Hi, everyone. Welcome to the chat! I’m Kim Richardson, a member of WebMD’s Affordable Care Act team. Today we’re going to be talking specifically about how the Affordable Care Act will affect young adults. Many young adults have never had to shop for health insurance before, so they are likely to have many questions about it works. We’ll get started in just a few minutes, but you can go ahead and submit your questions now by clicking the “comment” link.
Thank you, Kim! I'm excited to be hear and talk about this important topic.
We also have one of WebMD’s health reform experts with us – Lisa Zamosky. Lisa is a healthcare journalist and longtime WebMD health insurance columnist and blogger. Lisa, welcome to the chat.
Hi, great to be here. I'm looking forward to talking about the benefits available to young adults under the ACA.
One myth that we hear about young adults is that they don’t need health insurance because they’re young and healthy. Can you talk about why health insurance still matters for us?
That really is a myth. Although it's true that young people are healthier on average as a group, they do face health problems too. About 16% deal with chronic illnesses that require them to seek care on a regular basis. And young adults between the ages of 19 and 29 visit the emergency room more than any other group under the age of 75, mostly due to accidents.
What's more, there's a significant amount of research that shows young people themselves recognize the value of health insurance to protect them both physically and financially. The biggest barrier to health insurance for this group has been cost, not a lack of interest in being covered. The ACA provides financial assistance that is expected to help make insurance much more affordable for the majority of young people entering the market.
Hi Shainal, that's a great question. Under the law, open enrollment will start in a few weeks on October 1st. You can take a look at the plans available to you in your state and purchase a plan that will start January 1. Since insurers can no longer deny anyone coverage, you're guaranteed access to a health plan. In addition, it sounds like you're likely to qualify for a tax credit that will lower the cost of coverage. Anyone earning less than about $46,000 a year will qualify for some kind of financial assistance.
We also have another of our WebMD Health Reform Experts here today, Dean Rosen. Dean is president and CEO of Breakaway Policy Strategies in Washington, DC, a firm that provides health care providers and patients with in-depth analysis of the ACA and other government health programs.
Thanks to the ACA, young adults can now stay on their parent’s plan until age 26. Is it better for young adults to stay on their parent’s health plan or to get their own?
Financial assistance is available based on income and the size of your family. If you qualify for a tax credit to lowers the cost of your insurance premium, you have a few choices about how to take advantage of it. First, you can have the money sent directly to your insurer so you pay the lowest possible cost for your coverage. The second option is to pay the full amount of your premium throughout the year and take the tax credit at tax time. Or, you can take some of the cost reduction during the year to lower your premium by a bit and take the rest at tax time. You would just have to specify what you want to your marketplace when you sign up for coverage.
Hi Deatrice, you'll want to log onto your state's health insurance marketplace, which opens October 1st to see your options. Based on the fact that you don't currently have an income you'll most certainly qualify for significant cost reductions -- possibly both in what you pay for your premium (the monthly cost to keep your health plan going) and what you pay each time you go to the doctor. If you live in a state expanding it's Medicaid program, you may qualify for that program. If you're income is below what's required to file for taxes and you're unable to find a plan you can afford, you will not be on the hook for the penalty for not having insurance.
A big concern for young adults when it comes to health insurance is affordability. Can you talk about some of the free and low cost options that are going to be available to young people starting October 1st?
a_mo, your question touches upon a very important issue and one that many Americans struggle with. Millions of people either hang onto a job because they can't afford to lose the health insurance or go uninsured, which is particularly dangerous for folks like yourself with a chronic condition. Job gaps after January 1, 2014 will no longer be a concern with regard to health insurance. You'll be able to buy a policy through your state's marketplace and be guaranteed coverage, even with a pre-existing health condition. When you lose access to affordable coverage provided by your employer, you'll be eligible to buy a plan on your own. Likely you'll also qualify for financial assistance to lower your costs.
Young adults under 30 are eligible to buy “catastrophic plans.” What are some of the pros and cons of this type of plan?
Smokers can be charged more for their coverage under the law than non-smokers by as much as 50%. The law defines a tobacco user as someone who uses any tobacco product, including cigarettes, cigars, chewing tobacco, snuff, and pipe tobacco, four or more times a week within the past 6 months. Under small employer health plans you can't be charged the surcharge if you join a smoking cessation program, but that's not available to people buying coverage on their own. Some states have decided that insurer cannot charge smokers more for coverage, so see what's available in your state.
To figure out which plan is best for you, your best bet is to head to your state's marketplace where you'll be able to compare plans side-by-side. In addition, there will be Navigators, folks working with the marketplaces who will be trained to explain the plans to you, though they can't tell you specifically which plan is best for you. An insurance broker can give you that kind of information and it won't cost you more to do so. But I would suggest you work with one specifically authorized to work with the marketplaces. You can get access to this information through your state's marketplace. Check out WebMD's state pages to find out more information.
What are some benefits of the ACA that young people might not be aware of?
For starters, recent studies have highlighted that most young people aren’t aware that new online health insurance marketplaces are opening October 1st. These offer a new way to shop for and purchase a health plan.
They may not know that they are guaranteed a health plan – they cannot any longer be turned down for any reason.
And, perhaps most important, is that for millions of young adults, high cost has been the biggest barrier to getting health insurance. The ACA provides financial assistance and expands Medicaid in many states. It’s expected that the majority of young people will qualify for some type of financial assistance, meaning that many may find health insurance affordable for the first time.
If a young adult is working as an unpaid intern, can he/she qualify for Medicaid?
It's possible you're seeing the result of the high cost of insurance and people having a hard time affording coverage. But as Dean pointed out in an earlier response, drug discount programs -- even when you have insurance -- can help to make medications more affordable for many consumers. And, in some cases, paying with a discount program can result in lower cost even than using insurance coverage. It's always a good idea to ask which is the best method for lowering your costs.
Some colleges offer student health plans. What changes to student health plans can students expect to see this fall?
Like other types of insurance, student health plans have undergone changes and now offer more protection for students.
The law requires that these plans now provide preventive health services and access to contraception at no additional cost. In addition, lifetime limits to coverage have been eliminated, and annual limits are being phased out. This year, annual coverage limits must be at least $500,000 and are eliminated entirely starting August 1, 2014.
However, some college health plans (those that self-insure, meaning they pay medical claims out of their own funds) don’t have to comply with the annual dollar limit rule under the law, though most do. You should check with the plan before signing up.
In order for a family of two to qualify for Medicaid under the law, your household income would need to be less than about $21,000 annually.
A reader asked us if there are still going to be programs like CHIP available?
If my college offers a student health plan, do I have to sign up for it? What other options do I have for getting covered?
Many universities do require students to show proof of insurance coverage, but it doesn’t have to be the student plan. If you’re covered under your parents’ health plan or have other insurance coverage – whether through a job you’re working while attending school or coverage you’ve purchased yourself – those plan often suffice. Just keep in mind that at some colleges and universities, if you don’t actively opt out of the health plan they offer, you’ll automatically be signed up for it.
Also, some schools may require you to pay a health fee to help support an on-campus health clinic even if you don’t buy the student health plan. Often the charge ranges from $100 to $200 per semester. This charge helps to support on-campus clinics that any student can use for primary care services.
Open enrollment starts on October 1st and goes for six months, ending on March 31, 2014. But if you want your insurance coverage to start on January 1, 2014 you'll have to sign up for coverage no later than December 15 of this year. After that, and you'll have to wait a little longer for coverage to start. Ask about the schedule when you sign up through your marketplace.