Editor:

Some of the health law-sometimes called Obamacare-has already started. This includes protecting kids with pre-existing conditions, giving discounts to seniors hitting the prescription drug donut hole, letting young adults stay on parents’ insurance, and preventive care without cost-sharing to get a handle on the preventable chronic diseases causing 75 percent of our health costs.

The bulk of the law will start in 2014, though, and many aren’t aware of how these parts work-including the “individual mandate.” A key point to understand is that if you already have insurance, you’re not subject to the mandate. A recent Urban Institute study found that only 2-5 percent of Americans will be. It’s also important to understand the mandate takes effect only when other interconnected parts of the law kick in to help uninsured people afford insurance.

The first interconnected part is the creation of Affordable Insurance Exchanges, or marketplaces, in each state. These marketplaces will offer various levels of private insurance plans with quality coverage. They will allow small businesses and uninsured middle class people to pool together to get the leverage big companies already have and compare plans “apples to apples.” And there will be no discrimination against adults with pre-existing conditions anymore.

There are also tax credits. Uninsured middle class people will get credits to help pay for insurance within the marketplaces. Small businesses, including nearly 63,000 in Wisconsin, are already eligible for credits to help provide insurance for employees. That credit increases in 2014.

If someone still doesn’t want to get insurance even with these options, they can choose to pay a penalty to pick up the costs the rest of us pay, for them, because they don’t have insurance when they go to the emergency room. The penalty will be $695, or 2.5 percent of taxable income, whichever is greater (though it’ll be less in 2014 and 2015).

This is what’s ahead now that the Supreme Court has affirmed Obamacare. You can visit healthcare.gov for more, or you can email me at [email protected] if you have questions or a story of how you’ve been impacted already.

Doug Hill, Wausau
Director, Know Your Care Wisconsin