1 What happens and why? Open enrollment begins for the online health insurance marketplaces, the centerpiece of the 2010 Affordable Care Act, open for business. People can begin shopping for insurance plans on the exchanges. Lower- and moderate-income people will be able to apply for tax subsidies to offset the cost of premiums or enroll in Medicaid in states expanding the program.
The initial open enrollment period for the marketplaces, which operate as interactive websites, runs from Oct. 1 through March 31. Most Americans are required to have insurance by Jan. 1, 2014, or face a fine, but officials have said those who are insured by April 1 won't be penalized. Insurance bought by mid-December will take effect Jan. 1; coverage bought by mid-March is effective April 1. For the first time, insurers will be barred from rejecting people with pre-existing conditions or charging them more.
2 What will you find on exchanges? Each state will have its own online marketplace, or exchange, and offer in-person help. The marketplaces will tell people if they are eligible for Medicaid, which many states are expanding, or if they should sign up for private plans.
There's help with co-payments and deductibles for people with incomes up to 250 percent of the poverty level ($28,725 for an individual or $58,875 for a family of four). If someone doesn't qualify but earns less than four times the federal poverty rate — $45,960 for an individual and $94,200 for a family of four — that person may qualify for subsidies to reduce the cost of the premiums. People who receive subsidies will be required to pay 2 to 9.5 percent of their incomes toward premiums, depending on how much money they make.
Individual policies will be organized into four tiers — bronze, silver, gold and platinum — depending on their coverage and costs.
3 Here are some key dates and facts to remember in the next phases of the health care law:
Jan. 1, 2014: Coverage obtained on the exchanges goes into effect. Most individuals are required to have health insurance. Penalties for those who fail to do so kick in, beginning at $95 a year per person, or up to 1 percent of a family's income, whichever is greater. (The penalty will increase in future years.) The penalty for an uninsured child is $47.50. Insurance companies cannot deny coverage on the basis of pre-existing conditions nor charge higher rates based on an applicant's sex or medical history. Policies must offer a basic package of benefits.
March 31, 2014: Open enrollment period ends for the year. It will reopen in October 2014.
