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The Affordable Care Act and You

What is the Affordable Care Act?

The Affordable Care Act is a comprehensive reform of health insurance that aims to:

  • Expand health insurance coverage to Americans
  • Hold insurance companies accountable
  • Lower healthcare costs
  • Guarantee more choice
  • Enhance the quality of care for all Americans

To accomplish these goals, the ACA involves many phases, but most affect the insurance industry and employers.  Those affecting most Americans include:

  1. The expansion of Medicaid programs to cover individuals who did not qualify in the past
  2. The creation of state Marketplaces to provide coverage options for those not covered by government healthcare, and for those who don't receive insurance from their employers.  Individuals in this category will receive federal subsidies to help make their insurance affordable.  Individuals covered by a qualifying employer-based insurance can still opt into a plan offered in the Marketplace, but their plans will most likely not be subsidized by the government.
  3. Individual mandates - Like mandatory auto insurance for all cars on the road, health insurance is mandatory for all Americans.  Individuals not covered by a qualifying insurance program by April 30, 2016 may be charged a penalty when they file their 2016 income taxes unless they qualify for a hardship exemption.

Here are some links to information about the Act itself:

How does the Affordable Care Act affect me?

The Affordable Care Act affects everyone to varying degrees.  This short, animated video produced by the Kaiser Family Foundation explains how (ver el video en español aquí)


In general, though, you DO NOT need to apply if you are:

  • A beneficiary of government healthcare programs like Medicaid or Medicare because you are already covered by a healthcare plan.
  • Already covered under your employer's insurance plan.  However, you are free to apply in order to compare your employer's coverage with the plans offered in the Marketplace to see if you might prefer one of these plans.  In this case, though, you are not likely to receive any federal subsidies to cover the cost of a Marketplace plan.
  • Already enrolled in your state's Marketplace. Most people who enrolled during the previous open enrollment periods can simply automatically renew their policies.  However, these individuals are encouraged to review their options to make sure that they're getting the best deal for their needs. 

You DO need to apply if you:

  • Are employed by a business that does not provide health insurance.
  • Are unemployed and not already covered under government healthcare programs.
  • Are not already enrolled in a qualifying plan from the previous open enrollment period. 

What do I need to apply?

Health Insurance Marketplace Application Checklist 

Gather these materials or information

  1. Social Security Numbers (or document numbers for legal immigrants) for every member of your family.
  2. Employer and income information for every member of your household who needs coverage (for example, from pay stubs or W-2 forms - Wage and Tax statements)
  3. Policy numbers for any current health insurance plans covering members of your household.
  4. A completed Employer Coverage Tool  for every job-based plan you or someone in your household is eligible for. (You'll need to fill out this form even for coverage you're eligible for but don't enroll in.).  Download the Employer Coverage Tool from this page (see below) or from healthcare.gov (towards the bottom of the page).

How do I apply?

2017 OPEN ENROLLMENT BEGINS NOVEMBER 1, 2016. See other dates and deadlines for 2016 health insurance here. 

If you need assistance with your application, see the tabs below. 

You can apply:

Online.  Start by answering a few basic questions at Get Covered Illinois.

  • Depending on your answers, you will either be directed to the federal Marketplace portal at healthcare.gov, or to the new Application Benefits Eligibility (ABE) for government health insurance programs.  Learn more about ABE here.
  • Once you are directed to the right starting point, create and account and log in to fill out the online application.
  • For more detailed information about applying online, check out this Get Covered Illinois fact sheet (Spanish translation).

Please be patient when accessing Healthcare.gov, as you might have a short wait before you're connected. 

By filling out and sending in a paper application

  • Paper applications are available to print out from this webpage (see Forms and Applications below), or you can request a copy from any Peoria Public Library information desk.

Apply via telephone

  • You can also apply via telephone using the toll-free hotline:
    • For individuals and families: 1-800-318-2596 (TTY: 1-855-889-4325)
    • For Small Businesses using the SHOP Marketplace: 1-800-706-7893 (TTY: 1-800-706-7915)

Telephone hotline assistance is available in English and Spanish. La asistencia telefónica está disponible en inglés y español.

