The Affordable Care Act and You

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:
• The expansion of Medicaid programs to cover individuals who did not qualify in the past
• 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.
• Individual mandates – The individual mandate still exists. But as of 2019, there is no longer a penalty for non-compliance with the individual mandate.

Here are some links to information about the Act itself:
Read the full text of the Affordable Care Act
Or look at the breakdown of key features and a timeline of the Act’s various phases

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.

Health Insurance Marketplace Application Checklist

Gather these materials or information:
• Social Security Numbers (or document numbers for legal immigrants) for every member of your family.
• 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)
• Policy numbers for any current health insurance plans covering members of your household.
• 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).

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 at healthcare.gov or to the Application Benefits Eligibility (ABE) for government health insurance programs. Learn more about ABE here.
Once you are directed to the right starting point, create an account and log in to fill out the online application.
For more detailed information about applying online, check out the Get Covered Illinois fact sheet. (click here for the Spanish translation)

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 telefonica esta disponible en ingles y espanol.

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

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:

Blogs | News Feeds
Healthcare.gov blog
Get Covered Illinois newsroom

Email or Text | SMS Alerts
Healthcare.gov alerts
Get Covered Illinois alerts

Social Media
Healthcare.gov on Facebook and Twitter
Get Covered Illinois on Facebook and Twitter

Traditional News Sources
Traditional news sources (print and digital) are also continuously publishing new articles and information about the ACA and related issues. You can find several of the latest articles in Peoria Public Library’s newspaper databases, where you can search local, state, and national publications. Try searching for keywords like “Affordable Care Act,” “Obamacare,” or “Healthcare.gov,” while also limiting the results by date to make sure you find the most recent content available. Remember, you can always Ask a Librarian if you need assistance!

If you still have questions about the ACA, try searching or browsing the articles on Healthcare.gov or the Kaiser Family Foundation’s FAQ page to find your answers, or take advantage of the Live Chat option on Healthcare.gov 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.

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:

• The short animated video explaining the ACA, open enrollment, and who needs to apply
• If you or your family need to enroll in the Insurance Marketplace, get an idea of your costs and how much assistance you might receive with the Subsidy Calculator
• The “Visualizing Health Policy: Health Coverage Under the ACA” flow chart. While a little dated, this chart helps you map out your most likely coverage options.

ILLINOIS HEALTH MATTERS
Find useful information about the Affordable Care Act and how it’s being implemented in Illinois. Sign up for email updates or follow the blog! Explore Illinois Health Matters.

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.

Forms & Applications

Click on the buttons below to download.

Employer Coverage Tool
Individual Short Form Marketplace Application
Instructions For Individual Short Form Application
Family Marketplace Application
Instructions For Family Marketplace Application
Individual Without Financial Assistance Marketplace Application
Instructions For Individual Without Financial Assistance Marketplace Application
SHOP Small Business Marketplace Employee Application
SHOP Small Business Marketplace Employer Application

Need Assistance with an Application?

If the library is able to secure specially trained navigators to provide assistance in our computer labs like we have in previous years, we will post the schedule here just as soon as it is available. If you have any questions, please call the library’s Call Center at 309-497-2000.

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

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