Most people who have coverage at work — about 160 million — will continue their coverage without any significant changes. The big changes will come for millions of Americans without coverage. Individuals who do not have insurance at work and small businesses (with 50 or fewer full-time workers) will be able to buy coverage through exchanges run by the states, websites on which buyers can compare and purchase policies, starting in 2014.
Tax credits will be available to help people buy insurance. This financial help will be available to those with incomes equal to 400 percent of the federal poverty standard (an amount equal to $43,560 for an individual and $89,400 for a family of four in 2011). The coverage is for people who do not have insurance through work. People also cannot be eligible for federal programs such as Medicare and Medicaid.
“The premium tax credits will be advanceable and refundable, meaning they will be available when an individual purchases coverage and will be available regardless of whether or not an individual owes any taxes,” according to a report by the Kaiser Family Foundation. “The premium tax credits will vary with income and are structured so that the premium an individual or family will have to pay will not exceed a specified percentage of income, ranging from 2 percent for those with incomes up to 133 percent of the poverty level ($14,484 for an individual) to 9.5 percent for those with incomes between 300 and 400 percent of the poverty level ($32,670 to $43,560 for an individual).
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