Answers about the health care ruling

ByABC News
June 28, 2012, 7:43 PM

— -- Q: Will my adult children younger than 26 be able to remain on my insurance?

A: Yes. Children ages 19 to 25 are eligible for insurance through their parents. About 2.5 million people are covered through this portion of the 2010 health care law, according to the Department of Health and Human Services.

Q: Will we receive insurance rebates?

A: Yes. Insurers must spend at least 80% of consumers' premiums on health care — not on salaries, office rental or office equipment — or give rebates to customers. The first ones must be mailed by Aug. 1. The Obama administration said insurers will send $1.1 billion in rebates, about $151 per household, this year.

Q: Will I be able to get insurance if I have a pre-existing condition?

A: Yes. About 60,000 people are covered through the government's Pre-existing Condition Insurance Plan, and that number is expected to increase, according to the Centers for Medicare & Medicaid Services. Insurers may not exclude children from policies because of pre-existing conditions now due to the law, and beginning in 2014 for adults. Beginning in January 2014, insurers may not place annual spending limits on consumers. A recent Commonwealth Fund report found that 9 million people were rejected by insurers over the past three years because of pre-existing conditions.

Q: Will most Americans be required to purchase health insurance?

A; Yes. If they don't, they will pay a percentage of their income or a dollar amount — whichever is greater. In 2014, that will be $95 or 1% of a person's income. In 2015, that will increase to $325 or 2%. However, some groups are excluded: Anyone whose insurance cost would equal 8% of their income, anyone who doesn't have to pay taxes because of low income, those who refuse care for religious reasons, undocumented immigrants, those who are in jail or prison and members of Indian tribes.

However, anyone who falls within 400% of the poverty line (the poverty line is $19,090 for a family of three in 2012) might receive help paying for their insurance from the government through the state exchanges.

Q: Will there still be an expansion of Medicaid?

A: Originally, the law extended Medicaid to all those who fell within 133% of the poverty level — about $30,700 for a family of four. Almost 60% of adults in that category were uninsured for at least part of 2011. However, the Supreme Court ruled Thursday that states cannot be forced to extend Medicaid by a threat to withhold federal funding. For the first three years, 2014-16, the federal government will pay for the expansion, but then it will gradually decrease, and states will be expected to pick up the slack. It remains to be seen which states will pick up their 10% of the tab by 2020.