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Laying out Obamacare exceptions

Updated: Monday, September 16, 2013 |
Laying out Obamacare exceptions story image
KALAMAZOO, Mich. (NEWSCHANNEL 3) - Newschannel 3's Healthcare Navigator is helping you sort through the confusion surrounding the Affordable Care Act.

Now, we're looking at health care exemptions.

Not only the hundreds of thousands who are exempt from enrolling in federal health care, but one very noticeable exception to the coverage itself.

Texas Senator Ted Cruz is often the loudest voice in the anti-Obamacare chorus.

His message: Obamacare means big government forcing socialized medicine on America at an unsustainable cost.

Most people will be required to have insurance or face a penalty--but most does not mean all.

While there's no doubt the Affordable Care Act is a game-changer for the entire country, the vast majority of Americans--85 percent--already have insurance and won't have to do anything differently, so long as their current insurance company keeps them on.

"If they're happy with their insurance, there's nothing you need to do on October 1st or January 1st," said Caleb Buhs, with the Department of Insurance and Financial Services. "You already satisfy the requirements of the Affordable Care Act."

Even the uninsured aren't required to enroll in the federal health care marketplace.

But they will pay an annual fine to the federal government for refusing the insurance.

There are, however, some groups who are exempt from Obamacare altogether and not subject to fines.

Certain religious groups, including the Amish, immigrants in the country illegally, Native American tribal members and the incarcerated are not involved.

And you also might have heard about a hardship exemption for folks who simply can't afford even discounted medical coverage.

Well, there is one, but in Michigan, because state lawmakers voted to expand Medicaid, you can't claim a hardship exemption here.

As for those folks who will be eligible for expanded Medicaid in Michigan, once it takes effect next year, they have no two options.

The Department of Community Health says they can not enroll—continue to have no insurance and wait for Medicaid expansion in April of 2014—although they may be subject to a fine from the federal government for doing that.

Or they could enroll, get the federal tax credit, pay a small premium, and then cancel their policy when Medicaid becomes available.

There are also some notable exceptions to the coverage plan provided by the Affordable Care Act—namely no required dental or vision coverage for adults.

Dr. Steve Ray is a dentist in Kalamazoo. He says your mouth is the gateway to your body, and that a chronic lack of dental care can lead to a host of other problems.

"Heart disease, increase your risk for heart attacks, strokes, diabetes,” Dr. Ray said. “For pregnant women is can cause low birth weight."

Because Obamacare doesn't include dental coverage for adults, many dentists fear that dental care will go by the wayside.

"If we can catch things when they're easy, then it's much cheaper and less painful for the patient later on," Dr. Ray said.

Adults who want dental and vision coverage can buy that insurance off the federal exchange, but separately, and at additional expense.

Be sure to stay with Newschannel 3 for the latest on the Affordable Care Act.
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