AFFORDABLE CARE ACT FAQ
Is the Affordable Care Act (ACA) the reason my premiums are going up?
Are Members of Congress and their staff exempt from the ACA?
Does the ACA cut Medicare benefits for seniors?
Do seniors on Medicare have to buy more insurance to comply with ACA regulations?
Do Medicare beneficiaries have to purchase insurance products on the exchange?
Will Medicare beneficiaries pay more for their medications under the ACA?
Are Medicare Supplemental Plans (Medigap) impacted by the ACA?
Will Medicare beneficiaries be able to see their current doctors?
Is the ACA causing Medicare premiums to go up?
Does the ACA create health insurance?
Where can I go to get new insurance or shop on the exchange?
Do I have to use the health insurance marketplace or exchanges, to purchase insurance?
Does my employer have to cover me?
Does the ACA establish Death Panels that will make decisions about my medical care?
Does the ACA require a "chip" to be implanted in me when I get health care?
Is the ACA constitutional?
Do illegal immigrants get free health care services under the ACA?
Are small businesses going to be forced to fire workers or cut their hours because of the ACA?
Does the ACA allow federal funding to be used for abortions?
Will the IRS will pursue and jail Americans who do not purchase health insurance?
Will retired federal employees be able to continue to participate in the Federal Benefit Health Plan?
Is the Affordable Care Act (ACA) the reason my premiums are going up?
Health care premiums have been going up for more than a decade. One of the main goals of health care reform was to find a long-term solution to skyrocketing premiums.
Double-digit increases occurred before ACA without justification or explanation. While premiums continue to rise, they have been growing slower since the law was passed.
If your rates have been dramatically increased, you should file a complaint with the California Department of Insurance. Our office will help you file the complaint. You should also visit Covered California to see what other plans are available to you.
To contact the California Department of Insurance’s HMOs Complaints Hotline you can call 1-888-466-2219. To contact their Non HMOs Complaints Hotline by calling 1-800-927-4337
You can also contact Covered California at 1-800-300-1506 or CoveredCa.com.
Are Members of Congress and their staff exempt from the ACA?
No. Members of Congress and staff are not exempt from the ACA. In fact, they buy their insurance through the ACA exchanges from private insurance companies like Blue Cross Blue Shield, Kaiser, and others. This is an even higher standard than what is required of the public who are not under an obligation to purchase insurance through the exchanges.
They receive the same employer contribution that all other federal employees receive, and is similar to the contribution that private sector employees covered by health insurance through their employers also receive.
Does the ACA cut Medicare benefits for seniors?
No. In fact, the ACA specifically forbids Medicare benefit cuts and extends the life of Medicare by 8 years. Many of the provisions contained within the ACA strengthen Medicare, improve its quality, help lower costs and ensure Medicare for years to come.
Because of the ACA, seniors will pay less for prescription drugs, have access to preventive services, and receive higher quality care.
Do seniors on Medicare have to buy more insurance to comply with ACA regulations?
No. Medicare beneficiaries can keep their current Medicare coverage and do not need to make any changes to their coverage.
Medicare (including Medi-gap and Medicare Advantage), Medicaid, CHIP and TRICARE are all considered as adequate health insurance coverage. Therefore, current beneficiaries do not need to buy any additional coverage.
Do Medicare beneficiaries have to purchase insurance products on the exchange?
No. Medicare Advantage plans, Medicare Part D prescription drug plans and Medigap (Medicare Supplemental Plans) will not be sold through the exchanges. No changes will be made. They will continue to be available as they have been in the past and as they are today.
Will Medicare beneficiaries pay more for their medications under the ACA?
Under the ACA, high-income Medicare beneficiaries – those who earn more than $85,000 per person or $170,000 per couple a year – pay slightly more for their Medicare Part D prescription drug coverage. This only affects the top 5 percent of beneficiaries.
The ACA included changes that could save money for the remaining 95 percent of Medicare Part D beneficiaries, if they have very high prescription drug costs.
Medicare beneficiaries who are in the prescription drug “donut hole” will be eligible for discounts on brand-name drugs. Under the ACA, the “donut hole” will be closed by 2020.
