‘Obamacare’ Individual Mandate Stands: What You Need to Know Before October

As posted on Healthline.com

Written by Brian Krans

After years of debate, pandering, lawsuits, and grumbling, the mandatory coverage provision of the Patient Protection and Affordable Care Act—better known as “Obamacare”—is on its way.

Come Oct. 1, open enrollment begins for all qualifying U.S. citizens in the federal Health Insurance Marketplace. People who have insurance through their employers need to do nothing because those benefits will satisfy the government’s requirement that everyone carry health insurance. However, through the Marketplace they can see if they might qualify for a plan with lower monthly premiums or fewer out-of-pocket costs.

Healthcare coverage offered through the Marketplace must cover emergency care, outpatient care, hospitalization, maternity and newborn care, prescription drugs, mental health services, preventive care, laboratory services, and more.

“For millions of Americans and their families, the time for having the security of affordable, quality health care coverage they need and deserve is finally within sight,” Kathleen Sebelius, Health and Human Services secretary, wrote on the department’s blog.

Signed in 2010, the nation’s largest healthcare law makes numerous changes to the current healthcare system, including allowing individuals to get cost-effective healthcare through the government. All eligible Americans are required to carry a minimum level of healthcare coverage or face fines of $95 a year or one percent of their income, whichever is greater.

However, the U.S. Department  announced Tuesday it will delay the start of the employer mandate, requiring companies with 50 or more full-time employees to offer their employees healthcare coverage, until 2015, a year-long delay the department says will allow for a smoother transition.

“During this 2014 transition period, we strongly encourage employers to maintain or expand health coverage,” Mark J. Mazur, assistant secretary for tax policy with the U.S. Department of the Treasury, said in a statement.

Open Enrollment on HealthCare.gov Begins Oct. 1

While open enrollment begins Oct. 1, the healthcare plan benefits won’t kick in until Jan. 1, 2014.

On its website, HealthCare.gov (para Español, ver CuidadoDeSalud.gov), the 50 million Americans without adequate healthcare coverage can sign up for insurance plans to suit their needs. This includes the option of complete coverage for those who qualify and partial coverage for the unemployed, part-time workers, small business owners, and others.

Open now, the redesigned website walks people through the steps needed to determine which kind of coverage they qualify for, including people in states that chose to partner with the federal government.

Government and insurance companies are notorious for confusing, jargon-riddled policies and even more confusing consequences if you don’t follow them. The new website offers plain language answers to questions such as “Where can I get free or low-cost care in my community?” and “How much will Marketplace health insurance cost?”

The Department of Health and Human Services has also opened a 24-hour-a-day consumer hotline staffed with employees who speak more than 150 languages. You can call 1-800-318-2596 with questions about the Marketplace and your individual situation.

A Healthline reporter called the number at 4 p.m. on Monday and, after a brief automated section, he waited a mere 37 seconds before a polite and lively person was on the line to help.

There’s also a live online chat option for people with healthcare questions who are allergic to phone trees.

Just like with Christmas shopping, you’re better off getting an early start by checking out your options now. Unlike the lines at Target, there may be a few million people in front of you if you wait until Oct. 1 to sign up for a health plan.