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Tuesday, August 24, 2010

Expert Q&A: I can't afford health insurance

Many of you have sent in questions about how the new health care law will affect you and your family. We’ve compiled answers for select questions to our experts in a short series to help you navigate changes to the health care system. Here's the latest:

Question: I cannot afford health insurance. What options are available under health reform and what will it take to qualify?

Health reform makes health care more accessible and affordable for everyone. Here are some of the options for affordable coverage under health reform, along with information about where you can find out if you’re eligible. (Note that many of these options do not take effect until 2014, but new information sources for existing options are available now).

 1. Medicaid: You may be eligible for Medicaid depending on your income and family size. Medicaid provides health coverage for low-income children and adults and people with disabilities, and it also provides assistance with health and long-term care expenses for low-income seniors. Currently, Medicaid eligibility varies from state to state. However, beginning in 2014, health reform will expand Medicaid eligibility levels to 133 percent of the federal poverty level, or $29,327 for a family of four (according to the current poverty guidelines). This means that many more people will be eligible for Medicaid.

2. Premium Subsidies: If you don’t qualify for Medicaid, but you still can’t afford coverage, you may be eligible for help with your premium. Starting in 2014, individuals and families earning up to 400 percent of the federal poverty level, or $88,200 for a family of four in 2010, will get help paying their health insurance premiums in the form of tax credit subsidies.

3. Cost-Sharing and Out-of-Pocket Help: In addition to providing help with premiums, health reform also includes ways to make out-of-pocket costs, like deductibles and copayments, more affordable. Beginning in 2014, plans for individuals and small employers will have new caps that limit how much enrollees have to spend each year out of their own pockets to get care. And, individuals and families with lower incomes will be protected with even lower out-of-pocket spending caps. Depending on your income, you or your family may also qualify for additional help paying copayments, co-insurance, and deductibles.

Next Step – Visit to find out about health coverage options available to you both now and in 2014, visit This new web portal will provide you with information about health coverage options in your state, including private insurance, Medicaid, the Children’s Health Insurance Program (CHIP), Medicare, plans for individuals with pre-existing conditions, and coverage for small businesses.