45 Days to Open Enrollment for ACA

It's only 45 days until open enrollment for the Affordable Care Act begins.  States, employers, employees, insured and uninsured are all waiting and wondering how this will work.  I wish I could give some idea about what will happen but I feel I'm not alone in not knowing anything about it.

Here's what I do know.  You can sign up now at www.healthcare.gov to set up an account so that you'll be ready to start shopping on October 1.  You can also sign up to receive email notifications as new information becomes available.

What does this mean for small businesses?  Most small businesses I know are exempt.  Employers must have 50 or more employees to be required to provide health insurance.  And that was recently moved back one year.  Small employers, that is businesses with 49 and fewer employees, may provide health insurance if they wish or have their employees buy insurance through the Marketplace exchanges.

Tennessee has chosen not to set up a state exchange or to modify Medicaid to accept low income individuals and families.  The Governor hasn't ruled out modifying Medicaid in the future, but as of right now, Medicaid in Tennessee won't be changing any rules to allow more low income people to apply for and receive insurance.  We'll have to wait and see what happens there.

This means that some low income individuals and families still won't be able to obtain insurance in Tennessee.  If an individual makes less than $11,500 ($23,840 for a family of 4) and is not eligible for Medicaid, then they can buy insurance on the Marketplace if they can afford it (I would assume that is doubtful) but they won't get any federal subsidies to pay for the premiums.  They will have to pay the full premium to receive insurance.  If you make too little to receive a subsidy for health insurance premiums but also don't quality for Medicaid, you won't have to pay a penalty for not having insurance.  You will be exempt from this penalty.  That's good news, I guess.

Another possibility for good news, I don't know if this will be true, is that people who were previously unable to obtain insurance because of preexisting conditions and had to pay very high premiums may now be able to buy insurance at a more affordable rate.  It still might be high, but might be lower than before.  We'll have to wait and see.

If an individual makes more than $11,500 ($23,840 for a family of 4) then they will receive a federal subsidy to buy health insurance and will have to pay a penalty if they don't buy any.

How much will this insurance actually cost?  No one knows.

Everything is is in a state of flux.  And just like Medicare, Social Security, Medicaid and all other Federal programs the state of flux is constant.  Hold on to your hats and tighten those seat belts.