As the first major benchmark for the Affordable Care Act looms, cynics have chimed in with doomsday predictions of insufficient health coverage, inflated premiums and hemorrhaging employment. They're pitted against Obamacare optimists with rose-colored forecasts concerning more options for coverage and possible employment. In the middle is a confused and concerned public that doesn't understand how the ACA will affect them, their current job benefits as well as their future job prospects. For the average American, the most pressing question may be, "How will I be affected on Oct. 1?"
The simple answer is ... not much. Next week is expected to mark the beginning of the open enrollment period to purchase health insurance, and it's when states will unveil an online insurance marketplace with health care options. However, the elected coverage doesn't actually begin until Jan. 1, 2014, and open enrollment lasts up to March 31.
That means there's still ample time to brush up on the basics of how Obamacare will affect you as an employee or job seeker. Here are the five things you most need to know:
[See: A Consumer's Guide to Obamacare.]
1. It's unlikely that you'll lose your job. Obamacare requires that all companies with more than 50 full-time employees offer health care to that staff by 2015, otherwise they may face a penalty of up to $3,000 per employee. A small number of companies have threatened to either cut back hours of full-time employees or to layoff some staff, but according to Dean Baker, co-director at the Center for Economic and Policy Research, those are outlying circumstances. "There are a small number of employers who might push some employees below 30 hours to avoid a sanction, but our research found absolutely no evidence that this was happening," he says. "That doesn't mean no one will do it. It just means that it's too small a number of firms to be noted as a trend."
2. But you might say goodbye to some colleagues ... in time. Some of the current workforce might be part of what economists call "job lock:" Maintaining a steady job strictly to secure private health insurance coverage. It's very unlikely that these workers will quit their jobs in the next few months or even at the start of 2014, but there might be some gradual shedding of those close to retirement age, those who prefer independent work and those with an entrepreneurial bent. "It'll probably be the span of one to four years before you see some people, like older workers who are pre-Medicare age, for instance, who will decide to stop working," Baker says.
Tal Gross, an assistant professor at Columbia University's Mailman School of Public Health, co-authored "Public Health Insurance, Labor Supply, and Employment Lock," a report distributed by the National Bureau of Economic Research. The authors studied an incident in 2005 when more than 100,000 Tennessee residents lost public health coverage (like from Medicaid). Roughly half of those people regained insurance by finding work. "We extrapolated that there's a very tight link between the need for health insurance and employment," Gross says. "Our results suggest that what happened in Tennessee can be applied to what might happen to the country as a whole." According to Gross, if those workers who have been working strictly due to job lock choose to quit or retire early, the ACA may ultimately reduce the employment rate by a half a percentage point.
3. If you're seeking a job, you may now be more choosy. There will be other options for receiving affordable coverage, so you may now want to take a chance with an exciting startup that doesn't provide insurance, or you could accept a job that has attractive opportunities but a puny benefits package. "I think people are going to find it liberating to not have to worry so much about health care insurance," Baker says. "People are going to feel much more comfortable in the job market and actually look for jobs that make them happy as opposed to jobs they need strictly for the health insurance."
4. You won't be penalized for being out of work. For some, the most confounding portion of Obamacare is the individual mandate, which imposes a penalty fee on anyone who fails to obtain "minimum essential coverage" - public or private health insurance - by Jan. 1, 2014. If you're uninsured and unemployed, don't panic: You may qualify for Medicaid or subsidies on a state-based insurance exchange program. Eligibility is based on household size and income, including unemployment compensation. If you don't qualify you may still avoid the penalty, which has many exemptions including one for being without insurance for up to three months and another for what's termed "financial hardship." Calculators to determine your options, including whether you meet the requirements for the penalty exemption, are available on HealthCare.gov.
5. If you're employed and your job has a benefit's package, you should probably take it. The ACA considers job-based health insurance to be the minimum essential coverage, so if you're employed and insured, you may choose to do nothing during the open enrollment period. If you're not happy with your employer's insurance terms and opted not to take the employer's policy, you must have other coverage from elsewhere by Jan. 1 to prevent paying the individual mandate penalty. Once again, visit HealthCare.gov to shop for options, and take note: It might be cheaper to stick with your job-based coverage, since employers shoulder some of the premium and because your job-offered plan may disqualify you to receive discounts on insurance exchange programs.
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