* You now must have health insurance. Your only out: If you earn less than the poverty level (currently $11,670 a year for one) or you meet one of the federal exemptions.
* Maine did not expand Medicaid (also known as MaineCare). Because of that, Mainers who earn less than poverty level do not qualify for government insurance based solely on being poor. They also won’t get a subsidy to help pay for insurance on their own.
* Open enrollment lasts until Feb. 15. Most people have until then to buy health insurance or change plans.
* You can only buy insurance past the Feb. 15 deadline if you change jobs, get married, get out of jail or have another particular life-changing event. However, American Indians and Alaska Natives can buy or change insurance at any time.
* American Indians and Alaska Native shareholders have a number of benefits and protections under the ACA, including plans with little to no out-of-pocket costs, easier eligibility for government insurance and no penalty for going without insurance.
* There are now three insurance companies on the marketplace for Maine: Anthem Blue Cross and Blue Shield, Harvard Pilgrim Health Care and Maine Community Health Options.
* If you bought health insurance through the marketplace, you can change your financial information at any time during the year. That allows you to adjust your subsidy when you gain or lose income so you don’t end up paying too much or too little for insurance.
* If you didn’t have health insurance in 2014 and you were supposed to, you’ll be charged a penalty come tax season. Right now that penalty is either 1 percent of your annual household income or $95 per adult for the year/$47.50 per child, whichever is higher. The penalty goes up quite a bit in 2015 and again in 2016.
* Starting in 2015, businesses with 100 or more full time-equivalent workers must provide insurance to their employees. Starting in 2016, businesses with 50 or more must. The insurance plans must be affordable and must meet federal quality standards.
ACA 201 Online: A one-year checkup on how the ACA is doing in Maine and a subsidy calculator can be found at SunJournal.com/ACA201
Profiles of Mainers who bought health insurance through the ACA marketplace:
- Sherri Tripp: ‘I think it’s wonderful’
- Blake Pooler: Finally insured, for $160 a month
- $22 a month: ‘I am totally flabbergasted’
- Business owner: ACA offered another option
You’ve seen how the Affordable Care Act affected other Mainers in 2014. How about you? Good, bad or neutral — share your ACA stories
Resources:
- Where to get help
- Tips, hints and other things you need to know
- Get insurance: The step-by-step
- Answers to frequently asked questions
- Know the lingo
- ACA by the numbers
Affordable Care Act 101: We break down the ACA, what it does and what it requires you to do.
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