Fact Sheet: What the Health Care Law Means for People With Moderate or Low Incomes

Expands Medicaid

• A joint state and federal government program, Medicaid pays the health care costs of people who have very limited incomes. Before the health care law, only certain very specific groups of low-income people were eligible. In most states childless adults, including millions of uninsured 50- to 64-year-old Americans, were ineligible no matter how low their incomes.

• By 2014 many more people will be eligible for Medicaid. If you are under the age of 65, not eligible for Medicare and earn less than about $15,000, you might qualify to have Medicaid pay most of your health care costs. Couples earning less than about $20,000 will also be eligible. This new eligibility group includes children, pregnant women, parents and adults without dependent children. States can start offering Medicaid coverage to these people beginning this year, but most states are likely to take until 2014 to fully implement the change.

• You will need to show how much income you receive, but you will not have to prove how much you have in resources. States will also be required to make it easier for you to apply for Medicaid, in part by cutting back on how much paperwork an applicant must provide to prove eligibility.

Helps people with moderate incomes

• Starting in 2014, health insurance exchanges will be established in your state to offer insurance plans to people with moderate incomes who are self-employed, work for businesses that don't offer employee health insurance and others who've been unable to buy insurance.

• Exchanges provide one-stop shopping, so it will be easier for you to compare private plans and prices for health insurance. Also, buying insurance through an exchange instead of on your own will give you the advantage of group rates, which tend to be much lower.

• Once an exchange is set up in your state, all health insurance plans in the exchanges must offer a set of basic benefits. Those benefits include medical, mental health and rehabilitation services, as well as coverage for prescription drugs. Standardizing benefit levels will make it easier for you to compare benefits and costs. Plans cannot refuse to sell you a policy because of your health status, and insurers must comply with many new consumer protections.

• People eligible to shop in the exchanges will be able to pick among several levels of coverage. This will allow you to find the plan that best fits your needs.

• Depending on your income, you may receive subsidies or tax credits to reduce the cost of buying insurance through an exchange. This help will be based on a sliding scale, provided your income is below a certain level. For example, individuals with incomes between about $14,400 and $43,300 and families of four with incomes between about $29,300 and $88,200 would be eligible. The exact income ranges and the amounts of the available help will be announced as the exchange details are worked out.

• What the insurance policies will cost individuals is not yet known, but there will be annual limits on how much you have to spend on deductibles and copayments for insurance purchased through an exchange. 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 calendar year.

Provides help now

• People who have been uninsured for at least six months and have a pre-existing condition are able to get temporary insurance through the Pre-existing Condition Insurance Plan. This insurance is currently available and will continue until the exchanges start in 2014, at which time all insurance plans will be required to cover pre-existing conditions.