Frequently-asked questions about the Affordable Care Act or 'Obamacare'

2:05 PM, Sep 27, 2013   |    comments
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KUSA - There are big changes coming to health care in America, as more parts of the so-called Obamacare kick in.

BREAKING DOWN: The Affordable Care Act

Most people who have health insurance through their employer will not have to do anything different, but very soon, people who don't have health insurance will be able to get it through an insurance exchange.

AFFORDABLE CARE ACT: Where do you fit?

Under the Affordable Care Act, the uninsured will have to buy insurance on so-called exchanges, which are online marketplaces that allow them to compare prices and choose policies. If they don't buy insurance, they will face an annual penalty on their taxes.

Every state must start offering insurance to those who don't have it on Jan. 1, 2014; enrollment begins Oct. 1.

States can build an exchange that's all their own, operate it in partnership with the federal government or simply let the federal government do it for them. The Department of Health and Human Services is required to set up an exchange if a state can't or won't do it, then will handle the consumer help functions, in part through its own call center at 1-800-318-2596.

Fifteen states have approval to do their own exchange, the federal government is running 27 and eight others are different versions of federal and state partnerships. Here's a look at who's running the exchanges. in each state.

The call centers have their work cut out for them explaining the confusing and still-changing details of President Obama's health care law. During September, the first question may well simply be "huh?" or at least "What's an exchange?"

Slightly more than half of 1,500 people polled by the Kaiser Family Foundation in August said they didn't know enough about the law to understand how it will impact their families. And 44% of 1,000 people polled separately by Kaiser in August said they weren't even sure the law is in effect after all of the political fighting and a Supreme Court challenge that was rejected.

Many people "know something's coming, but they don't know how it works," says Karen Pollitz, a senior fellow at the Kaiser Family Foundation.

AFFORDABLE CARE ACT: Everything you need to know

That has triggered a lot of questions, and from 7 to 9 a.m., 9NEWS viewers can get them answered by calling Health Insurance Line9. For those who missed the call line, they can call Connect for Health Colorado at 1-855-752-6749 or Metro Denver Association of Health Underwriters at 303-745-4600.

Members of the Metro Denver Association of Health Underwriters answered phone calls Thursday morning, trying to help consumers understand Obamacare and how it will affect their lives.

Not everyone is excited about the prospect of Obamacare.

NOT AFFORDABLE CARE ACT: Opposing view

In most states, the cost of individually purchased health insurance will increase significantly, as much as 160 percent. A handful of states will see average rates go down. But that's generally because those states, like New York, had long ago imposed Obamacare-like mandates that made insurance unaffordable for the young and healthy. Nationally, so far, we've found that ObamaCare will increase premiums in the individual market by an average of 24 percent.

Poorer Americans will be insulated from these increases by Obamacare's subsidies. But the middle class will face a double whammy: higher premiums, along with higher taxes to pay for the subsidies that others receive. Younger, healthier Americans will get hit especially hard under this system.

And everyone agrees that the success of Obamacare hinges on the Obama administration's ability to persuade young people to buy in - to pay for insurance that is even costlier than the coverage they already can't afford. That isn't what Democrats promised when they named their bill "The Affordable Care Act."

READ: Health law offers quandary for youths

Zach Ryan's decision will help determine the success or failure of the Affordable Care Act. He's not a powerful politician, a corporate executive or a federal judge. He's a 26-year-old without health insurance.

Whether he and millions of other young people buy coverage is crucial for the federal health law to reach the goal of making insurance affordable. Their participation is needed to offset the cost of guaranteed coverage for older people with pre-existing conditions. But with barely more than two weeks before enrollment begins on a newly created exchange for the uninsured, most young people know little or nothing about what's at stake for them, according to polls and surveys.

"I can find the most obscure stuff on Google," Ryan said. "I mean stupid, obscure stuff. ... But I couldn't find how to get health care through the government. When you type in Obamacare, you would think it would come right up and have some clear instructions."

Obamacare - how many people refer to the federal health law - is not its official name. If Ryan had typed in Affordable Care Act, he might have gotten closer to the information he needed. The insurance exchange where people actually can sign up for coverage is the Health Insurance Marketplace. The website does not start taking applications until Oct. 1, but it does explain subsidies toward purchasing coverage and penalties for going without it.

FREQUENTLY ASKED QUESTIONS ABOUT AFFORDABLE CARE ACT

The carrot can be sweet, bland or nonexistent, depending upon the subsidy amount, which is tied to income. The stick is tiny. With a penalty of only $95 or 1 percent of income for a single person, some young people will opt to forgo coverage next year.

"You need people in your 20s, your 30s and even early 40s to help balance out the costs of people in their late 40s, 50s and early 60s," said Robert Zirkelbach, a spokesman for America's Health Insurance Plans, an industry trade association.

Besides the small penalty for next year, it's also possible to game the system - to wait until sickness or injury occurs before buying a policy, as long as it's during an enrollment period. Enrollment does not end until March 31. That six-month window is a one-time deal. It will be only 53 days next time around.

FACT CHECK: Who's telling the truth about 'Obamacare?'

(KUSA-TV © 2013 Multimedia Holdings Corporation)

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