What does health care reform mean for me?

Who is this for?

Michigan Health Insurance – Customer Service – Learn More

If you’re under age 65 and you're looking for help understanding health care reform, this information can help you sort through the confusion.

One of the goals of the Affordable Care Act is to improve the quality and safety of health care. In that way, health care reform means better care for everyone. 

Other provisions of the Affordable Care Act help people get health insurance who couldn't before. They also help make coverage more affordable. So what does health care reform mean to you? It may depend on how you get your insurance, or whether you have any.

If you're insured through an employer

Employers with more than 50 full-time employees weren't required to make changes to the health plans they offer. If your employer has fewer than 50 full-time employees, health care reform means your coverage changed. That's because small-group health plans must cover the same basic set of benefits and plans you buy yourself.

Regardless of business size, your employer's plan may not be your only option. If the coverage your employer offers doesn't meet certain health care reform guidelines, it might be cheaper for you buy your health insurance. Then you may qualify for a tax credit that lowers your costs. What are those guidelines?

  • Your annual share of the cost of your plan's premium for one person is more than 9.5 percent of your household income.
  • Your plan doesn't share at least 60 percent of the cost of covered services.

If you buy your own health insurance

Health care reform brought a lot of changes to people who buy their own health insurance. It means that your health plan:

  • Must meet Affordable Care Act requirements.
  • Covers a basic set of services, called essential health benefits.
  • Falls into one of four metal tiers.

It also means you may be able to get financial assistance from the government that lowers the cost of your health insurance. This assistance is called a subsidy. One subsidy lowers your monthly payment. Another kind of subsidy lowers your share of the costs. Many people qualify. When you're shopping for plans, you'll be able to see if you qualify for lower costs

If you don't have health insurance

Health care reform has made it possible for more people to get coverage. How?

  • Health insurance companies can't turn you down because you're sick or have a medical condition. They also can't charge you more based on your health.
  • You may get help paying for your plan, or be eligible for plans with lower deductibles and other cost sharing. This help is called a subsidy.
  • More people are now eligible for coverage through the state of Michigan that costs you very little or nothing. These programs include Medicaid, the Healthy Michigan Plan and the Children's Health Insurance Program.

If you're uninsured, it's time to get covered. If you don't, you could pay a fee. Learn more.