Health Insurance Assistance: Do You Qualify?

Health insurance reform will make coverage more affordable for working Americans through refundable tax credits that will be calculated on a sliding scale. These subsidies will be available for Americans who do not get coverage through their employer and earn between 100 and 400 percent of the federal poverty level (FPL), or between $22,000 and $88,000 for a family of four. If an employer offers coverage exceeding 9.8 percent of a worker's family income, or the employer pays less than 60 percent of the premium, the worker may also be eligible for subsidies. Annual out-of-pocket expenses will be capped for lower income individuals as well. Small businesses with less than 25 employees will be eligible for a new tax credit that could pay for up to 50 percent of their total health premium costs.

The Kaiser Health Foundation has an interactive tool to determine premiums and government subsidies for individuals and families under the U.S. Senate and U.S. House plans. Click here to see if you qualify for a subsidy.

In negotiations with U.S. Senate leaders, House Democrats, with the support of President Obama, are hoping to increase the subsidies for working Americans.

Currently, in Texas, only adults who have children and make less than 26 percent FPL are eligible for Medicaid. This sad fact demonstrates the difficulty that low-income individuals have accessing health care in our state. Alabama is the lowest in the nation at 24 percent FPL. Texas should be beating Alabama by much more than just two points.

The U.S. Senate health insurance reform bill will expand Medicaid eligibility to all children, parents, and childless adults with incomes under 133 percent FPL. This provision alone will vastly increase access to a million low income Texas adults who account for a significant percentage of uninsured individuals.

All Americans will immediately benefit from health insurance reform. The following are some of the immediate improvements, which will be implemented in 2010:

• Eliminate lifetime and unreasonable annual limits on benefits;
• Prohibit rescissions of health insurance policies;
• Provide assistance for those who are uninsured because of pre-existing conditions;
• Require coverage of preventive services and immunizations;
• Extend dependant coverage up to age 26;
• Develop uniform coverage documents so consumers can make apples-to-apples comparisons when shopping for health insurance;
• Cap insurance company non-medical, administrative expenditures;
• Ensure consumers have access to an effective appeals process and provide consumers a place to turn for assistance navigating the appeals process and accessing their coverage;
• Create a temporary re-insurance program to support coverage for early retirees;
• Establish an Internet portal to assist Americans in identifying coverage options; and
• Facilitate administrative simplifications to lower health system costs.

Below is a visual, user friendly guide from Newsweek that highlights how the health insurance reform bill will affect you.