Unsure and Uninsured?

Written by  Nina Hemphill Reeder

As mandated by the Affordable Care Act (also known as Obamacare), health insurance is now a requirement in the new year. However, many Americans still remain confused about the new law and its complexities, so we polled our online audience to find out what questions they still had regarding the ACA law. We then took a few of these questions to our expert Ashley Allison of Enroll America, which is a nonpartisan nonprofit organization charged with the mission of enrolling uninsured Americans in a health insurance plan. Read below for your questions and her answers.

Q. Everything keeps saying if you’re already insured, things won’t affect you. I pay into my employer’s insurance, but I’d like to find something cheaper. Can I do that on the exchanges?—Jessica

A. Yes, regardless of whether you already have health insurance, anyone is free to use the Health Insurance Marketplace to look at the options available to them. The Marketplace gives consumers the opportunity to compare plans side by side to find the best fit for your needs and budget.


Q. I tried going online and everything is a bit confusing. Are there services or people who can help me enroll? But I want to keep my personal information confidential.—Paula from Stockbridge, Ga.

A. Through our Get Covered America campaign, we offer a number of resources to help consumers get the information they need before they enroll. You can visit our website getcoveredamerica.org or text “Covered” to 877-877 to learn more about the new coverage options available in your area. You can also check out our Get Covered Calculator at getcoveredamerica.org/calculator, which will give you a cost estimate of what you would be eligible for through the Health Insurance Marketplace. It’s free, easy to use, and doesn't require any personal information.

Once you’re ready to enroll, you can call the Health Insurance Marketplace hotline at 1-800-318-2596 and speak to an expert who can help answer any additional questions and assist you with the enrollment process. Navigators and in-person assistors certified by the Department of Health and Human Services are also in communities across the country and can sit down with you and help you enroll. In order to confirm your eligibility for subsidies that will help you pay for your plan, they will need some personal information from you; and as long as they are certified by the government, your information will be safe. To find assisters in your area, visit localhelp.healthcare.gov.

Q. How will they know if I don’t get insurance? How will I be forced to pay a fine?—Sabrina

A. The fine is assessed when you pay your taxes, so if you aren't required to file federal taxes, then you don’t have to pay the fine. The bottom line is that as long as you can prove you have health insurance by March 31, you won’t have to pay the penalty. If you’re currently uninsured, the Health Insurance Marketplace makes it easy for you to find the best plan that fits your needs and your budget. You may even be eligible to receive subsidies to help pay for your plan.


Q. I’m a self-employed party promoter. I make my income through that and several other side gigs. Because my income varies from month to month, I never wanted to lock myself into paying for insurance, especially since I’m healthy and fit and never really get sick. I’m thinking about not getting insurance again this year but don’t understand how I will be fined. How do the fines work?—Maurice

A. If you don’t have health insurance by March 31, 2014, you will be required to pay a $95 fee or 1 percent of your income when you pay your taxes. But we’re finding that many young and healthy people like yourself value the peace of mind and financial security that comes with having health insurance. While you may not go to the doctor regularly, having health insurance protects you from the unexpected, so you won’t go bankrupt from a sudden injury or illness. We encourage everyone to at least check out the options available through the Marketplace and find the best plan that fits your needs and your budget. Plans on the Marketplace are required to cover the basics, like hospital visits, prescriptions and preventative care, and many people will be able to get financial help paying for their plans.


Q. I’m currently unemployed but hope to be employed again by next year. I would like to wait on getting insurance through my new job. If I happen to get a job later in the year, like in March or April, will I be charged a fine for the months I didn’t have insurance even though I end up insured for 2014?—Tiffany from Dallas, Tx.

A. If you have insurance coverage by March 31, you do not have to pay the fine. If you don’t, but get coverage later in the year, the fine will be prorated to only the extent of time that you were uninsured after March 31, 2014. If you can’t get insured through your job by the end of March, you can use the Marketplace to find a plan to cover you until you do. Through the Marketplace, you might be eligible for Medicaid or financial assistance to help pay for your plan, especially if you have no income.


Q. What happens if the government defunds Obamacare after I have already purchased insurance?—Amber from Charlotte, N.C.

A. Despite all the political mudslinging and grandstanding, the bottom line is that the Affordable Care Act is the law of the land and is a historic opportunity for millions of Americans to find quality and affordable health insurance—many for the first time ever.


Q. Someone told me that all the good doctors won’t accept insurance from [the ACA health exchanges] and that those with [health exchange–purchased] insurance will be force to use the same doctors Medicare patients use and that you’ll never been seen or be able to get an appointment because Medicare patients have more health issues and are always at the doctor’s.—Suzette from Jacksonville, Fla.

A. That is simply not true. Many people eligible for Medicare and/or Medicaid go to the same doctors as people with private insurance. The plans available through the Marketplace are private plans offered by private insurance companies. While doctors covered in each plan will differ from one another, nobody will be forced to only use a doctor that sees Medicare patients.


Q. I live in a Republican state, and I’ve seen little to no information about enrolling in the insurance exchanges. I’m particularly curious to know what happens to the people who don’t qualify for their state’s Medicaid program if that state has refused the Medicaid expansion.—Latasha from Atlanta

A. Some states, such as Georgia, chose not to expand Medicaid coverage, but we encourage everyone to use the Marketplace to see what options are available for you. There are still many opportunities for financial assistance, and you never know what you may be eligible for until you look.


Q. What is the difference between a state-run exchange and the federal exchange?—Jordan from Flint, Mich.

A. The Affordable Care Act gave states the choice of whether they wanted to run their own health insurance marketplace or opt to participate in the federal government-run marketplace known as the Health Insurance Marketplace. Thirty-six states, such as your state of Michigan, chose to use the federal Health Insurance Marketplace, which is run by the Department of Health and Human Services. Regardless of whether the marketplace is state run or federally facilitated, all plans are required to cover the basic requirements like prescriptions, hospitalizations and preventive care, and no one can be turned away because of a preexisting condition. Both types of marketplaces will also have opportunities for financial assistance. If you go to healthcare.gov and enter your ZIP code, you will be routed to the appropriate marketplace based on your location.

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