. Open enrollment through the health exchange begins Oct. 1. Within that exchange will be a number of “Qualified Health Plans” or QHPs. These plans must meet certain requirements, provide certain benefits and be within a cost framework. The state will be responsible for certifying each plan. The state has devised an informational website for the New York Health Benefit Exchange. It can be accessed at healthbenefitexchange.ny.gov.

One of the concerns I have about Obamacare is its cost. First, in order to make health insurance more affordable, nearly 450,000 New Yorkers with incomes up to $92,000 for a family of four, or 400 percent above the federal poverty level, will be eligible to receive tax credits to offset the cost of buying coverage. They can also receive cost-sharing credits to reduce co-pays and deductibles. Obviously, providing credits to families with income levels this high will be incredibly expensive. Furthermore, Obamacare substantially expands those who will be eligible for Medicaid. A report out this month suggests that another 500,000 New Yorkers will be enrolled in the State’s Medicaid program due to Obamacare. This will only further increase what is already the state’s biggest budget item.

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