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The Health Care Law and You

Fact Sheet: What the Health Care Law Means for People Under 64

If you are between the ages of 50 and 64, the health care law may benefit you in several ways.

For instance, the law will make it easier to get health insurance, and it helps make coverage and long-term care services more affordable.The law also aids small-business owners and early retirees. The law will be phased in over several years.

Makes it easier to obtain health insurance

• The law creates health insurance exchanges for people who can't or don't receive coverage through their job. Exchanges will be set up in every state to provide "one-stop shopping," so it will be easier to compare plans and prices. If you are eligible for insurance through an exchange and do not purchase it, you will be subject to a penalty. Insurance exchanges will begin in 2014.

• Insurance plans sold in the exchanges must cover a range of benefits, including maternity care, prescription drugs and mental health care. You will be able to pick among four levels of coverage to best fit your needs.  

• If you have been uninsured for at least six months and have a pre-existing condition, you may be eligible for coverage through a Pre-existing Condition Insurance Plan, which is now available in your state and will continue until the exchanges begin in 2014.

Helps make coverage more affordable

• Starting in 2010 for new plans, you will not have to pay some of the costs for preventive care. Such services include mammograms, immunizations, and screenings for diabetes and certain cancers.

• Starting in 2010, small businesses with fewer than 25 employees (whose average wage is below $50,000) can get tax credits to help buy health insurance.

• In 2014, Medicaid benefits will be available to qualifying children, parents, and childless adults who do not have Medicare and who have a limited income. (The income limit as of 2010 is about $14,400 for a single person and $20,000 for a couple.)

• Starting in 2014, you may be able to get tax credits that can be used toward paying premiums for insurance purchased through an exchange. You will qualify if you earn less than $58,280 for a couple or $43,320 for an individual.
    
Expands insurance coverage for children and young adults

• As of July 2010, insurers must cover children under age 19 who have pre-existing conditions.

• As of 2011, your adult son or daughter may be able to remain on your insurance policy until he or she turns 26.

Helps protect health benefits for early retirees

• If you are between 55 and 64 and have retiree health coverage through your work, you have added protection. New federal funds encourage your employer to continue offering health benefits until you become eligible for Medicare.

Makes key improvements in insurance practices

• As of 2010, insurance companies cannot drop your health coverage if you become sick. Your health insurance coverage is guaranteed so long as you pay your premiums.

• Insurance companies can no longer place lifetime or restrictive annual limits on your health coverage. This change will ensure that your benefits won't run out when you need them the most. The ban on lifetime limits began in 2010, while the ban on annual limits begins in 2014.

• Starting in 2014, adults cannot be denied health insurance because of a pre-existing condition.

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