By Amy De Vore+

Vermont joins the District of Columbia in declaring that small business owners with less than 50 are required to offer health insurance. Small businesses under Obamacare are only required by law to offer health insurance if they have more than 50 full time employees -which we are still waiting to learn if this it is legal to require employers with less than 50 to offer health insurance. However, Vermont may have bigger troubles than that, though. Vermont’s Exchange is under review because Vermont is requiring that individuals and small businesses are required to only purchase the new “metal” plans known as the Bronze Plan, Silver Plan, Gold Plan, and Platinum Plan.

Vermont’s ACA Violation

According to the Associated Press a letter was sent from the House Oversight and Government Reform Committee to Mark Larson, commissioner of the Department of Vermont Health Access, to let Vermont know that it appears their requirement has violated the Affordable Care Act (ACA). Quoting the AP, “The letter referred to a section of the law saying ‘nothing in this (law) shall be construed to prohibit’ health insurance companies from selling plans outside the exchange, or individuals and businesses from buying them.” Meaning the ObamaCare law includes that both in Exchange and outside of the Exchange plans should be available to Americans.

Vermont pointed out the federal government has stated that it is the state’s responsibility to choose to offer plans outside of the Marketplace. It has been suggested that Vermont is trying to set up a single payer system as early as 2017 -with less competition in plans. At the moment we are waiting to learn how the US House of Representatives handles this situation, and we will update this article as necessary.

Further Questions:
For further questions about the Vermont case, or about current plans available or the Exchange plans, call 800-980-7956 or contact Medicoverage.

By Amy De Vore+

The Affordable Care Act helps the uninsured in a few ways. For instance, in the LA Times today there was an article about a woman making $12.68 an hour, mother of one child, lives in Los Angeles, and recently choose to forego surgery because she was uninsured. As of January 1st this woman would have options for health coverage.

How the Affordable Care Act Helps Uninsured

She isn’t qualified for Medicaid, however since she works she may qualify for job-based insurance as 2015. Until then and if her employer doesn’t offer insurance she would qualify for premium subsidies and cost-sharing subsidies, and her daughter would qualify for Medi-Cal.

Costs for Lower-Income Families

The article doesn’t state how old she is, but if she is 30, her Silver plan premium could be as low as $93 a month and her deductible would be reduced from $2000 to $500, and a reduced maximum out of pocket from $6,350 to $2,250. This would apply to any single parent to one child living in the Los Angeles area, making her salary.

How do Lower-Income Families and Individuals Get Insurance?

First, it’s important to remember for anyone purchasing a plan from the Health Insurance Marketplace you need your W2 paperwork and financial information handy like child support, alimony, assets. Then you can either go directly through your state’s newly established call center’s navigators or you can go through your insurance agent. Many don’t realize that agents can help with on and off-Exchange plans.

Lower Income Seniors

Seniors do not have to do anything as of January 1st. Seniors stay on Medicare and do not apply for the new metal plans. Make sure your friends and parents are aware that there is nothing for them to do, because states are vocally expressing their concerns about seniors being tricked by scammers into giving away personal information due to the lack of awareness in regards to the ACA.

To learn if you qualify for a subsidy call 800-930-7956 or contact Medicoverage.