It’s Here: The Federal Health Insurance Marketplace in Wisconsin

1. Presents It’s Here: The Federal HealthInsurance Marketplacein Wisconsin Public Forum & Professional Conference November 7 - 8, 2013 UW-Fox Valley, Menasha, WI

2. Conference Planning Committee • Melody Lane Buller, Fox Cities Chamber of Commerce and Industry • Lisa Cruz, Red Shoes PR • Eric Giordano, Wisconsin Institute for Public Policy and Service • Laura Hunt, Wisconsin Institute for Public Policy and Service • CorinaNorrbom, Wisconsin Institute for Public Policy and Service • Genia Lovett, Gannett Wisconsin Media • William Mann, ThedaCare • Craig Moser, Outagamie County • Megan Mudge, University of Wisconsin-Fox Valley • John Rathman, Outagamie County • Martin Rudd, University of Wisconsin-Fox Valley • Pamela Utpadel, Universal Insurance Advisors • John Viste, Wisconsin Institute for Public Policy and Service • Mary Wettstein, Associated Financial Group Thank you!

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4. The health reform law requires nearly all Americans to have health insurance starting in 2014 or else pay a fine. A. TrueB. False

5. TRUE Starting in 2014, most U.S. citizens and legal residents will be required to obtain health coverage, or pay a penalty. Some exemptions will be granted, for example, for those with religious objections or where insurance would cost more than 8% of their income. Adapted from http://kff.org/quiz/health-reform-quiz/

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7. The health reform law establishes a government panel to make decisions about end-of-life care for people on Medicare. A. TrueB. False

8. FALSE No such panels exist. While early versions of the law did contain provisions that would allow Medicare to reimburse physicians for voluntary discussions with patients about end-of-life planning, these provisions were dropped from the final legislation. Adapted from http://kff.org/quiz/health-reform-quiz/

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10. The health reform law gives states the option of expanding their existing Medicaid program to cover more low-income, uninsured adults. A. TrueB. False

11. TRUE The ACA called for the expansion of state Medicaid programs beginning in 2014 to cover nearly all individuals under age 65 with incomes up to 138% of the federal poverty level ($15,856 for an individual or $26,951 for a family of three in 2013). However, while the Supreme Court upheld the ACA, it limited the federal government’s ability to enforce the Medicaid expansion to low-income adults, effectively making the Medicaid expansion a state choice. Adapted from http://kff.org/quiz/health-reform-quiz/

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13. The health reform law allows undocumented immigrants to receive financial help from the government to buy health insurance. A. True B. False

14. FALSE Under the ACA, undocumented immigrants will remain ineligible for Medicaid and will be ineligible for the premium tax credits. They also will be prohibited from purchasing coverage through an exchange even at full cost. Adapted from http://kff.org/quiz/health-reform-quiz/

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16. The health reform law increases the Medicare payroll tax on earnings for upper income Americans. A. TrueB. False

17. TRUE The law increases the Medicare Hospital Insurance (Part A) payroll tax on earnings for higher-income taxpayers (more than $200,000/individual and $250,000/couple) by 0.9 percentage points from 1.45 percent to 2.35 percent, beginning in 2013. Adapted from http://kff.org/quiz/health-reform-quiz/

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19. The health reform law require employers with 50 or more employees to pay a fine if they don't offer health insurance. A. TrueB. False

20. TRUE Beginning in 2015, employers with over 50 FTE workers face penalties if they don’t make affordable coverage available to employees. To avoid fines: • Employer plans must cover 60% of health care costs • Employees must not pay more than 9.5% of family income for their insurance Adapted from http://kff.org/quiz/health-reform-quiz/

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22. The health reform law cuts benefits for people in the traditional Medicare program. A. True B. False

23. FALSE The federal law does not cut benefits for people in Medicare. In fact, it improves certain benefits, such as coverage of preventive services, and closes the Medicare drug coverage gap known as the “doughnut hole.” Adapted from http://kff.org/quiz/health-reform-quiz/

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25. The health reform law provides financial help to low- and moderate-income Americans who don't get insurance through their jobs to help them purchase coverage. A. TrueB. False

26. TRUE Tax credits will be available to eligible U.S. citizens and legal immigrants who purchase coverage in the new health insurance exchanges and who have income up to 400% of the federal poverty level ($45,960 for an individual or $94,200 for a family of four in 2013). Adapted from http://kff.org/quiz/health-reform-quiz/

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28. The health reform law creates a new government-run insurance plan to be offered along with private plans? A. True B. False

29. FALSE The law does not create a new government-run health insurance plan. The existing Medicaid program will be expanded to cover more low-income people, government regulation of the health insurance industry will be increased, and tax credits will be provided to make private health insurance more affordable for people. Adapted from http://kff.org/quiz/health-reform-quiz/

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31. The health reform law creates health insurance exchanges or marketplaces where small businesses and people who don't get coverage through their employers can shop for insurance. • True • False

32. TRUE There will be a health insurance marketplace in every state for individuals, families and small businesses. Some marketplaces will be operated by states (such as CoveredCalifornia). Wisconsin has opted to join the federally run marketplace. The marketplace offers a choice of different health plans and provides information to help consumers better understand their options. Adapted from http://kff.org/quiz/health-reform-quiz/