What Laws Protect Me
Federal protections
- The Health Care Rights Law, as part of the Affordable Care Act prohibits sex discrimination, including anti-transgender discrimination, by most health providers and insurance companies, as well as discrimination based on race, national origin, age, and disability. Under the ACA, it is illegal for most insurance companies to have exclusions of transition-related care, and it is illegal for most health providers to discriminate against transgender people, like by turning someone away or refusing to treat them according to their gender identity. On May 5th, 2021, the Biden Administration and HHS announced that the Office for Civil Rights will interpret and enforce Section 1557 and Title IXs prohibitions on discrimination based on sex to include:
Section 1557 prohibits discrimination on the basis of race, color, national origin, sex, age, or disability in covered health programs or activities. The update was made in light of the U.S. Supreme Courts decision in Bostock v. Clayton County and subsequent court decisions. Now transgender people are encouraged to report any discrimination they experience while seeking health care services. The HHS has encouraged consumers who believed that a covered entity violated their civil rights may file a complaint at:
- Puerto Rico private insurance
How Can I Avoid The Tax Penalty
Your circumstances can change unexpectedly. This is particularly true recently, as Californians deal with the impact of pandemic and wildfires. For your health and financial well-being, you need health insurance to help cover the high cost of medical care and to avoid the California health insurance penalty come tax time. Whether you are self-employed, between jobs, or an early retiree, eHealth can help you find an affordable health insurance plan that meets your needs. Take a closer look at the health insurance options available, including:
- ACA plans in the state health insurance exchange an attractive option if you qualify for government subsidies and can purchase health insurance during the annual fall Open Enrollment period or because your unique circumstances qualify for a Special Enrollment period.
- Individual/Family health insurance offered by private insurers off the exchange a preferred option for people who dont qualify for government subsidies and who want no restrictions on when they purchase.
Let eHealth help you find the plan that works for you! Get an instant quote for health insurance plans available where you live and find out if you qualify for a subsidy. If you need more help, eHealths team of experienced health insurance agents are ready to help you find the right plan both online and over the phone. Get started finding your health insurance plan today!
How To Offset The Cost Of Covering Expensive Enrollees With Pre
Since the ACA made it so that health insurance companies couldnt deny applicants based on pre-existing conditions, the scales needed to be balanced so that health insurance companies could afford to cover people without raising plan prices astronomically.Unless the Affordable Care Act addressed the problem of people only wanting health insurance when they are sick, the balance between healthy and unhealthy people enrolled in the plans would shift. There would be more people with high medical bills, and fewer relatively healthy people paying premiums but making fewer claims. This dynamic would result in high premiums for those who do enroll in health insurance. That is where the individual mandate came in to bring balance to the system.The individual mandate was designed by the Affordable Care Act to be a solution to that problem. By requiring that everyone enroll in a health insurance plan with minimum essential coverage the Affordable Care Act intended to bring a greater number of people into the health insurance system. This was meant to have two major benefits:
- More people would have health insurance
- The health insurance system would be stronger because more people who were relatively healthy would be paying premiums
- Premium rates would drop due to more people paying premiums, including healthy individuals who dont make many claims
Recommended Reading: Does Starbucks Provide Health Insurance For Part Time Employees
Health Insurance Coverage As A Voluntary Benefit
Many smaller companies offer health insurance as a benefit, even if they aren’t required to by law. In fact, the majority of Americans have health insurance coverage through an employer. A study by the Urban Institute reported that 83.1% of all workers were offered health insurance through an employer in the first quarter of 2016.
In other words, you are likely to receive health insurance through your company, but it’s perfectly legal for employers of any size to refuse to provide it.
How Can I Find Resources In My Community
IEHP Community Resource Centers
The IEHP Community Resource Centers are your local resource for healthcare information in Riverside, San Bernardino and Victorville. Our bilingual staff can help you to take free classes, learn about health care & learn about health coverage.
Connect IE
Connect IE is a new one-stop, interactive website that makes it easy to link people to community resources in the Inland Empire. By clicking on the link below you will be leaving the IEHP site.
Visit ConnectIE to find out more!
Don’t Miss: What Health Insurance Does Starbucks Offer
I Can’t Afford To Lose My Most Important Employeesthe Ones That Reallycare About Their Work They’re The Ones That Can Move To Another Company Forbenefitsand They Will
The goal is to attract and keep the best employees. We all know they’re hardto find.
Employer health benefits are essential to this end.
Bad healthcare can affect moral, productivity, and business success
If your employee can’t get physical therapy after a accident or needed medsto prevent a large health issue in the future, that’s going to affect your dayto day business.
Almost every employer has a story.
We won’t spend to much time on this but you can see the core reasons thatemployer offer group health insurance even when they are not required to.
