CLEVELAND – In a little more than a week, people all over northeast Ohio will be able to sign up for health insurance thanks to the Affordable Care Act, also known as Obamacare.
This is the first in a series of 5 On Your Side reports called “Understanding Obamacare.” They are all about the key elements you need to know about before the health care marketplaces, or exchanges, open on Oct.1.
The first question: Who will be affected?
The U.S. Department of Health and Human Services reports there are nearly 1.4 million people in Ohio who are uninsured and eligible to sign up.
“In 2006, I battled ovarian cancer,” said Bethena Glenn from Cleveland. She has a pre-existing condition because of the cancer that invaded her body.
“I have not been able to get health care for myself as a result of that,” Glenn said. She also told us she is raising her son on her own.
“Even now, I’m a single mom. My son is 6 and I have health care for him, but not for myself,” she said,
Glenn is finding herself in the pool of those who are eligible to sign-up through the exchanges.
Local experts told us if you’re more than 65 years old and on Medicare, you don’t have to worry about enrolling through the exchanges. But if you are on Medicaid, because Ohio has not expanded the Medicaid program yet so, you could need to sign up.
“I expect we’re going to have a lot of people who without that Medicaid expansion who are not going to have coverage,” said Director of Strategy at Medical Mutual of Ohio Gregory Young.
Other people directly impacted generally fall into two categories, according to Cleveland State Univeristy Assistant Professor of Law Gwendoly Roberts Majette.
“If you’re a self-employed individual, you’re purchasing on your own, you’re going to go to the exchange… or if you work for a small business,” Roberts Majette said.
A small business is defined as 50 employees or less. Also, if you’re not fulltime, that is you work less than 30 hours per week and don’t have insurance, you can use the exchange.
Roberts Majette further explained who is eligible.
“If you’re employer doesn’t offer it, you do go to the exchange,” she told us. “Employers are supposed to provide affordable coverage. So, some employers might offer the coverage, but it’s not affordable to the individual.”
HHS reports if your share of the premium costs for employee-only health care coverage is more than 9.5 percent of your yearly household income, then the coverage is not affordable. For example, if you make $50,000 per year and your premiums are more than $4,750 then you should go to the exchange.
HHS also notes if you are covered by your employers insurance, then more than likely you won’t have anything to do come Oct. 1.
Glenn said she plans to sign up through the health care exchanges as soon as she can.
“I’m definitely looking forward to seeing some actual numbers and how that’s going to play out.”
Another interesting thing to keep in mind is if you do not qualify for Medicaid or for the Children’s Health Insurance program, then look at the exchange. And if you are unemployed and are not covered by assistance, you should examine the exchange.
The other option is for you to bypass the exchange and get your insurance directly from an insurance company or broker.