Signed into law on March 23, 2010, the Patient Protection and Affordable Care Act (PPACA) will go into effect on October 1, 2013. The PPACA is commonly referred to as Obamacare.
New options for choosing a healthcare plan under this Act will start October 1st of this year and end on March 31, 2014.
The topics below may help to assess your needs under the PPACA.
Key dates and coverage
- If you want coverage to start on January 1, 2014 you must sign up by December 23, 2013, in a Covered California-approved plan (PDF), and make your first premium payment by December 31st. .
- The open enrollment for 2014 health insurance coverage ends on March 31, 2014. “After March 31, 2014, you can get new private health insurance for 2014 only through a special enrollment period if you have a qualifying life event like a job loss, birth, or divorce.” Source: healthcare.gov
- After March 31, 2014, if you can afford to pay for health insurance but do not have coverage, you may be assessed a fine.
If you currently do not have any health insurance
- California residents who do not have medical coverage do not have to wait until the open enrollment period to get started. See if you qualify for Medi-cal insurance.
San Francisco residents who do not have coverage and need Medi-cal can contact the local Medi-Cal Health Connections Office:1440 Harrison Street (between 10th Street and 11th)
San Francisco, CA 94103
Open Monday - Friday from 8:00 a.m. to 5:00 p.m.
Call (415) 863-9892
Email them at SFMedi-Cal@sfgov.org
Apply online at https://www.mybenefitscalwin.org/
View more information (PDF)
- If you are low income but are not eligible for Medi-cal, you may qualify for the State of California Healthy Families or the City's Healthy Kids program.
- San Francisco residents may qualify for the Healthy San Francisco plan.
- If you are not a California resident and do not have health insurance, you can find a health center near you.
If you currently have coverage
If you have an individual insurance plan but are thinking of changing it, review this federal Healthcare.gov site.
Interactive sites to determine your needs
- Plan ahead by using this healthcare.gov site and identifying your insurance options.
- Before you begin the application process, answer less than ten questions and get a list of coverage options, and a personalized checklist of what needs to be done.
- Based on your tax return, enter information about your household size and income. The calculator will estimate your monthly cost for insurance.
Self-employed individuals and small businesses
- Find out if you are defined as self-employed and the options you have.
- If you have 50 or fewer full time equivalent employees, you may qualify for the SHOP marketplace. If you have 50 or more full time equivalent employees, you may qualify for the Employer Shared Responsibility Payment program.
- If you have 25 or fewer employees, you may qualify for a small business healthcare tax credit.
- As a small business employer do you have to offer coverage at all? Find out here.
- If you already insure your employees, see what changes, if any, affect you.
- Will COBRA coverage be affected by the new reform laws?
- See more information about COBRA and healthcare reform from the perspective of the Department of Labor.
IRS and tax issues
The IRS will play a role in the PPACA, affecting itemized medical deductions, W-2 reporting, and other tax-related topics.
Open enrollment assistance
The clinics and organizations listed below will help you to enroll in an insurance program.
- Click on a state and find an enrollment center near you.
- San Francisco centers assisting in open enrollment
"Medicare is the federal health insurance program for people who are 65 or older, certain younger people with disabilities, and people with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a transplant, sometimes called ESRD."
- If you have Medicare is there anything that needs to be done? Find out here.
- See how the new laws will affect your Medicare coverage. Your coverage may include other free services.
Medicaid is a "state-administered health insurance program for low-income families and children, pregnant women, the elderly, people with disabilities, and in some states, other adults. The Federal government provides a portion of the funding for Medicaid and sets guidelines for the program. States also have choices in how they design their program, so Medicaid varies state by state and may have a different name in your state."
A pre-existing condition is defined as “a health problem you had before the date that new health coverage starts.” Source: Healthcare.gov
The law itself
- Department of Health and Human Services features highlights of the PPACA. Overview and timeline of the PPACA from 2010 - 2015.
- The UCLA School of Law has created a resource page on federal legislation, bill summaries, etc.
State - national
Representing all 50 states, the National Conference of State Legislatures provides information on the PPACA and its health benefit plans, implementation, and other policy issues.
State – California
State Assembly; Committee on Health; Special Session on the PPACA.
Research and statistics
The National Library of Medicine provides abstracts and full text articles on the PPACA. Articles range from policy law, governance, the impact of the PPACA, etc. Enter “PPACA” in the search box at this site: http://www.ncbi.nlm.nih.gov/pubmed
State – California
- Legislative Analyst’s Office – “The Patient Protection and Affordable Care Act: An Overview of Its Potential Impact on State Health Programs.”
- Department of Insurance – List of reforms currently in force and reforms to be implemented in 2014.
- Factors Affecting Premium Rates in California 2014 a Milliman Client Report prepared for Covered California.
County/City – San Francisco
A PowerPoint presentation of Covered California (PDF) authored by the Health Service System, City and County of San Francisco.
- The Institute of Medicine, a non-profit organization, aids the government and private sector in making informed decisions concerning health issues. Enter “PPACA” in the search box.
- San Francisco Public Library card holders can access full text articles via our Articles and Databases page. Suggested databases include Opposing Viewpoints, Rand California, Consumer Health Complete, etc.
- Since 1923, CQ Researcher has reported on health, criminal justice, international affairs, etc. San Francisco Public Library does not have online access to CQ Researcher; however print copies for the years 1991 – current are available at the Main Library, including the article “Assessing the New Health Care Law,” dated September 21, 2012.
Resources for librarians
- Resources for library staff authored by the American Library Association
- OCLC WebJunction – view archived webinars relating to the Affordable Care Act.
- Researching since World War II, RAND analyzes health, education, the environment, and public policy issues.
- State of California – Health Benefits Exchange Stakeholders Webpage
- National Network of Libraries of Medicine - information and resources for California libraries.
- Affordable Care Act Resources for California Public Library Staff by Infopeople.org
Other language resources
- Healthcare.gov. Choose from Cantonese, French, French Creole, Russian, Gujarati, Hindi, Korean, Polish, Portuguese, Spanish, Tagalog, Vietnamese, and German.
- Covered California. Select the drop down menu for Spanish, Chinese, Arabic, Armenian, Farsi, Hmong, Khmer, Korean, Lao, Russian, Tagalog, and Vietnamese.
- Health Insurance Marketplace - Materials in Other Languages
- Downloadable pamphlets in English and Spanish from publications.usa.gov
- Healthcare.gov Help Center
- 1-800-318-2596. Available 24 / 7
For small businesses: 1-800-706-7893. Available 9-5pm (EST)
- Covered California
- 1- 888-975-1142