HEALTH LAW QUESTIONS, ANSWERS
Q: What if I missed Monday's deadline?
A: The government last week announced "special enrollment periods" for two big groups of people: those who have started an application but didn't manage to finish the complicated enrollment process by Monday, and people dealing with "special circumstances" such as natural disasters, technical difficulties, family problems, complications related to immigration status and more. If you're not in one of the groups eligible for an enrollment extension, you will have to wait until next year for coverage. The next enrollment period starts Nov. 15. In the meantime, you risk being fined for not having coverage.
Q: How big are the penalties?
A: The penalty for 2014 is $95 per person ($47.50 per child under 18) or 1 percent of annual income above the tax-filing threshold of $10,150, whichever is higher. The fines are due when people file their 2014 taxes. If someone is due a tax refund, the IRS can deduct the penalty from the refund. Otherwise, the IRS will let people know what's owed.
Q: Does signing up for coverage seal the deal?
A: No. People still have to pay their premiums. There's no definitive word yet on how many people are following through.
Q: Who's still uninsured?
A: Millions of low-income people, in part because nearly half the states haven't acted to expand Medicaid, which was supposed to cover them. Also, the estimated 11 million-plus immigrants who live in the U.S. illegally aren't eligible to get insurance through the health exchanges.
Q: Signing up young people is supposed to be key to holding down the health law's costs because they are cheaper to insure. Are they participating?
A: During the first five months of enrollment, 26 percent of those who selected plans were between the ages of 18 and 34, although this group makes up about 40 percent of potential enrollees.
Q: How come more people aren't signing up?
A: For some, it's just a matter of procrastination. But polls show that many of the uninsured are uninformed or confused about the new law or don't think they can afford coverage. A very small slice say they don't want or need coverage.
Q: What happened to all those people who got insurance cancellation notices last fall?
A: Many have gotten a reprieve. Others found new coverage. More than 4.7 million people got cancellation notices because their policies weren't good enough to meet the higher standards set in the health care law. After a public uproar, the government agreed to let states give those affected two years to switch to better coverage. That extension is good for policies issued up to Oct. 1, 2016.
Associated Press —
COMING UP
Nov. 15: Open enrollment begins for 2015. Americans can sign up for coverage or switch to a new plan. And they'll see what rate increases are in store for the coming year.
Jan. 1, 2015: Deadline for large employers — those with 100 or more employees — to offer coverage or face tax penalties.
Jan. 15, 2015: Open enrollment for 2015 ends.
April 15, 2015: Tax day. Fines are due for people who weren't insured in 2014.
2018: So-called "Cadillac" health plans offered by some employers come under a new tax. Some companies will pass the tax on to workers and others may trim employee benefits to avoid it.
Associated Press
MEDICARE FEES APPROVED
With just hours to spare, Congress on Monday finalized legislation to prevent doctors who treat Medicare patients from being hit with a 24 percent cut in their payments from the government. The Senate’s 64-35 vote sends a measure to delay the cuts for a year to President Barack Obama, who is expected to quickly sign it. The House passed the measure last week. It’s the seventeenth temporary “patch” to a broken payment formula that dates to 1997, and comes after lawmakers failed to reach a deal on financing a permanent fix. Though there is widespread agreement on bipartisan legislation to redesign the payment formula that would doctors 0.5 percent annual fee increases and implement reforms aimed at giving doctors incentives to provide less costly care, there is no agreement on how to pay the approximately $140 billion cost.
Associated Press
The sign-up period for insurance under President Barack Obama’s health care law ended Monday as it began: with long, frustrating waits and a new spate of website ills.
Twice during the day, HealthCare.gov stopped taking applications; at other times, with as many as 125,000 last-minute applicants online simultaneously, it moved with frustrating slowness. For long stretches Monday, applicants were shuttled to a virtual waiting room where they could leave an email address and be contacted later.
“This is like trying to find a parking spot at Wal-Mart on Dec. 23,” said Jason Stevenson, working with a Utah nonprofit group helping people enroll.
It was reminiscent of the first month of sign-up, starting Oct. 1, when many applicants found that flaws and glitches prevented them from getting information about policies, let alone enrolling.
Officials said Monday that the site had not crashed but was experiencing very heavy volume. It had recorded about 1.6 million through 2 p.m. EDT as compated to 1.5 million a day last week.
Supporters of the health care law fueled the surge as they fanned out across the country in a final dash to sign up uninsured Americans. People not signed up for health insurance by the deadline, either through their jobs or on their own, are subject to being fined by the IRS, though the administration announced last week that people still in line by midnight would get extra time to enroll.
At St. Francis Hospital in Wilmington, Del., enrollment counselor Hubert Worthen plunged into a long day. “I got my energy drink,” he said. “This is epic, man.”
At a Houston community center, there were immigrants from Ethiopia, Nepal, Eritrea, Somalia, Iraq, Iran and other conflict-torn areas, many of them trying anew after failing to complete applications previously. In addition to needing help with the actual enrollment, they had to wait for interpreters. Many had taken a day off from work, hoping to meet the deadline.
The White House and other supporters of the law were hoping the surge would push sign-ups in the new health insurance markets to around 6.5 million people. That would be halfway between a revised goal of 6 million and the original target of 7 million, a figure that was scaled back after the website’s disastrous launch last fall.
The insurance markets — or exchanges — offer subsidized private health insurance to people who lack coverage through their jobs. The federal government is running the exchanges in 36 states, while 14 others plus Washington, D.C., chose to set up their own websites.
New York, running its own site, reported more than 812,000 sign-ups by Sunday morning, with nearly 100,000 coming last week.
However, it’s unclear what those numbers may mean. The administration hasn’t said how many of the 6 million people nationally who had signed up before the weekend ultimately closed the deal by paying their first month’s premiums. Also unknown is how many were previously uninsured — the real test of Obama’s health care overhaul.
In addition, the law expands coverage for low-income people through Medicaid, but only about half the states have agreed to implement that option.
Supporters of the law held their breath early Monday when the day began with the website unexpectedly inoperative.
Administration spokesman Aaron Albright said the site undergoes “regular nightly maintenance” during off-peak hours and the period was extended because of a “technical problem.” He did not say what the problem was, but an official statement called it “a software bug” unrelated to application volume.
In Oakton, Va., enrollment counselor Rachel Klein said she noticed the website was running slowly.
“We all came into it understanding that today was going to be challenging,” said Klein. “We’re all relieved that there’s going to be a little extra time for people.”
House Speaker John Boehner aid Monday that Republicans remain committed to repealing Obama’s law. But its supporters are wasting no time trying to shape the next open enrollment season, starting Nov. 15. The advocacy group Families USA will announce 10 recommendations today to make the system more consumer-friendly.
They range from providing more in-person assistance with sign-ups, to eliminating premium penalties for smokers, to aligning enrollment with tax-filing season.
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