Health Care for Dummies: What You Need to Know

I don't have health insurance now. What about me?

Health care reform is aimed primarily at you if you do not currently have health insurance, or buy it for yourself on the open market. Beginning in 2013 or 2014, depending on what the final bill says, insurance companies will have tough new rules to insure better access to coverage, mandatory baselines for what insurance coverage will include, and assurances that it will be more difficult for companies to drop people from insurance coverage.

Insurance plans for people who do not get it through their employers will be sold on web portals administered either at the national (House bill) or regional/state (Senate bill) levels. But all this will come at a cost. The insurance companies will have to cover more sick people than they currently do. But many more healthy Americans will be forced to buy coverage, offsetting those costs and theoretically driving prices down for everyone. Theoretically.

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How much money do you make?

If you don't have Medicare and don't have insurance through your employer, how much the government helps you buy insurance depends on how much money you make in relation to the federal poverty level. Each state has its own Medicare program and some are more generous than others. Find out about your state at the Department of Health and Human Services Web site.

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Senate Democrats would expand Medicaid eligibility to 133 percent of the poverty level -- just under $30,000 for a family of four. The House bill would expand Medicaid to 150 percent of the poverty level. After that, for people buying health insurance on the new exchanges, the government, starting in 2013 or 2014, would give financial help to everyone up to 400 percent of the poverty level -- just over $40,000 for an individual and $88,000 for a family of four.

Refer back to the Kaiser Family Foundation calculator for more specific scenarios.

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At the highest income level, under the Senate plan, a family of four would be responsible for paying $8,600 per year -- about 9.8 percent of their income -- in premiums. The government would pick up the rest -- just over $1,500 for a health plan that cost $10,000 per year.

In the House, the income cap for people at $88,000 is 12 percent. So there would be no subsidy. If the family made $75,000, the subsidy would be around $2,000. At an income of $50,000 for a family of four, the government would kick in $6,900 for health insurance after the family paid close to $3,500.

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What if I don't want health insurance?

For Americans who think the subsidy sounds like a bad deal, they can ignore the government requirement to buy health insurance and pay a fine. The max the government could charge, under the Senate plan, is $750 per person and $2,250 per family -- less for people who make less money. The House plan's fine would be worked out by the HHS Secretary.

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