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The Patient Protection and Affordable Care Act

ACA News ACA Key Dates ACA Resources Kaiser Family Foundation Calculator Frequently Asked ACA Questions
  1. What is the Affordable Care Act?


    The Patient Protection and Affordable Care Act was passed by Congress, and signed into law by President Barack Obama on March 23, 2010.

    The law aims to expand health insurance coverage to millions of uninsured Americans. It requires most Americans to have health insurance, either through their employers or through a health insurance marketplace “exchange” beginning Jan. 1, 2014.

    For those who can’t afford coverage, the federal government provides subsidies. The level of expense considered “affordable” is about 9.5% of family income. The law also allowed states to expand their Medicaid programs to help provide many more with coverage, but Maine opted out.


     

  2. How do I know if I have to have health insurance?


    Under the law, you are required to have health insurance, unless your income is below the federal poverty level (currently $11,490 a year for an individual and $23,550 for a family of four) and you live in a state like Maine that did not expand its Medicaid program. Those who don’t have health insurance could face a fee (or penalty). There are some exemptions to the penalty, however. They include those who:

    Are uninsured for less than 3 months of the year.


    Are determined to have very low income and coverage is considered unaffordable.


    Are not required to file a tax return because their income is too low.


    Would qualify under the new income limits for Medicaid, but their state has chosen not to expand Medicaid eligibility.


    Are a member of a federally recognized Indian tribe.


    Participate in a health care sharing ministry.


    Are a member of a recognized religious sect with religious objections to health insurance.


    If you don't qualify for these situations, you can apply for an exemption asking not to pay a fee.


     

  3. How much time do I have to buy insurance?


    The insurance requirement kicks in Jan. 1, 2014, but the enrollment period, which begins Oct. 1, 2013, lasts until March 31, 2014, so there would be no penalty until after that date.

    Individuals and small businesses can start buying insurance through the exchange beginning Oct. 1, 2013.


     


  4. How much are the subsidies?
    Many people who don’t have health insurance through their employer and need to buy it on the exchange will be eligible for federal subsidies to help pay for coverage.

    Those who earn between 100 percent and 400 percent of the federal poverty level will be eligible for subsidies, which will be calculated on a sliding scale.

    To get an idea of how much you might be eligible for, plug your information in to the Kaiser Family Foundation “Subsidy Calculator.”

    In general, subsidies are designed so that no family pays more than 9.5% of its income on health insurance premiums.

     

  5. Where do I find the “Marketplace Exchange?”


    Some states are setting up their own exchanges, but Maine is one of several states that decided not to set one up.

    Thus, Maine residents must enroll through the federal government. This can be done online, at www.healthcare.gov, by mail or in person. Two telephone lines have been set up for those who have questions.

    For individuals, the number is: call 1-800-318-2596. For small businesses, the number to call is 1-800-706-7893.

    TTY users should call 1-855-889-4325.

    The federal government is also supplying “navigators” to work help people one-on-one with questions and concerns.

    For the one nearest you, check out the list of navigators in Maine.



     


  6. Do you have more questions?

    The Kaiser Family Foundation offers answers to many more questions you might have about the ACA.

    For more information, click here.



     

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