Question: I am 60 years old, single and not married. I own my house, no mortgage. I am unemployed and a caregiver for my elderly father (he lives with me). I now buy my own health insurance with my savings. When the affordable care act goes into effect in 2014 and I am still unemployed what next? What are my options for healthcare coverage? 

Do I buy from a health care exchange, or keep buying insurance with my savings? If I still buy my insurance do I fill out a 1040 form with me not having any income and be compensated when I list the money paid for insurance. I would like to know how I will be subsidized for the money put out!!! I'm lost.

- Bruce

Answer: Bruce - You should find it much easier to enroll and pay for health insurance once the Affordable Care Act takes full effect in 2014. The insurance exchange in your state will direct you to a menu of different policies from which you can choose. If your income falls below 400% of the federal poverty level, which is $45,960 in 2013, you will be eligible to receive a subsidy to help with the cost. The exchange will automatically deduct the amount of the subsidy from the premiums you have to pay. You will not have to file a form 1040 to receive it.

Edit: July 11, 2013

Question: I forgot to insert my state Pennsylvania, or any state that opts out of ACA. Where do I go from there. How do I get subsidized, or do I?

- Bruce

Answer: Insurance exchanges will operate in all states, including those, like Pennsylvania, that have opted not to run them on their own. The exchange in Pennsylvania will be operated by the federal government, and the subsidies provided for by the Affordable Care Act will be available through it. When you apply to the exchange for coverage, you will be asked to enter your annual income. If it is less than 400% of the federal poverty level, the subsidy amount will automatically be calculated and deducted from the cost of the coverage.


Robert I. Field, Ph.D., J.D., M.P.H. is a professor of law at the Earle Mack School of Law and professor of health management and policy at the School of Public Health at Drexel University. He also writes for The Field Clinic blog. Ask Rob your questions about the new healthcare law.