How much will you have to pay for affordable health care?

By Amy Davis, Investigative Reporter/Consumer Expert, adavis@kprc.com
Published On: Sep 24 2013 05:23:37 PM CDT
Updated On: Sep 24 2013 06:02:37 PM CDT

August 24, 2013: Only six days remain until Americans can sign up for insurance under the Affordable Care Act. Amy Davis reports.

HOUSTON -

Only six days remain until Americans can sign up for insurance under the Affordable Care Act. That's why all this week we're explaining health care reform.

The clock is ticking. Consumers who need health insurance are supposed to be able to sign up beginning October 1.

While there are no prices or insurance plans posted for Texans, Local 2 consumer expert Amy Davis did some checking and discovered it is not the state dragging its feet.

Insurance companies that want to participate have already submitted the prices and coverage information to the federal government. We are now waiting for the feds approval.

"They just keep saying 'This is the date to sign up. This is the date to sign up.' But they're not giving any information on their websites telling you what this is going to cost you or what you're going to get," said Jack Van Pelt.  

Van Pelt owns a small jewelry business in the Houston Heights. He is 57 years old with a couple of health issues. He is concerned there will be more as he gets older.

Van Pelt is hoping he can sign up for insurance coverage created by the Affordable Care Act, but three years after it was passed, he is still asking how much it will cost.

"That's gonna be the $64,000 question," said Van Pelt.    

According to the Kaiser Family Foundation, only the 17 states and the District of Columbia have released rates and policies so far.

You can calculate online approximately how much you'll pay by punching in your household income, number of people in your family and answers to a few other questions at the Kaiser Family Foundation's subsidy calculator.

It shows insurance would cost Van Pelt about $612.91 per month; but, because most of what he makes at his store goes right back to the cost of doing business, his take-home pay is low.

It means after tax credits, Van Pelt would only pay $25 a month for insurance coverage. What the calculator does not tell him is what kind of coverage he would get for that price.

"I have two hernias and one of them is very large," explained Van Pelt.  

What we do know: Under the new plans, treatment for Van Pelt's hernias will have to be covered. Insurance companies cannot deny coverage based on pre-existing conditions or charge you more based on your health problems. Insurance companies can only use age and tobacco as reasons to raise the cost of your premiums.

Preventative care like annual checkups and exams will also be 100 percent covered.

A lot of preventative care is 100 percent covered. Services recommended with a rating of "A" or "B" from the U.S. Preventive Services Task Force, immunizations recommended by the Centers for Disease Control and Prevention's Advisory Committee on Immunization Practices, and additional services for women contained in guidelines issued by the Health Resources and Services Administration (including routine mammograms for women over age 40). In addition, plans are required to cover these preventive services without any cost-sharing for patients.   

As we've explained, you will be able to sign up for insurance coverage through the Marketplace beginning October 1. Your plan would take effect January 2014. If you do not sign up for some type of health insurance by the end of March, you will have to pay a penalty.

Coming up Wednesday on Local 2 News at 5, we'll explain how much and how those penalties will be assessed.

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