Let’s look at what the law says about employers with 50+ full time employeeequivalents
The Future Of Individual Health Insurance Mandates
Over the past year, a few additional states have considered or are considering individual mandates, including:
- Connecticut
- Washington
However, so far, none of these states havemanaged to ultimately pass state individual mandates.
Lawmakers who push for individual mandate laws argue that its needed to incentivize people to get health insurance. The argument is that if not enough healthy people sign up for coverage, the pool of insured individuals will be made up mostly of sick people, and health premiums will rise for everyone. However, many states have attempted and failed to pass individual mandate legislation, and these laws remain politically controversial.
According to Forbes.com, the new Biden administration is expected to bring back the federal tax penalty for going without ACA-compliant health coverage. Its unclear yet whether he would do this through an executive order or legislative reform.
You May Like: Does Starbucks Provide Health Insurance For Part Time Employees
Californias Health Mandate Penalty And Coverage Of Immigrants In The State Illegally Explained
A leader of a student group that supports President Donald Trump claimed that California is “putting illegals first” when it comes to health care.
“Starting January 1, 2020, California will tax legal citizens if they dont have health insurance. Why? The state needs to come up with $98,000,000 to pay for free health insurance for illegal aliens. Why do Democrats keep putting illegals first?” tweeted Ryan Fournier, founder and co-chairman of Students for Trump.
Starting January 1, 2020, California will tax legal citizens if they dont have health insurance.Why?The state needs to come up with $98,000,000 to pay for free health insurance for illegal aliens. Why do Democrats keep putting illegals first?
Ryan Fournier
A screenshot of the tweet was Oct. 21. The post was flagged as part of Facebooks efforts to combat false news and misinformation on its News Feed.
Fournier told PolitiFact his claim was based on two June articles, one from a TV station in Los Angeles and the other from USA Today. The KTLA article said the California legislature voted to tax Californians who dont have health coverage starting Jan. 1, 2020. The USA Today story said California would become the first state to offer health coverage to low-income adults living illegally in the country and that the plan would cost $98 million.
Californias health care mandate
The new state subsidies sunset after 2022, but the mandate and related penalty will continue.
Featured Fact-check
Our ruling
What Is Obamacare And The Affordable Care Act
Obamacare is the shorthand name for the federal Affordable Care Act , which was signed into law by President Barack Obama in 2010.
This wide-reaching law does many things, but most significantly it:
- protects consumers — for example, by requiring insurance companies to cover people with pre-existing conditions and preventing them from arbitrarily canceling your coverage
- allows states to expand Medicaid coverage
- creates marketplaces for health insurance plans that meet the requirements of the ACA, and
- establishes new funding for public health and prevention.
Until 2019, the law also required most U.S. citizens and legal residents to have health insurance or, if they didn’t, to pay a tax penalty. Beginning in 2019, however, the penalty goes away in all states except those that have enacted their own penalties. Currently, the list of states with health insurance requirements includes California, D.C., Massachusetts, New Jersey, Rhode Island, and Vermont.
At ObamacareByZipCode, we focus on helping you understand how the Affordable Care Act works in California, to help you get the coverage you need.
Don’t Miss: Starbucks Medical Insurance
What Happens If I Don’t Have Health Insurance
The Affordable Care Act was set up to make it easier for people who couldn’t afford health insurance to get it. It was an attempt to make health care more affordable for everyone by reducing the number of people who can’t pay their medical bills, which drives costs up for everyone else.
The ACA set up penalties for not having health insurance, in order to try to keep people from not being able to pay their medical bills. This portion of the ACA was repealed in 2019, with the authority to enforce health care transferred to the states. Depending on the state where you live, you may be required to pay a fee when you file your state taxes if you do not have health insurance. Check your state health care regulations to be sure.
If you are fined by your state for not having insurance, it could be a significant amount, so if you decide to take the chance of not having health insurance, you should be ready to pay this amount and factor it into your budget.
Keep in mind that there are other financial risks associated with forgoing health insurance, such as not being able to pay for health care. This can turn into large amounts of debt should you need more than minor care. Some 17.8% of Americans with credit reports have medical debts in collections. This is why you should consider health insurance a necessity instead of a nice-to-have.
How Much Its Going To Cost Taxpayers
Health care is not cheap and countries thrive through good health care. There is an estimate of over 10.5 million undocumented residents and around 6 million do not have healthcare of any sort.
There is no cost estimate for now but it is safe to say that it will be an expensive journey. Those in favor of the debate believe that eventually the payoff will be good for the country and help America thrive.
Recommended Reading: Starbucks Benefits For Part Time Employees
Private Health Care Organizations Have Footed The Bill For Illegal Immigrant Medical Services
Before Health Care Reform and up until recently, usually private hospitals got stuck with the bill. Uninsured immigrants would show up at their doorstep with medical needs, and these private health care organizations, had to service them even though they would get compensation neither from the client nor the government.
