What consumers can expect with Affordable Care Act

Ready or not, changes are coming in how some of us in Ohio will buy health insurance.

Starting Oct. 1, individuals, families and small businesses will be able to buy health coverage for 2014 on the federal insurance exchange.

One very popular feature is that insurers have to accept you even if you have a pre-existing condition. Small businesses can now compare policies from many different insurers to figure out what is best for you and your employees. People who are at the lower end of the income scale can qualify for a subsidy for your purchase of health insurance — up to 400 percent of the poverty line based on your family size. The higher your income, the lower your subsidy.

Young people get a bad deal. Premiums for someone younger than 35 are higher under Obamacare than otherwise, as the premiums of a 64-year-old can only be three times the premium of the youngest, cheapest 21-year-old. To keep the premiums down for older insureds, younger ones are paying higher rates.

The design of the exchange is great. You put in your age and county and then you choose whether you want a basic plan (bronze,) a normal plan (silver,) a fancy plan (gold), or a super-premium one (platinum.) The higher you go up the colors, the higher the premium, and the better the coverage when you need medical care. Bronze buyers have more out of pocket and less choice in care. The neat thing is, it is your choice.

If you work for a large company that provides healthcare or you are on Medicare, generally nothing for you changes for now.

You can choose to be uninsured, but in 2014 you will pay a minimum $95 annual penalty for not buying coverage. The maximum penalty is 1 percent of what you make annually.

Read more about my ideas on how to improve healthcare at clarkhoward.com.

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