ACA UPDATE

The ACA remains the law of the land. While the American Health Care Act (AHCA), a bill that would repeal key provisions of the ACA, was passed in May by the US House of Representatives, it has not become law.

This means that nothing has changed for consumers. If you already have health insurance, you should continue paying your premiums and using your coverage as normal. If you don’t have insurance, you can still apply and enroll for 2017 coverage if you qualify for a Special Enrollment Period (see below). In the event that the AHCA does pass this year, most changes will not begin to take effect until 2018 or later. We will continue to provide any major updates, but if you would like more information in the meantime you may contact Lindsey Bryan (###yoelna#at#znvarzbovyr.bet### / 207-215-1869) or visit Consumers for Affordable Health Care at www.mainecahc.org.

What is it?

The Affordable Care Act (ACA) is a law to improve access to health care in the US. The ACA requires most people to have health insurance while creating more ways to get affordable coverage. It also protects people by setting certain rules for insurance companies and the plans they offer.

Under the ACA, all insurance plans must guarantee coverage for the following services:

  • Emergency care
  • Hospitalization
  • Lab testing
  • Maternity care
  • Behavioral health care
  • Outpatient services
  • Pediatric services
  • Prescription drugs

All plans provide preventive services at no cost to the patient, including:

  • Immunizations for children and adults
  • Yearly check-ups with your doctor that include basic health screenings
  • Birth control as prescribed by your doctor
  • Recommended cancer screening tests such as mammograms, colonoscopies and pap tests.

Am I eligible?

The ACA also created the Health Insurance Marketplace where people can shop for health insurance. You can choose from several private insurance plans to pick the one that works best for you and your family. Many people qualify for help paying for coverage, too.

You may qualify for financial assistance if:

  • You are a citizen or lawfully-present immigrant
    AND
  • You are not eligible for MaineCare, Medicare, or health insurance from your employer.

We’re here to answer your questions about Marketplace eligibility or other healthcare programs you may qualify for.

When can I enroll?

Most people are required to sign up for an insurance plan during a specific time of year called “Open Enrollment.”

The Open Enrollment period for 2018 coverage will be November 1 – December 15, 2017. Note that this is a much shorter period than in years past, so we recommend that you don’t wait until November before preparing to enroll!

Some people are able to sign up after Open Enrollment has ended during what is called a “Special Enrollment Period” (SEP). You might qualify for a SEP if you have recently experienced any of these qualifying life events:

  • Moving to a different state
  • Coming to the US
  • Changes in your immigration status
  • Getting married
  • Having a baby
  • Loss of health coverage
  • Certain changes in income or other life changes

In most cases, you must apply within 60 days of the event.

What happens if I don’t have coverage?

If you do not have insurance for any part of the year, you may have to pay a penalty when you file your federal income taxes.

You might not owe the penalty if:

  • You are only uninsured for less than 3 months
  • You are not lawfully present in the US
  • You are a temporary worker in the US for 3 months or less
  • You can’t afford insurance because…
    • It would cost more than 8% of your yearly income,
    • You earn so little that you aren’t required to file taxes, OR
    • Your income is below 138% of the Federal Poverty Level and you DON’T qualify for MaineCare

Help! I can’t afford insurance!

Don’t worry!

Your health matters to us. There are other services in Maine providing free or low-cost health care. We will help you get the care you need.

Maine Mobile Health Program makes healthcare available to farmworkers, aquaculture workers, seafood processors and other seasonal workers and their families. www.MaineMobile.org, 1-888-351-9634

Hospital Free Care requires that all Maine hospitals provide medically necessary care at no cost if your income is below a certain level.

Community Health Centers use a sliding-fee scale to charge for services based on your household income. Some can also help you get discounts on prescription medicines.

Consumers for Affordable Healthcare can help you understand the healthcare system and connect you with other resources. www.MaineCAHC.org, 1-800-965-7476

How do I find out more about the ACA?

MMHP is one of many organizations in Maine offering free in-person assistance to help you apply for and enroll in health insurance.

For more information about coverage options, contact Lindsey Bryan at ###yoelna#at#znvarzbovyr.bet### or (207) 215-1869.

To learn more about the Health Insurance Marketplace or to apply for coverage:
www.HealthCare.gov 1-800-318-2596