Last week, the Congressional Budget Office released updated projections of the Affordable Care Act's cost and the news is good: the law is costing less originally expected because the competition it creates among insurers is driving down prices. Those lower-than-expected prices are reducing the cost to help Americans purchase coverage through tax credits and cost-sharing reductions.
When the law was passed in March of 2010, the CBO estimated its cost at $710 billion between 2015 and 2019. After several updates to that initial prediction, the CBO now says the law is expected to cost nearly one-third less: $506 billion, over the same time. Despite this investment in expanding access to affordable health insurance, the law is still a deficit-reducer overall. The CBO projects that the Affordable Care Act is on track to reduce the federal budget deficit by $124 billion by 2019.
Those numbers show that the Affordable Care Act is working on a policy level — but we can also see how it's working on a human level. The Pennsylvania Health Access Network's enrollment assisters have helped nearly 3,000 Pennsylvanians to get covered during the last two open enrollment periods, and we hear every day how the Affordable Care Act has helped not only their health, but also their finances.
The law does that in a very simple way: by capping the cost for health insurance based on what you earn. The less you make, the less you have to pay. For example, a single Mom, Maria, who earns $23,800 a year would have to pay 4.02% of her income (about $80/month) for health insurance. Because her income is less than 250% of the poverty level, she's also going to save money — if she picks a Silver plan — on out-of-pocket costs, like co-pays when she fills a prescription, and deductibles, if she needs to go to the hospital.
But what if Maria didn't sign up for health insurance in 2014? What if she's uninsured, and can't get coverage through an employer? In that case, assuming she doesn't qualify for an exemption, Maria would have to pay the penalty for going uninsured in 2014 when she files her taxes this year. The penalty for going uninsured in 2014 is $95 or 1% of your taxable income, above the filing threshold.
That's the bad news. The good news is that Maria — and many others — will get another chance to enroll for 2015 thanks to a new "Tax Season Special Enrollment Period" that began Sunday, March 15th and continues through April 30th. You can take advantage of this new window to enroll, if you do not have health insurance right now and didn't have it in 2014; will be subject to the shared responsibility fee when filing taxes this year; and did not know about or understand the law's requirement to have health insurance.
Taking advantage of this new opportunity to enroll is a good idea, considering that 81% of Pennsylvanians who are covered by Marketplace plans are getting tax credits to reduce their premiums. While paying the penalty — which increases to $325 or 2% of your taxable income in 2015 — may be less than the cost of getting covered, it's a decision that risks your physical and your financial health. Plus, there are many new insurance options in Pennsylvania this year that are worth a look.
Whether you decide to use this Tax Season Special Enrollment Period to get covered or not, you should understand all your options. PHAN offers help at (877) 570-3642 and www.pahealthaccess.org/GetHelp.
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