The Affordable Care Act – What it means for you
Small employers
(1-50 employees)

Individuals and families
       Children can’t be denied health coverage if they’re sick No out-of-pocket costs for preventive services No cap on lifetime benefits Young adults can stay on their parents’ plan up to age 26 Seniors’ prescription drug “donut hole” closing No out-of-pocket costs for seniors’ preventive Medicare services Expanded coverage for early retirees

Small businesses are not required to offer health insurance, but if they do, they could get a tax rebate:  Up to 35% today  Up to 50% in 2014

Large employers
(more than 50 employees)
 Large employers will pay a penalty, starting in 2015, if they don’t offer meaningful and affordable health insurance to their employees  A plan is considered unaffordable if it costs more than 9.5% of the employee’s household income or if it pays for less than 60% of covered health care expenses  Large businesses can’t buy coverage through Washington’s Health Benefit Exchange

Coming in 2014:
 Most people must have health insurance by 2014 or pay an annual fine of $95 or up to 1% of your income, whichever is greater    No one can be denied health coverage if they’re sick You can buy a health plan through Washington’s Healthplanfinder All individual and small employer health plans will cover essential health benefits  There’s help if you can’t afford coverage:  Subsidies for individuals earning up to $45,960 and up to $94,200 for a family of four  Medicaid expansion for childless adults who earn less than $15,856

How Washington state is implementing health reform
The Health Benefit Exchange’s Washington Healthplanfinder
 Washington’s Health Benefit Exchange is creating a new online marketplace called the Washington Healthplanfinder where individuals and families can buy private health insurance. (www.wahealthplanfinder.org)    Unbiased advisors, known as “in-person-assistors” and “navigators,” will help you compare and select a private health insurance plan that’s best for you, for free. All plans sold in the Healthplanfinder will cover 10 categories of essential health benefits More than 477,000 people will qualify for subsidies to help them afford coverage Learn more at: www.wahealthplanfinder.org

Medicaid expansion
   Federal money is available to cover approximately 328,000 additional people in Washington state Expanded to cover individuals between the ages of 19 up to 65 (parents, and adults without dependent children) with incomes up to $15,856 (138% of the Federal Poverty Level). Learn more at: www.hca.wa.gov/hcr/me/Pages/index.aspx

Learn more about health reform at

Updated 8/21/13


The Affordable Care Act – What it means for you
Email us at AskMike@oic.wa.gov Call us at 1-800-562-6900

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