How can I stay up-to-date on the ACA and Marketplace website?

There are a number of ways to keep up with updates and developments in the ACA and Health Insurance Marketplace portals.  Pick one that suits your needs from the list below:

Need help?  Check out this tutorial!

Need help? Check out this tutorial!

Need help? Here's a guide!

 

Still have questions?

If you still have pressing questions about the Affordable Care Act, try searching or browsing the Healthcare.gov articles or the Kaiser Family Foundation's FAQ page to find your answer, or take advantage of Live Chat to pose your question directly to a Healthcare Marketplace representative.

You can also bring your questions to local application counselors who've been trained to help area residents with the open enrollment process.  These counselors will be available in different organizations throughout the community.  See the tabs below, or call the Peoria Public Library at (309) 497-2000 for more information.

Need assistance with your application?

The 2017 Enrollment Period ended on January 31.  To see if you qualify for a Special Enrollment Period, just answer a few questions on Healthcare.gov.

Representatives from the Heartland Community Health Clinic will be available in Peoria Public Library's Main and Lincoln branch computer labs and meeting space to provide information and in-person application assistance on specific days and times throughout the open enrollment period (November 1, 2016 - January 31, 2017).  You can also call the Heartland Community Health Clinic at 309-680-7632 for more information.

Other nearby agencies and organizations are also providing information or assistance.  Search for additional assistance locations on the federal and state Healthcare Marketplace sites.  You can also call Get Covered Illinois at (866) 311-1119 to find additional help near you. 

Call one of these toll-free numbers to speak to a trained federal Marketplace representative. 

For individuals and families: 1-800-318-2596 (TTY: 1-855-889-4325)


For small businesses: 1-800-706-7893 (TTY: 711)
 

You can also call the Get Covered Illinois Help Line at 1(866) 311-1119

Telephone hotline assistance is available in English and Spanish.  La asistencia telefónica está disponible en inglés y español.

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Reliable Information Sources

Consumer Reports: Health Insurance guide

Always full of useful information about important consumer purchases, Consumer Reports Health Insurance information page provides a wealth of information and tips on shopping for and purchasing health insurance. 

Login using the library's Consumer Reports subscription link on the "All Databases" page to get free access to even more Consumer Reports content.

Kaiser Family Foundation: Understanding Health Reform

The product of an independent research foundation, the "Understanding Health Reform" section of this website offers a lot of crucial information on the ACA in an easy-to-navigate and -understand format.  In particular, be sure to look at:

Illinois Health Matters

Illinois Health Matters - Find useful information about the Affordable Care Act and how it's being implemented in Illinois, as well as this new Illinois Marketplace Health Plan Comparison Tool.  Sign up for email updates or follow the blog!

Marketplace Sites

The state and federal marketplace portals, Get Covered Illinois and Healthcare.gov, are more than an entry point.  They also provide a great deal of information about the Affordable Care Act and the open enrollment process.  

To stay on top of updates and developments with the ACA and Health Insurance Marketplace, follow the federal Health Insurance blog, or sign up for email updates on both the federal and state Marketplace pages. 

Health Care: Department of Health & Human Services

Visit the DHHS's Health Care page to learn more about the ACA and its various components, as well as its implementation in different states with the "State by state" feature.  Be sure to follow the blog and Twitter feed for the latest developments!

State of Illinois: Health Reform

Visit this site for Illinois-specific news and information about the Affordable Care Act, especially about Illinois's new Application for Benefits Eligibility (ABE), the new streamlined, all-in-one application for all state government benefit programs, including Medicaid, SNAP, etc.

PAGE UNDER CONSTRUCTION

There is a bill heading to the Senate that could repeal and replace the Affordable Care Act as it is detailed on this webpage.  Library staff will continue posting new articles about these developments, but will wait until final decisions and potential changes are made before updating the bulk of this page. 

Please contact the Peoria Public Library at 309-497-2000 if you have any questions.