How the new federal health law affects you

Expert advice

March 25, 2010

When health care reform became law this week, readers had many questions about how it would affect them. Bradley Herring, an assistant professor in health policy and management at the Johns Hopkins Bloomberg School of Public Health, whose research focuses on private and public health insurance coverage, answered some of them in a live chat on our Picture of Health blog. He cautioned that the legislation is complex, and that readers should double-check their circumstances before making decisions. Here are some excerpts:

Question: I have a 26-year-old son who is unemployed without health care. Will he be able to obtain health care and at what cost?

Answer: Starting in 2014, the public Medicaid program will cover everyone under 133 percent of the federal poverty line ( FPL). (Medicaid's currently geared toward low-income families and not single individuals.) And also starting in 2014, private health insurance coverage will be heavily subsidized for people between 133 percent and 400 percent FPL without access to employment-based insurance.

Q: I'm 23 years old and just got bumped off my parents insurance five months ago on my birthday. Since this supposedly covers young people until they're 26 under their parents' plan, will I be insured retroactively?

A: Allowing children ages 26 and under to be covered by their parent's plan is one of the other immediate effects of the bill. This starts in six months, so you'll be able to get back on your parent's plan. But once you're back on, the plan won't retroactively reimburse expenses you incurred while off the plan.

Q: I live in North Carolina, make around $50,000, and have a son who is 3 . How will this affect me? I currently do not have insurance and cannot afford it. Also, does this affect the employer at all?

A: Subsidies will be available to people obtaining health insurance in the new exchange. So if you're not offered group insurance through your employer, tax credits will offset a portion of the premium (again, starting in 2014). The tax credits will be available for people up to 400 percent of the federal poverty line, on a sliding scale. An income of $50,000 for a family of two is roughly 350 percent of the federal poverty level. At this level of income, the tax credit amount will be such that the remaining premium is 9.5 percent of your income. The tax credits will be more generous at lower levels of income.

Q: My husband and I are self-employed and purchase our own high-deductible health insurance. This year I was diagnosed with breast cancer, and our insurance company is spending thousands on us. Is there any provision in the new health reform bill to prevent insurance companies from skyrocketing premiums due to new medical conditions?

A: First off, I'm sorry to hear about your recent diagnosis of cancer. Best wishes. Even prior to reform, you should be OK. Most individual insurance is "guaranteed renewable" right now, meaning they can't drop you and they can only raise your premiums at the "class average" rate; in other words, they can't single you out because of your new chronic health condition. Having said that, these "class average" premium increases can still be quite large.


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