John Roska: March 31 deadline nears for insurance marketplace

John Roska: March 31 deadline nears for insurance marketplace

Q: What happens if I miss the March 31 deadline to get health insurance? Can I get insurance on my own after that?

A: March 31 is the deadline to get insurance through the official "Health Insurance Marketplace." That's the government system — or "exchange" — for providing health insurance to everyone. It can provide assistance based on your income, and won't screen you out for pre-existing conditions.

March 31 ends the marketplace's "open enrollment" period. It began Oct. 1, 2013, with a "rollout" variously described as "bumpy" or "botched." After March 31, the marketplace won't open again until Nov. 15.

The requirement that you get health insurance comes from the Affordable Care Act, or "Obamacare." It was signed into law in 2010, and found constitutional (for the most part) by the Supreme Court in 2012. In particular, the Supreme Court upheld the "individual mandate" that requires everybody to be insured.

Insurance provided by your employer satisfies that mandate, as does Medicare or Medicaid.

Otherwise, although insurance may be required, you're not required to get it through the federal marketplace. Private insurance you get on your own can satisfy the individual mandate, as long as it provides the coverage required by the law.

So, you can still get your own private insurance after March 31, outside the marketplace. But that could leave you liable for a penalty for being uninsured for more than three months of 2014.

Getting insured through the marketplace, before the March 31 deadline, avoids that penalty. Among other things, the marketplace can also provide assistance on paying premiums, based on your income.

If you miss that March 31 deadline, the marketplace will be closed until Nov. 15. It'll then reopen, until Feb. 15, 2015.

After March 31, a special "qualifying life event" can reopen the otherwise-closed marketplace. According to the HealthCare.gov website, examples are moving to a new state and "certain" changes of income or family size.

If you're not insured for all of 2014, you may have to pay an "individual shared responsibility payment." Also known as a fine, that payment will be a minimum of $95, or 1 percent of household income over $10,150. (That's the income threshold for being required to file a 2014 tax return.)

If you're uninsured for three months or less in 2014, you won't be fined. And if your 2014 income is less than $10,150, you won't have to file a 2014 tax return, and can't be fined (in which case, you'd probably qualify for Medicaid).

Several exemptions can excuse you from having to get insurance. For example, a temporary one-year exemption for people whose old insurance coverage was canceled has now been extended until at least 2016. Expanding the definition of "hardship" (and making it easy to satisfy) opens this exemption to lots more people.

Paying the fine in 2015 for not being insured in 2014 won't satisfy the requirement that you be insured in 2015. The fine for not being insured in 2015 will double, to 2 percent, with the minimum fine more than doubling to $325.

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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