By Linda Marsa
Your Situation: I'm uninsured.
As you've probably heard, the legislation guarantees that at least 94% of Americans not covered by Medicare will have adequate, affordable health care. High-risk pools—group insurance programs for people with more serious illnesses—were set up immediately to provide coverage for Americans who haven't been able to get insurance because of preexisting conditions. Up until now only 34 states offered some type of high-risk pool, and the ones that did typically had long waiting lists, and coverage was skimpy.
If you've been without insurance for six months or more, you can now buy a policy at the prevailing rate. And your annual out-of-pocket medical costs—in addition to monthly premiums—will be capped at $5,950 for individuals and $11,900 for families.
In cases in which cost is still an issue, there won't be relief right away—Medicaid will be expanded to cover more of the uninsured in 2014. If you make too much to qualify for Medicaid (individuals who earn more than $14,404; more than $29,327 for a family of four), you could get help buying private insurance in the insurance exchanges. The new law will provide billions of dollars in subsidies based on a sliding scale once premiums exceed a certain percentage of annual income. The subsidies end at four times the poverty level, which is $88,200 for a family of four or about $44,000 for an individual.