John Roska: Health care law requirements

John Roska: Health care law requirements

Q: What do I have to do to comply with the new health insurance law? Do I have to do anything if I have insurance through my employer? What are the deadlines, and possible penalties?

A: To comply with the law, you must have health insurance. If already do, you don't have to do anything. If you're uninsured, you have until March 15 to get insured.

If you're not insured in 2014, you pay a fine. That "fine" is paid when you pay your taxes. If you don't earn enough to pay taxes, you don't have to pay a fine. (But then you'd probably qualify for Medicaid, which would make you insured, and not subject to a fine.)

The Patient Protection and Affordable Care Act is the law that sets this out. Nicknamed "Obamacare," the ACA provides something like universal health care by requiring everyone to have health insurance.

If you have insurance through your employer (or a spouse's, or a parent), or are on Medicare or Medicaid, you're insured. You therefore comply with the law, and don't have to do anything.

University of Illinois students can apparently satisfy the ACA requirement with the Student Health Insurance Plan ($254 per semester).

If you don't have insurance, the "open enrollment" period for you to get it began Oct. 1. That's when healthcare.gov started taking applications, and when the problems with online applications began. You can also apply by calling 800-318-2596.

The open enrollment period to apply for insurance runs to March 15. To actually have insurance in place Jan. 1, you must apply before Dec. 15.

The March 15 deadline to apply for insurance gives you enough time to report by April 15 on your tax return whether or not you have insurance. If you don't, the fine is $95, or 1 percent of your income. So if your income exceeds $9,500, you'll pay more than the minimum (e.g., $500 fine on $50,000 income).

The application process connects you to the "exchange" of insurance companies that provide the coverage required by law. It will tell you if you qualify for Medicaid, or for a subsidy to help you pay for the insurance you choose to satisfy the mandate. Incomes up to 400 percent of the poverty level qualify for subsidies (maximum $94,000 for a family of four).

Background: The Senate passed the ACA in 2009. In 2010, it was passed by the House and signed into law by President Barack Obama. In 2012, the Supreme Court said much of the law was constitutional, although requiring states to expand Medicaid was not. (Illinois expanded.)

Most importantly, the Supreme Court upheld the "individual mandate," which requires everybody to get insurance. Chief Justice Roberts said that the "requirement that certain individuals pay a financial penalty for not obtaining health insurance may reasonably be characterized as a tax." Which is OK, since Article 1 of the Constitution gives Congress "the power to lay and collect taxes, duties, imposts and excises."

John Roska is a lawyer with Land of Lincoln Legal Assistance Foundation. You can send your questions to The Law Q&A, 302 N. First St., Champaign, IL 61820. Questions may be edited for space.

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