This time next year, East Texans living without health insurance will pay some hefty fines. It's all because of the Patient Protection and the Affordable Care Act, which is designed to reduce healthcare costs and offer more affordable plans.
Starting October 1, 2013, open enrollment will begin and insurance companies will compete in a health insurance exchange pool, which will help decrease insurance premiums.
"It's coming down fast and we really didn't think this would happen," said John Wynn, the sole proprietor of Wynn Life and Health Insurance in Lufkin.
Even though we have almost a year before the PPACA requires most U.S. citizens to get health insurance, Wynn says it's time to start planning now.
"I've been told from people in a home office that they are estimating it's going to be 30 to 40 percent higher than what it is now. For you who do not have insurance, find you a local agent, get with them, because you'd be better off to buy the insurance now while they still underwrite it," Wynn said.
According to the PPACA, private insurance, Medicare and Medicaid will not be replaced.
"The poor are always going to be taken care of by Medicaid. So when it gets back to the Obama health care, well the people are now saying it's not going to be affordable," Wynn said.
The PPACA says those that do not get health insurance by 2014, will have to pay annual taxes of up to $95. Each year those taxes will increase and by 2016, the rate will be $695 per adult. After the year 2016, the tax penalty increase annually based on cost-of-living adjustments. But the PPACA says those people will only have to pay one-twelfth of the total annual penalty for each month without coverage.
Right now, Texas is currently ranked as the fifth state in the nation for the most uninsured citizens.
"It's just gotten too expensive. People are paying health insurance premiums that's more than their mortgage," Wynn said.
The U.S. Census Bureau lists uninsured citizens made up about 30 percent of the state's population in 2006.
"Another thing is we have free will. People have the freewill to buy the insurance or to not buy the insurance and a lot of people are choosing to not buy the health insurance," Wynn said.
But that won't be the case in January. Insurers will have to cover everyone, regardless of health status or history meaning everyone will have to get health insurance.
However, there are some exceptions to the act. The PPACA lists individuals and families below a certain income, people who cannot afford coverage, individuals who have been uninsured for less than three months, members of American Indian tribes, and people who do not obtain coverage because of religious objection will not be expected to pay the fines for not having health insurance.
Wynn says young adults can stay on their parent's coverage until the age of 26 and he believes those with pre-existing conditions, like diabetes, low-income families and seniors will benefit the most from the act. He says he also thinks young adults who are just getting off their parent's coverage should consider joining a company-based insurance plan at their job.
"My advice to the people is to get in a policy now. While it's still underwritten. If you got medical problems, if you have pre-existing conditions that you are being declined, you will be able to get it in 2014. But, if you're healthy, get into it now. And hopefully you won't be thrown into that block of business with all the ones with pre-existing conditions where the healthy is paying for those with those conditions," Wynn said.
Wynn believes there are many more pros and cons to this act, but the best thing right now is to make sure our health is insured before the act goes into affect.
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