How Does Health Reform Impact Your Family?

California residents may experience a lot of changes in the way they get their health insurance because of the new healthcare reforms enacted in 2014. Most of the major changes impact Californians who do not have access to group health insurance through their employers, the formerly uninsured and those who hope to qualify for public health programs.Image

First, it might be helpful to review some statistics about California health insurance from a 2012 Kaiser Family Foundation profile of insurance coverage:

  • Number of Californians with group health insurance: 16,888,300
  • Number of Californians with individual or family health policies: 2,264,700
  • Californians on Medicaid: 7,305,300
  • Californians on Medicare: 3,802,500
  • Total number of uninsured people in California: 7,106,100

How Will Californians Without Group Benefits Get Covered Today?

Medicare beneficiaries still get Medicare, and they are free to buy supplements or Medicare Advantage plans to maximize their benefits. This does not change. The discussion really centers on people without public or employer-based coverage who need to purchase individual policies, and this includes children and adults who are under 65 or otherwise qualified for Medicare.

The three main ways for families and individuals without group insurance benefits to get covered are through individual policies sold by private insurers, Medicaid and CHIP or the Children’s Health Insurance Program. The Affordable Care Act and California health reforms help more of these people access affordable medical plans.

Since qualification is mostly based upon income and family size, you might want to refer to federal poverty level guidelines. You can also access the California health insurance marketplace here at www.CoveredCa.com.  

Who gets help with health insurance:

  • Because of the Affordable Care Act, many families and individuals with an income that is between one hundred and four hundred percent of the federal poverty level can qualify for subsidies that can defray the premiums of private health insurance found on the new marketplace.  For example, this would be an income between $23,850 and $95,400 for a family of four people.
  • California has expanded Medicaid to cover many adults with a family income up to 138 percent of the poverty level.
  • California children of families who earn less than 266 percent of the federal poverty level might qualify for CHIP.
  • In California, both Medicaid and CHIP are handled by Medi-Cal.

Some people earn too much money to qualify for a subsidy or public program, but they might still decide to purchase a marketplace plan. All of these plans have to offer essential benefits and cannot decline applicants because of a pre-existing medical condition. Ordinarily, people who already have access to affordable health insurance through an employer may not qualify for subsidies either.

At Basi Insurance Services in Oakland, our experienced and professional agents can help children, adults and senior citizens find the right medical coverage at the right price. You can contact us at your earliest convenience to ask questions, select the right medical plan or get help applying.

Sources: http://kff.org/other/state-indicator/total-population/ http://aspe.hhs.gov/poverty/14poverty.cfm

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