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Health Care Reform and Moderate or Low Income Earners

If You Have a Moderate or Low Income
If You Have a Moderate or Low Income

Getting access to health insurance is one thing. Paying for it is another. No one knows yet how much private health plans will charge to cover people who purchase policies through the state insurance exchanges that begin in 2014, when most people will be required to have coverage. But buying it through an exchange instead of on your own will give you the advantage of group rates, which tend to be lower. Also, starting in 2014, the law helps people with moderate or low income in these ways: 

  • Provides subsidies or tax credits to reduce the cost of buying insurance through a state exchange. This help will be given to people on a sliding scale, if your income is below a certain level. Currently, for example, that would include those individuals with incomes of $14,403 to $43,320 and families of four with incomes of $29,326 to $88,200.
  • Limits annual out-of-pocket costs—deductibles and copayments—of insurance bought through an exchange for single people and families with moderate incomes. For example, a family of four now earning $60,000 could spend no more than $11,900 out-of-pocket for health care in a year.
  • Expands Medicaid, the health care program run by the states for low-income people, to cover any low-income legal residents under age 65 with annual income under a certain level—$14,403 for a single person, $19,378 for a married couple.

 

For the first time, these measures offer financial help with health insurance to millions of Americans without access to government-run programs like Medicare or employer health plans—and drastically reduce the risk of going bankrupt because of medical ex­penses. Whether the changes are sufficient, or still leave some people falling through the cracks, remains to be seen.

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