More of your Affordable Care Act questions answered

9:32 PM, Sep 18, 2013   |    comments
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MINNEAPOLIS -- The next major phase of the Affordable Care Act begins October 1, when people can begin enrolling in private and public insurance plans sold through Minnesota's new health exchange, known as MNsure.

We've been fielding dozens of questions from viewers on the KARE 11 News Facebook page.  Round two of responses involves the health history of prospective insurance customers.

Question: KARE viewer Charlene wrote, "Our family's currently on two separate insurance plans. I have my own coverage because of a pre-existing condition. Does this mean we'll all be able to go under one plan?"

Answer: Yes, as of January 1 insurance companies cannot deny coverage because of pre-existing condition, or charge you higher premiums based on your health history. The only factors carriers can take into account are your smoking status and your age.

Question: Viewer Jennifer asked, "What exactly is going to happen to people who are offered insurance through an employer, but have discovered the employer paid plan isn't major medical?"

Answer: If your plan doesn't offer major medical then it's not considered "essential coverage" under the new law. And in cases like this you'll be able to buy a plan on the exchange and tap into the discounts, which vary depending on your income.

How do you know if your company's plan meets the new standards in the Affordable Care Act?

Large employers will be sending out letters telling you if your plan at work meets the minimum essential coverage.

The letter my employer, Gannett, sent to me says our plan at KARE meets the essential coverage standard.  It goes on to explain that means I can't qualify for discounts on the health exchange, MNsure. Because of that I'm better off staying with the company plan.

In addition to that, the company will continue to pay part of my premiums, which will make the plan at work more affordable.

Question: Viewer Karen wrote, "My husband has health care from work. The cost is high for a spouse. Can I get health coverage through MNsure?"

Answer: Yes. You can remove yourself from your husband's plan and buy your own coverage through the MNsure exchange.

But you won't be able to use the discounts on the exchange as long as there's still a chance you can get coverage through your husband's job.

You'll have to run the numbers yourself and decide which plan is the more affordable option for you and your spouse.

Question: Viewer Julie asked, "If you have health insurance through work, can your children be covered through MnSure and not you?"

Answer: In most cases you can't move your children off your plan at work and get them insured through MNSure. But there's one key exception to that rule.

If you make less than 275 percent of the federal poverty level you can use MNsure to enroll your children in Medical Assistance, Minnesota's version of Medicaid.

That 275 percent threshold is $53,700 for a family of three, $64,700 family of four, and $75,000 for a family of five.

Discounts and eligibility will be automatically calculated for prospective enrollees.

Question: Viewer Aaron asked, "Why are businesses reducing employees to under 30 hours per week?"

Answer: Businesses make staffing decisions for a variety of reasons, so it's difficult to assess whether the prospect of Obamacare is what is driving employers to cut hours.

The Affordable Care Act requires all large employers to offer insurance to their full-time employees beginning in 2014. Those companies won't be penalized for failure to do that until 2015, when the full employer mandate takes effect.

So what's full time when it comes to this rule? Under the ACA a full time employee is one who averages 30 hours per week or more. So companies can cut those employees' hours and comply with the law.

Some companies that offer coverage to part-time employees are rethinking that benefit, now that an affordable marketplace option is available.

For example, the national grocery chain Trader Joes made headlines in August when the company informed part-timers they won't be offered health coverage anymore.

Instead Trader Joes will pay those part-time employees an extra $500 to help them buy coverage through a health exchange.

Question: Viewer Kirsten asked, "How is this going to affect those of us who already have an individual, private pay plan?"

She added, "I'm 31, single and self-employed. I'm extremely happy with my coverage and what I pay currently. I don't want to change one bit."

Answer: If you're happy with your current health plan there's no need to change anything.

Just remember your own plan has to meet that essential coverage standard -- include that essential set of benefits -- in order to qualify as real insurance in the new system.

If you'd like to learn more about the range of plans, premiums and discounts available in the MNsure Exchange, click on this MNsure cost calculator link.

In Wisconsin, which doesn't have its own exchange, people can learn more by going to the federal exchange home website Healthcare.gov.

(Copyright 2013 by KARE. This material may not be published, broadcast, rewritten or redistributed.)

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