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Friday, February 22, 2013 2:24 PM

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DELPHOS — The Affordable Care Act (ACA) will swing into action on January 1, 2014, and this year’s tax returns will determine who is eligible for government assistance and/or Medicaid for insurance coverage and who  is not.

H&R Block Tax consultant Denise Buettner spoke on the government-mandated insurance specifics and described the free service being offered to customers this tax season. Depending on their circumstance, the checkup will help them explore their options and guide them in the right direction.

“The checkup is geared to help people who don’t have insurance get insurance,” Buettner detailed. “For example, some people may qualify for a subsidy paid for by the government to the health-care provider or be eligible for Medicaid.”

After the first of next year, all Americans will have access to health insurance options. The new Health Insurance Marketplace will allow individuals and small businesses to compare health plans on a level playing field. Middle- and low-income families will get tax credits that cover a significant portion of the cost of coverage. And the Medicaid program will be expanded to cover more low-income Americans.

“To apply, the individual will need their 2012 tax return since income is used as the determining factor,” Buettner explained.

With the deadline for compliance looming, Ohio residents have the next eight months to prepare for the application process beginning on Oct. 1.

Starting in 2014, if an employer doesn’t offer insurance, individuals will be able to buy it directly in the Health Insurance Marketplace. According to, individuals and small businesses can buy qualified health benefit plans in this new transparent and competitive insurance marketplace, which will offer a choice of health plans that meet certain benefits and cost standards.

By signing up, creating an account and logging onto the official online marketplace, an individual can shop for the best deal. Depending on the income level, the individual will pay part of the premium and the federal government will pay the rest.

The health care law seeks to enroll people into the Medicaid program who earn up to 133 percent of the federal poverty level, which is $14,856 this year.
If a single individual earns close to $15,000 per year — about equal to a full-time minimum-wage job — or if a family of four makes $32,000 per year, they will be covered by Medicaid with no premiums and no cost-sharing.

“There is a fine for people who don’t sign up and it incrementally increases each year,” Buettner gave more details. “In 2014, tax filers must show they have health insurance coverage or they are penalized. In 2014, it would be $95 per uninsured person, in 2015 it would be $325 and in 2016, it will more than double to $695.”
In Ohio, the ACA requires that all non-grandfathered individual and small-group plans sold in a state, including those offered through the exchange, cover certain defined health benefits. At this time, Ohio’s benchmark Essential Health Benefits (EBE) plan will default to the largest small-group plan in the state, Community Insurance Company (Anthem Blue Cross Blue Shield) - Blue Access PPO.

Affordable Insurance Exchanges will provide individuals and small businesses with one-stop shop to find and compare affordable, quality private health insurance options. Exchanges will allow consumers to compare plans based on price and quality and increase competition between insurance companies, which will lower costs.

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