By Richard Kistnen, Esq.
For much of the past several weeks, there has been news coverage of problems associated with the rollout and implementation of the Affordable Care Act, otherwise referred to as “ObamaCare.” Generally speaking, the law provides that uninsured individuals will be assessed a penalty when filing their tax returns. (Currently, orders are being issued to extend the deadline by which an individual has to obtain health insurance to avoid the tax penalty.) The heart of the program is the implementation of an “online marketplace” in which people can see all of their options in one place (rather than having to call each provider, as before). The theory behind the law is to standardize health insurance plans with baseline coverage, and have enough “healthy people” purchase coverage that it would offset the costs associated with treating those with chronic and/or severe conditions.
Much attention in the news has been drawn to the federal exchange’s website, which has been plagued by implementation issues. New York, however, was one of the states that opted out of the federal exchange and to create its own marketplace. I used the New York website for my own use and thought that, overall, it worked well.
To begin, a user must create a profile. Thereafter, you must verify your identity with items such as date of birth, social security number, last known address, and so on. Once your profile is created and your identity is verified, you must provide household and income information. Information that is requested includes how many people are in your household, how many require health insurance, who is employed, what kind of income is earned, and what kinds of deductions can be taken. (It is in this area that the website gets tricky. For a regular wage earner, your paystub info can be directly entered into your profile. For self-employed and small business people, entering income and expense information is not as simple, and you will ultimately estimate your income.)
After putting in household and income information, this is cross-referenced with information which the state has on file (which I thought was pretty impressive technology). After the site determines that your income information is accurate, it presents you with your healthcare options. It lists out providers, monthly premiums, whether you are issued a tax credit and what plan is offered. (Again, plans are standardized, and go from Catastrophic to Bronze to Silver to Gold to Platinum. The minimum level of services covered in each group is the same from provider to provider.) From this list, you can determine what kinds of plans you can afford, including deductibles, co-pays, etc.
I, ultimately, was successful in picking out a health plan. While still costly, the plan I was able to find was cheaper by $200.00 than the plan I had looked at before the New York exchange was created. Moreover, there is no exclusion of coverage for people who have a pre-existing condition. To help you navigate your options, there are “navigators” available to help you in and around the city. People can also call the providers or the exchange directly with questions or help with their applications. If you have questions concerning the New York State Exchange, call 1-855-355-5777. You can also contact the Law Office of Richard Kistnen, (718) 738-2324.