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Affordable Care Act proponents: Health Insurance Marketplace to save money

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Proponents say the marketplace, an online store where multiple insurance companies will bid to provide coverage, will be an affordable option for the uninsured. It launches Oct. 1. Take a POLL.

Carmen Bell figures the Affordable Care Act’s Health Insurance Marketplace has got to save her money.

The 57-year-old Allentown woman has been paying $500 a month for health insurance since she lost her job 18 months ago.

Her COBRA insurance doesn’t take into account her income, while the marketplace, which opens next month as part of the federal Affordable Care Act, will.

“I don’t know what it’ll cost me, but I know unless I gain employment, the Affordable Care Act will cost less,” Bell said.

Affordable Care Act proponents say the federal law’s Health Insurance Marketplace will hopefully save many Americans money on their health insurance costs. The marketplace, an online store where multiple insurance companies will bid to provide coverage, is expected to open Oct. 1, six months before the federal mandate for health insurance goes into effect April 1.

The marketplace will include information on federal subsidies for health insurance, which will apply to people making up to 400 percent of the federal poverty level, said Antoinette Kraus, director of the Pennsylvania Health Access Network. That’s up to $45,000 for a single person and higher amounts for families.

Salisbury Township lawyer Mark Aurand, who specializes in health care law, said he expects about 90 percent of people who try the Health Insurance Marketplace will qualify for a subsidy. Most of the country’s uninsured are in lower-wage jobs where health insurance isn’t a standard benefit, he said.

The Kaiser Family Foundation, which specializes in health care issues, has set up an online Health Insurance Marketplace estimator. The foundation’s estimator predicts a family of four earning $53,000 a year would qualify for a monthly subsidy of $645 toward a $962 health care premium, making their out-of-pocket cost $317 a month, Aurand said.

“It’ll be far more affordable than ever before,” he said.

Marketplace information can be found online at healthcare.gov and certain organizations are getting set up to help people in person, including the Neighborhood Health Center of the Lehigh Valley on North Second Street in Allentown.

St. Luke’s University Health Network also is working to set up public information sessions on the marketplace, spokeswoman Denise Rader said. St. Luke’s physicians will be able to assist their patients with the marketplace, she said.

“People really do need their hand held through the process because it’s very complicated,” she said. “Everybody’s coverage is different and everybody’s needs are different.”

Congressional offices also will help where they can, though both Rep. Charlie Dent and a spokesman for Rep. Leonard Lance said neither office has received much information on the marketplace.

Both Republican congressmen voted against the Affordable Care Act but say their opposition won’t keep them from helping constituents sign up through the act’s Health Insurance Marketplace, though they do have concerns about the April 1 deadline for the individual mandate.

“This is one the reasons why the congressman continues to oppose implementation of the law,” Lance spokesman John Byers said in an email. “The federal government does not yet have the policies, procedures or tools in place to make it work.”

Both Lance and Dent voted Friday for a House resolution to wipe out the health care law and simultaneously prevent a partial government shutdown. The measure passed in the GOP-controlled chamber, but it's unlikely to get enough support from the Democratic-controlled Senate.

Affordable Care Act advocates plan to help residents with the Health Insurance Marketplace, as well. The Lehigh Valley chapter of Organizing for Action is planning several outreach events Oct. 1 especially targeted at young adults, member Gloria McVeigh said. Many uninsured young adults don’t realize how one serious injury could put them into major debt, McVeigh said.

“Our job is to make sure everyone knows it’s here and it’s coming,” she said of the marketplace. “Unless you’re on Medicare, you should check it out.” 

The Associated Press contributed to this report.

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What you need to know

A Health Insurance Marketplace that’s part of the federal Affordable Care Act launches Oct. 1. It’s an online store where multiple insurance companies will bid to provide health insurance.

The marketplace, found online at healthcare.gov, also will include information on federal subsidies for people making up to 400 percent of the federal poverty level to help pay for health insurance, which will be a federal requirement as of April 1.

Those without health insurance after that point will face an annual penalty of $95 or up to 1 percent of their taxable income, whichever is greater, a U.S. Department of Health and Human Services spokeswoman said. Those penalties will increase annually, maxing out at $695 or 2.5 percent of taxable income.

There are a few exemptions to the health insurance requirement, known as the individual mandate. They include those who would qualify for a religious exemption, those who can’t find health insurance at a cost less than 8 percent of their income and those who would qualify for coverage under the federal Medicaid expansion but don’t in their state, according to Antoinette Kraus, director of the Pennsylvania Health Access Network.

New Jersey has accepted the federal Medicaid expansion, which will provide health insurance to those making up to 138 percent of the federal poverty level, but Pennsylvania Gov. Tom Corbett is seeking to accept only a partial Medicaid expansion. Instead of enrolling more people in Medicaid, Corbett wants to use the additional federal money to go toward subsidies in the Health Insurance Marketplace for residents who would otherwise qualify for the Medicaid expansion.

It’s estimated that 14.9 percent of New Jersey residents and 12 percent of Pennsylvania residents are uninsured, according to Census figures.


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