Are Medicare Supplemental Plans (Medigap) impacted by the ACA?
No. The ACA has no impact on Medigap polices. Medigap plans are sold by private insurance companies and help cover some of the health care costs that original Medicare does not pay for.
Will Medicare beneficiaries be able to see their current doctors?
Yes. Nothing in the ACA changes or dictates which doctors Medicare patients can see.
Is the ACA causing Medicare premiums to go up?
No. Medicare premiums are calculated by the Medicare part B formula. This has nothing to do with the ACA. Premiums rise historically, but not due to the ACA.
Does the ACA create health insurance?
No. The ACA regulates the health insurance industry and helps increase quality, affordability and availability of private insurance.
It creates competitive state-based health insurance exchanges such as Covered California where individuals can shop for the plan that’s right for them, their budget, and their health care needs.
It provides subsidies and/or cost assistance to those that qualify, implements a number of cost containment measures, and creating rules that prevent health industry abuses and denial of care.
Where can I go to get new insurance or shop on the exchange?
California’s online marketplace is Covered California. You can visit their website, CoveredCA.com or call 1-800-300-1506.
On the website you can see all the options, compare policies, and, if they choose, pick a plan that fits their budget, and their health care needs.
Do I have to use the health insurance marketplace or exchanges, to purchase insurance?
No. No one has to use the marketplace to purchase their health care.
Anyone who likes their current insurance plan can simply renew that plan, if it remains available.
If you have and continue to qualify for Medicare, Medicaid, or CHIP, then you do not need to purchase additional insurance.
If you like your employer-provided insurance, you can keep it if it remains available.
The marketplace is for uninsured Americans, those who don't like their current plan, those whose employer does not provide affordable coverage, and those who choose to shop around.
Does my employer have to cover me?
The ACA requires that starting in 2015, employers with more than 50 full-time equivalent employees provide health insurance to their employees.
Small businesses with less than 50 full-time employees do not have to insure their employees.
Employers with 25 or fewer employees are eligible for tax breaks of up to 50 percent of their employee premium costs.
Does the ACA establish Death Panels that will make decisions about my medical care?
No. There is no such thing as a “Death Panel” or anything else in the ACA that will make decisions for you about your end of life care. This is a political talking point and scare tactic used by the ACA’s opponents to undermine the law.
Does the ACA require a "chip" to be implanted in me when I get health care?
No. There is no mandate requiring the implantation of a chip. The only time "CHIP" in mentioned in the bill is as an acronym for "Children's Health Insurance Plan".
Is the ACA constitutional?
Yes. In June 2012, the Supreme Court of the United States ruled that the ACA is constitutional.
Do illegal immigrants get free health care services under the ACA?
No. Illegal immigrants are not eligible to enroll in Medicaid or shop on the newly created health exchanges.
Are small businesses going to be forced to fire workers or cut their hours because of the ACA?
No. Nothing in the ACA forces anyone to be fired or have their hours cut back.
Small businesses with fewer than 50 employees do not have to provide health insurance to their employees. However, should a small business offer health insurance to their employees, the small business would be eligible for tax credits.
Does the ACA allow federal funding to be used for abortions?
No. Under current federal law, no federal funds can be used for an abortion, except in the case of rape, incest or when the life of the woman is in danger. The ACA did not change this.
Individuals may purchase additional coverage to cover the cost of an abortion with their own funds if such coverage is made available. However, no federal dollars may be used for this purpose, and no private insurance company is required to provide abortion coverage.
Will the IRS will pursue and jail Americans who do not purchase health insurance?
No. The ACA explicitly prohibits the IRS from seizing property, placing liens or putting anyone in jail for not complying with the law.
Any uninsured individual that does not purchase insurance and is not eligible for an exemption is subject to paying a fee/penalty. If an individual does not pay the fee/penalty, the IRS will hold back the amount of the fee from any future tax refund.
Will retired federal employees be able to continue to participate in the Federal Benefit Health Plan?
Yes. Under the ACA, retired federal employees will still be able to obtain coverage through the Federal Benefit Health Plan and the government will continue to pay its share of those premiums.