No one thought that private hospitals should have to foot the bill for health care services rendered to uninsured illegal immigrants, but many didnt want their tax dollars to pay for health care for those who are not lawfully present.
Restoration Of The California Individual Health Insurance Mandate
Since2014, the federal Affordable Care Act has required individual taxpayersand their dependents to maintain Minimum Essential Coverage or pay afederal tax penalty. However, Congress removed the federal non-compliance tax penaltybeginning in 2019 when it revised the tax code in 2017. As a result, Californiasaw an increase in health insurance premiums and a decrease in families withhealth insurance coverage in 2019.
California joined 4 other states Massachusetts, New Jersey, Rhode Island, Vermont and Washington, D.C. in putting state individual mandate laws into place. California health insurance law requires nearly all California residents to maintain MEC health insurance coverage for themselves and their dependents.
According to Covered California, Californias health insurance exchange, restoring the individual mandate for California is a factor in driving premiums to be, on average, 3.2% lower for 2020. Covered California estimates that Californians will save on average $167 per year in premiums during the 2020 coverage year.
Don’t Miss: Do Starbucks Employees Get Health Insurance
Should I Keep My Transitional Health Plan For 2022
If your current health insurance policy is not grandfathered but was in effect prior to 2014, your plan is considered a transitional health plan or grandmothered policy. These plans are not fully ACA-compliant, and were purchased between March 23, 2010 when the ACA was signed into law and the end of 2013.
This page offers a detailed overview of how grandmothered/transitional health plans are regulated and the specific rules that apply in each state.
Transitional health plans can remain in force throughout 2022 if states and insurers allow it
Transitional health plans were initially slated to end in 2014. But extensions have been granted by the federal government every year, allowing these plans to remain in force if the state agrees and if the insurer still wants to renew the plans. The latest extension allows transitional health plans to renew up until October 1, 2022, and remain in force until the end of 2022.
Transitional health plans still exist in 32 states.
Carefully consider the new plans available to you before you decide to renew your transitional plan
If youre enrolled in a transitional plan and your insurer is offering renewal for 2022, you have the option to keep your plan for another year. But its definitely in your best interest to carefully compare your plan with the new options that are available in the ACA-compliant market for 2022.
Are There Affordable Options
There are several ways that you can obtain affordable health insurance. If you are under 26 years old, you may be able to get coverage with your parents’ health insurance plan.Or, you might be able to get coverage through a spouse or domestic partner. Other consumers should explore health insurance offered by their employer, or even independent health insuranceplans that may be available outside of the Obamacare marketplace exchanges.
However, the most affordable and accessible option may be through your state’s Obamacare exchange. These exchanges are websites set up to assist you in finding health insurance plans that are right for you. The cost of these plans varies significantly, and a tax credit can significantly lower your premium if you qualify.
When you’re choosing a plan, you may want to consider a high-deductible health plan , which offers lower monthly premiums but charges higher deductibles. If you do choose this option, you could set up a Health Savings Account . An HSA is an account into which you can save pre-tax dollars that you can spend on medical payments, including copays and deductibles.
You May Like: Does Starbucks Provide Health Insurance For Part Time Employees
If You Travel Frequently
An insurance plan that meets the requirements of the ACA should cover you if you have to get emergency care out of state. For other types of care, your coverage will depend on the particulars of your plan.
You may want to read the article, Don’t Forget to Pack Health Insurance, from HealthInsurance.org for a deep dive into options for travel health insurance.
Learn More
What If I Want To Enroll In Health Insurance Outside Of Open Enrollment
If you missed the Open Enrollment Period for the year but want to enroll in health insurance, there are generally two options available to you.
First, you might be able to enroll in health insurance coverage if you qualify for a Special Enrollment Period . You may qualify for an SEP if you had a change in your household. This includes marriage, divorce, giving birth to a baby, or adopting a child. You can also qualify for an SEP if you have a change in residence, like a move to a new zip code, new county, new state. Or if youre a student moving for school. If you lose your existing health insurance coverage, you might also be able to qualify for an SEP. You can learn how else you might qualify for a SEP and how to apply for one here.
Second, depending on your income level, you might be able to qualify for Medicaid. Medicaid is the federal insurance program that provides health insurance, and thus medical care, to low-income Americans. Another critical part of Obamacare was that it allowed states the option of expanding their Medicaid programs. They did this by upping the percentage of the federal poverty level a person must earn annually to qualify. If your income level lets you qualify for Medicaid, you can enroll outside of the Open Enrollment Period. And if you qualify, your coverage will start immediately and so will your access to health services.
You May Like: Starbucks Employee Health Insurance
