Rep. Shaban Seeks to Clarify the Impact of Access Health CT/ACA

In response to public confusion, State Rep. John Shaban (R-135) is offering information to residents about the state’s new “Access Health CT” program, launched as part of the federal “Affordable Care Act” (ACA), and how these changes may impact Connecticut.

Insurance Mandate

Beginning January 1, 2014, the ACA will require most residents, and all businesses with 50 or more employees, to maintain a minimum level of healthcare insurance for themselves and/or their employees. 

Individuals who fail to comply with this mandate will be assessed a tax penalty based on personal income and/or the taxpayer’s filing and dependent status. 

Businesses that fail to comply with the mandate will have to pay tax penalties beginning in 2015 (this penalty was delayed a year).  Small business owners – i.e. less than 50 full-time employees – will not be penalized for failing to comply, but may nevertheless qualify for a tax credit if they purchase insurance through the public exchange.

Additional exceptions to the mandate include: anyone whose required premium contribution exceeds 8% of household income; anyone who goes without insurance for fewer than 90 days in a year; any member of a Native American tribe; or anyone the U.S. Health and Human Services secretary determines to have had a hardship obtaining insurance.  

Purchasing Healthcare Insurance

With the implementation of the ACA, citizens and legal residents can purchase/access healthcare insurance in one of three main ways: (a) through a private insurance plan, (b) through Access Health CT, the “public exchange” set up pursuant to the ACA, or (c) through a Medicare and/or Medicaid program depending on the individual’s age and income level. 

Access Health CT is supposed to create an insurance exchange marketplace where individuals and businesses can compare plans and enroll, if they so choose, in the health insurance plans approved under the program.  Currently, there are only three providers in Connecticut.

Along with the mandate, the main driver of the ACA are the federal subsidies that will be available to certain individuals based on income, age and county.  For example, a family of four with an annual household income up to $94,200 could be eligible for multi-thousand dollar subsidies.  The money for these subsidies is supposed to come from the tax penalties mentioned above, new taxes on (among other things) medical devices and private “Cadillac” health plans, and from large cuts in the Medicare program.

“At present the program’s funding sources and amounts are uncertain, as is the number of people who may be forced into an exchange due to the cancellation of many private plans and/or employers structuring their workforce to avoid the burdens of the ACA,” Rep. Shaban said.

Rep. Shaban added, “Needless to say, the shape, size and effectiveness of this program is in flux, and my office and I will work to keep you updated.”

For more information on how the Affordable Care Act impacts families and businesses, residents can take part in a local “Healthy Chat” event taking place Tuesday, October 22, from 6:00pm – 8:00pm at Western CT State University (Student Center Room #201), located at 181 White Street, Danbury.

To enroll in Access Health CT, RSVP to the Danbury “Health Chat” event, or for more information on the law, please call 855-805-4325 or visit http://www.accesshealthct.com