Businesses with over 50 full time employees will have to implement what’s called a Shared Responsibility Payment (SRP) by 2015. The SRP requires companies who do not offer health insurance to their employees to make a shared payment if at least one of its employees qualifies for lower cost monthly premiums through the marketplace. Employers could determine when coverage is affordable if the employee’s share of the premium cost is less than 9.5 percent of their yearly household income.

 

Small businesses that operate with less than 50 full time employees are not required to offer the SRP; instead they can opt for what’s called the Small Business Health Options Program (SHOP), an insurance marker program only for small businesses. Under SHOP, employers can control the coverage offered to employees and control how much they will pay towards employees’ premiums. Small businesses using SHOP could qualify for a small business tax credit starting 2014. Small businesses can enroll for coverage starting October 1, 2013. Coverage will begin on January 1, 2014. Employers using SHOP must cover all full time employees working 30 or more hours per week.

 

Individuals who are self-employed and without employees, can get coverage through what’s called the Health Insurance Marketplace. They are not eligible to get insurance through SHOP. The insurance marketplace is a system that allows individuals to find the type of coverage that best fits their needs. Individuals will be able to compare information about premiums, deductible and out-of-pocket costs.

 

Medicaid Coverage. Many people will continue to receive government subsidized health care, just like it is today. Not much will change for seniors on Medicare. Medicaid, on the other hand is expanding. States across the U.S. have the option to join the expansion and get help from the federal government.

 

Individuals who want to buy their own insurance could do it through the Marketplace, where they will be able to find several options among private insurers. Those individuals can select how much coverage they want and how much they want to pay for it. All plans should cover basics such as hospital visits, doctor visits, drug prescriptions, maternity care and mental health care. Insurance providers won’t be able to charge more for pre-existing conditions. Unlike the current health insurance system, men and women will pay the same price. Seniors’ insurance costs will also be less expensive, but younger people will have to pay more. Younger adults will be able to stay under their parents’ health plan until they are 26 years of age. Some will be able to buy inexpensive catastrophic insurance until they turn 30. For those buying insurance through the marketplace, the government will provide tax credits if their income is below 400 percent of the federal poverty level ($78,120 for a family of three).

 

Individuals who don’t have health insurance coverage by year 2014 would have to pay a yearly fee. That fee is either one percent of the individual’s yearly income or $95 whichever is higher. By year 2016, the fee will be 2.5 percent of the individual’s yearly income or $695 per person whichever is higher. In 2014, the fee for uninsured children will be $47.50 per child. A family could pay about $285. Those who pay the yearly fee are still responsible for the cost of their entire medical care. Individuals can get health coverage only under certain enrollment periods.