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    Q&A on Affordable Care Act in Virginia

    RICHMOND, Va. (AP) -- Hundreds of thousands of Virginians lacking health insurance can start enrolling Tuesday in the health insurance marketplace created through the federal Affordable Care Act. To receive benefits at the start of 2014, consumers must enroll by Dec. 15.

    Virginia is among 36 states in which the federal government is running all or part of the health benefits exchange. Following are some questions and answers about key elements of the act in Virginia.

    WHAT IS A HEALTH CARE EXCHANGE?

    It's created by the federal Affordable Care Act. The online marketplace allows for side-by-side comparison of coverage options before enrolling.

    HOW MANY VIRGINIANS LACK HEALTH INSURANCE?

    An estimated 844,753 are uninsured and eligible for coverage through the marketplace, according to the U.S. Department of Health and Human Services. The largest percentage of uninsured -- 333,428 individuals or 39 percent of all uninsured people -- are between the ages of 18 and 34.

    WHO IS SELLING IT IN VIRGINIA?

    Virginians will get to choose from an average of 47 different health plans in the marketplace. People can choose from four levels of coverage -- bronze, silver, gold and platinum. The big difference is cost sharing. Bronze plans have the lowest premiums, while platinum have the highest. But low premiums could result in big bills later if your expenses exceed what's considered reasonable.

    HOW MUCH WILL IT COST?

    The average premium, without tax credits, would be $237 a month for the lowest-cost bronze plan and $335 a month for the second-lowest silver plan.

    For a family of four making $50,000, a midrange plan, after tax credits, would be $282 a month under the second-lowest silver plan. Without a tax credit, $799.

    For a 27-year-old person earning $25,000 a year, the premium would be $80 a month, with a tax credit, for the bronze plan and $145 for the silver plan, also with a tax credit.

    Six out of 10 Virginians who are uninsured will be able to find coverage for less than $100 a month when tax credits and Medicaid coverage are included

    WHY SHOULD I SIGN UP?

    If the government decides you can afford health insurance and you don't have it by 2014, you may have to pay a fee. You also have to pay 100 percent of your medical bills on your own.

    The fee is 1 percent of your yearly income, or $95 per person for the year, whichever is higher. For children, it's $47.50 per child, up to $285 total.

    The fee increases every year. In 2016, it will be 2.5 percent of income, or $695 per person, whichever is higher.

    WHAT IF I HAVE A PRE-EXISTING CONDITION?

    An estimated 3.4 million Virginians with pre-existing conditions can no longer be turned down or charged for more coverage.

    WHAT IF I AM ON MEDICARE?

    Medicare beneficiaries don't have to do anything differently.

    WHAT ABOUT MEDICAID?

    A commission in Virginia currently is working through a process to determine whether to expand Medicaid. The legislature set up the commission this year and tasked it with determining whether certain cost-cutting and efficiency reforms in the Medicaid program were met. If so, Virginia would expand Medicaid to cover an additional 400,000 Virginians.

    CAN SOMEONE HELP ME?

    Virginia will have navigators, independent counselors who work under federal grants to help people find the best coverage plan. Many hospitals and health care facilities will have on-site navigators, and information about other places to find them will be coming out soon.

    WHERE CAN I LEARN MORE?

    http://www.HealthCare.gov

    U.S. Department of Health and Human Services: http://www.hhs.gov

    http://www.FamiliesUSA.org

    Comments

    @right honorable. I’ve paid at least 100K people taxes in my lifetime. I’m all for flat tax so everyone can pay their share. I don’t mind giving up my health care spending accounts, but then lets do away with welfare and food stamps and all the other social programs. Let’s make the unemployed work 15 hours a week for the state too.

    And majority can’t afford even ACA, you need to wake up and be informed. Majority live paycheck to paycheck(and those are the ones making over $50K-70K, I own a Small business on the side and know for a fact)


    My dear tea-party wingnuts.  You claim to believe that markets make the best decisions and only government intervention skews the process.  Well, you’re getting exercised about a treetop here and there and missing the message of the forest.

    The market has priced out all these costs of health care…and you are paying them every day in higher and higher prices…for example, today’s visit to the doctor of your choice costs more because you’re also paying for the guy that came into the hospital’s emergency room the other day and paid nothing.  Those events aren’t connected you say?  Who do you think the doctor’s affiliated with?  Who do you think makes up that loss on the balance sheet?

    Why wouldn’t you say…as the Heritage Foundation did when they proposed this model a few years ago… that if everyone were a participant in this market…all with skin in the game…we’d end up with a system that worked better for everyone?

    Maybe you think ideology can substitute for thinking.  If so, you’re wasting my time and that of everyone else.


    More Cowbell,
    You ain’t seen nothin’ yet.  Higher premiums, higher deductables, narrower list of docs, yadda, yadda, yadda.

    Dear LTM - just love your reference to seek more info— FamiliesUSA?  That is a FAR left organization.


    Oh, cowbell, you mean that account that sticks other taxpayers with the 20-30% of your medical spending?  I thought self-reliant folks like yourself didn’t want the government taking money from one taxpayer and giving it to another.

    You should be glad that instead of Uncle Sam asking folks like me to pay taxes so you’ll get a break on your medical costs that you don’t really need (assume you have a job and insurance), instead, we’ll all put in a little something so everyone gets some form of insurance and lowers the hidden costs to everyone else.


    “Hundreds of thousands of Virginians lacking health insurance can start enrolling Tuesday “

    How many of those lacking health insurance is because they are too poor to buy it? The ACA isn’t Free and many of those same people will receive sticker shock when they find out the monthly payment is a few hundred dollars.

    And guess what? If you don’t pay it, the IRS will assess a fee of $95/month or 1.00% of your income, whichever is greater. Some how I don’t think people realize the impact of the ACA.


    Will our health spending accounts ever go back $5k/year? How come the media doesn’t mention that part of this bill caused 100Ks of people to lose $2500/year in Health Spending Accounts? And when you have both working, it cost us $5K/year.

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