The Medicaid Option

If, after looking at the plans and the subsidies, health insurance remains out of financial reach for you, the ACA has devised a way for you to get healthcare for you and your family. New York State opted into the Extended Medicaid program, which will be available at little to no cost to you (depending upon income and family size). At the same time that Expanded Medicaid becomes available, the state will be phasing out Child Health Plus and rolling it into the Medicaid program. If your children are currently enrolled in Child Health Plus, they will most likely be covered by Medicaid.

Those on Medicaid can opt to purchase supplemental coverage in the Marketplace, but they won’t be eligible for subsidies to help pay for it. Besides, getting extra coverage through the Marketplace may not make sense. While Medicare will be their main coverage, the cost of any supplemental coverage is borne by the insured. If you are on Medicare, talk about this with a navigator, who can help you learn which options are right for you.

Shared Responsibility Provisions

  • Individuals must have health insurance, if affordable, or pay a penalty.
  • Small employers, with fewer than 50 employees, are not required to offer health coverage or pay for coverage for their employees.
  • Larger employees (50 and more full-time equivalent employees) may face a penalty beginning in 2015 if they do not offer coverage.

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