The Affordable Care Act and You
Find a simple flier with basic information about open enrollment here.
The Patient Protection and Affordable Care Act (sometimes known as Obamacare) was enacted in March 2010. This page explains how the law affects people in Northwest Washington.
The new law is benefitting people in the Pacific Northwest in many ways. Under the Affordable Care Act, many preventive services like cancer screenings and check ups are available to people without co-pays, coinsurance, or deductibles. This means more than 100,000 seniors, nearly 42,000 kids and 209,000 adults in Snohomish, Skagit, Whatcom, Island and San Juan counties can now receive this important preventive care at no cost to them. Another important improvement has allowed about 7,000 young adults in the district to stay covered through their parents’ insurance. And people of all ages can no longer be denied coverage because of pre-existing conditions. This benefit protects about 36,000 children in our area from losing their coverage because of their health history. The centerpiece of this law, the health care marketplaces, are open for business again this fall, with new insurance options available to thousands of people in Northwest Washington.
Open enrollment starts November 1 and goes through January 31. People who are buying coverage for the first time or who need to renew coverage through the Exchange and want changes or new coverage by January 1 should pick plans by December 23. The Washington Healthplanfinder has 210 health plans available from 15 different insurers to choose from.
Who does open enrollment apply to?
Open enrollment applies to you if you buy your own health insurance coverage. See if you are eligible for premium tax credits and check out the plans available at www.wahealthplanfinder.org.
What should I do to get ready for open enrollment?
- If you bought coverage through the Washington Healthplanfinder last year, you should have received a letter from the Healthplanfinder telling you about your new premium and updated subsidy eligibility, and from your insurer telling you about any changes to your plan for next year.
- Even if you are eligible for automatic renewal of your plan and are anticipating using this option, you should still plan to log into your Healthplanfinder account to do several things: check out your options; make sure your tax information is correct; and make sure you are familiar with all the details of your plan and your premium tax credit.
- Carefully review this information so you are aware of any changes. Even if your income and your plan have not changed, your subsidy may have changed, because subsidies are also based on the cost of insurance in your area. More information on this is available here.
- Premium information is available now through the Washington State Office of the Insurance Commissioner.
- When you sign back in to your account on or after November 1, you can confirm your health plan, or shop for a different plan.
- The Washington Healthplanfinder has detailed information about this process available at this website, as well as a more detailed FAQ here.
- If you didn’t buy coverage last year, you can still start this year – check out your options and your eligibility at www.wahealthplanfinder.org.
So how does health care reform affect me?
Have more questions?
Call the Health Exchange Call Center at 1-855-WAFINDER (1-855-923-4633) and speak with someone weekdays from 7:30 a.m. to 8 p.m.
If you’d like to find someone to help you through the process, visit http://www.wahbexchange.org/how-enroll/customer-support-network/. You can find a registered broker who can recommend what plan might be best for you, or a navigator who is trained and certified to help you enroll in coverage.
If you or a family member needs help connecting with the right resource, please call my offices in Everett or Bellingham. Visit my contact page for more information.
Questions about how health insurance works? Check out this video that explains some things to think about when selecting health insurance.
I do not have health insurance
The Affordable Care Act created marketplaces where individuals and families can shop online for different insurance plans. You may be eligible for subsidies that will reduce the cost of coverage. For more information and to find out if you are eligible for a subsidy, visit www.wahealthplanfinder.org.
Open enrollment for 2016 starts November 1, 2015 and goes through January 31, 2016. For coverage starting January 1, select and pay for your plan by 4:59 p.m. on December 23, 2015.
Some changes in life circumstances allow you to sign up for coverage outside of open enrollment. Visit www.wahealthplanfinder.org to learn more. Please note that enrollment in Apple Health (Medicaid) is available year-round.
You can also speak to someone about the options available to you by calling the Health Exchange Call Center at 1-855-WAFINDER (1-855-923-4633).
I have health insurance through my employer
If you have questions about your health coverage, contact your Human Resources office. For further information about other health insurance options, call the Health Exchange Call Center (1-855-923-4633) or the Whatcom Alliance for Health Advancement (360-788-6594).
See more information under “What should I do to get ready for open enrollment?” If you don’t buy your coverage through the Healthplanfinder, the process will be the same one you followed last year.
I am a small business owner
The Affordable Care Act offers resources for small businesses to help them provide health insurance for their employees. For more information visit this website. The Small Business Health Options Program (SHOP) is available statewide in Washington for 2016. There is no open enrollment period for the SHOP, and you can select coverage for your employees at any time, but you have additional options if you buy during open enrollment, which runs from November 1, 2015 to January 31, 2016.
I am enrolled in or will soon be eligible for Medicare
The Affordable Care Act improved coverage for seniors enrolled in Medicare. Medicare recipients do not need to visit the exchange and can continue to correspond directly with Medicare or their Medicare Advantage insurer. For more information visit www.medicare.gov or call 1-800-MEDICARE (1-800-633-4227).
I am enrolled in or might be eligible for Medicaid (Washington Apple Health)
In Washington state, Medicaid is known as Washington Apple Health and Washington Apple Health for Kids. Washington state has expanded eligibility for Apple Health, and enrollment is available year round. To find out if you are eligible or to enroll, visit www.wahealthplanfinder.org or call the Washington State Health Care Authority at 1-800-562-3022.
I am enrolled in TRICARE
The Affordable Care Act has no direct effect on TRICARE. Most TRICARE coverage meets the minimum essential coverage requirement of the law, but you can check your coverage here.
I am a military veteran and receive care through the Department of Veterans Affairs (VA)
The Affordable Care Act has no direct effect on the VA health system. If you have questions about your benefits, visit www.va.gov/healthbenefits.
I am receiving care through the Indian Health Services (IHS)
The Affordable Care Act gives American Indians more health care options. Depending on your eligibility you can enroll in coverage through Medicaid or a qualified health plan through the Exchange, or continue receiving health services through the HIS. For more information, visit http://www.ihs.gov/ACA/.
My insurance plan was cancelled
President Obama expanded the hardship exemption from the individual mandate to include individuals with plans that were cancelled prior to open enrollment in 2013. The Healthplanfinder has detailed information about your option to apply for this exemption and whether it may be helpful to you.
I think I may qualify for an exemption from the individual mandate
There are a number of ways to qualify for an exemption from the individual mandate. You can find out about those options here. Your hardship exemption for the 2015 tax year must be approved in advance of tax filing time in April 2016. The form is available here. If you are applying for the exemption based on affordability, membership in a health care sharing ministry, membership in a federally-recognized tribe, or being incarcerated, you can claim these exemptions when you fill out your 2015 federal tax return, or with the forms available under the “How to apply for an exemption” heading on healthcare.gov/exemptions.