Q: What are “Exchanges”? Can I still purchase coverage through my agent?
A: Exchanges are the central mechanisms created by the health reform bill to help individuals and small businesses purchase health insurance coverage. Beginning in 2014, Your Health Idaho, Idaho’s exchange, will be available to help consumers make comparisons between plans that are certified to have met benchmarks for quality and affordability. Your Health Idaho will also administer the new health insurance subsidies and facilitate enrollment in private health insurance, Medicaid and the Children's Health Insurance Program (CHIP). Nobody will be required to purchase health insurance through Your Health Idaho, though subsidies will only be available for plans sold through Your Health Idaho. If you would rather buy your insurance through an insurance agent or broker, you will be free to do so.
Q: I don't have insurance now, how can I get coverage?
A: Starting in October, 2013, Your Health Idaho will provide a way for individuals and families to shop for, compare and choose a health insurance plan. Some Idahoans, depending on their income, will be eligible to get assistance in paying their health insurance premiums. Coverage under the new plan will begin in January 2014.
Q: Will I be required to get health insurance, and what happens if I don't?
A: Individuals will be required to have health insurance, with some exceptions, beginning in 2014. Those who don't carry health insurance may have to pay an annual penalty. Penalties will be assessed by the Internal Revenue Service (IRS) at the time a federal income tax return is filed.
Exceptions will be given for:
- Individuals who cannot afford coverage
- Taxpayers with income below the filing threshold
- Members of Indian tribes
- Individuals who experience gaps in coverage of no more than three months
- Religious conscience
- Members of a qualifying health care sharing ministry
- Incarcerated individuals
- Individuals who are not lawfully present
Q: Why am I required to purchase health insurance coverage?
A: Under the health care reform law, nobody can be denied coverage or be priced out of coverage due to a health problem. The law requires that everyone have minimum coverage, creating a larger pool of both sick and healthy individuals.
Q: My family income is about $45,000, but my employer does not subsidize our health insurance and we cannot afford it on our own. What are my options?
A: Low- and moderate-income individuals and families whose employers do not subsidize health insurance coverage will be eligible for subsidies that enable them to purchase coverage through Your Health Idaho. The amount of these subsidies, which will reduce premiums and out-of-pocket costs for deductibles, co-payments and coinsurance, will depend upon the size of your family and your household income. The subsidies will be in the form of tax credits, which can be taken at the time of filing the federal income tax return, or can be paid in advance directly to the insurance company.