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Obama health law anniversary finds two Americas
Politics » 26 mostly red states decline to run their own insurance exchanges, so the feds will step in.


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Finally, there’s the passive and unengaged. "For these people, a significant education effort needs to happen," he said.

To keep premiums affordable, the government will need to sign up lots of people from the last two groups to balance those in poor health, who will have a strong motivation to join.

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At a glance

A closer look at Obama’s health care overhaul

The Patient Protection and Affordable Care Act is the biggest safety-net legislation since Medicare and Medicaid in 1965.

Enrollment starts Oct. 1; coverage takes effect Jan. 1.

It will move the U.S. closer to other industrialized nations that provide health care for all. About 30 million uninsured Americans will eventually gain coverage, at an estimated cost of $1.3 trillion from 2013-2023. Insurers won’t be able to turn away people with health problems.

The law mandates that most individuals have health insurance, provides subsidies to help pay premiums and penalizes people who can afford coverage but don’t get it. It imposes penalties on businesses with 50 or more full-time workers that don’t offer coverage.

Health insurance exchanges set up in each state will offer subsidized private health plans to middle-class households. Medicaid, the government’s health insurance for the poor, will be expanded to cover low-income people making up to about $15,400 for an individual. States can opt out of the Medicaid expansion.

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The official heading consumer outreach for the rollout, Julie Bataille, acknowledges the challenge but says she’s confident.

"This is a really an enormous opportunity for us to change the conversation around health care and help individuals understand the benefits they can get," she said.




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