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How the Health Care Reform could affect Nebraskans
It is the most significant government expansion and regulatory overhaul of the U.S. healthcare system since the passage of Medicare and Medicaid in 1965.
It's been 3 years now since the Patient Protection and Affordable Care Act went into law.
But what exactly is the law and how will one of its biggest provision effect Americans come 2014?
"The fundamental thrust of the law was to cover the uninsured," said Sean McGuire, E.D. Bellis.
President Barack Obama singed into the law the Federal Health Care Act on March 23, 2010.
At the time 46 million American were uninsured.
"It's coming to fruition here in 2013 and it's having a big impact on individuals and businesses alike," McGuire said.
The act includes numerous provisions that will take 10 years to fully take effect.
They began in 2010 and will be fully implemented by 2020, but one of the biggest impacts will take effect next year.
"Beginning January 1st, 2014, businesses over 50 employees have to provide health insurance coverage, an option, to their employees or face a penalty of 2000 dollars per employee," McGuire said.
And it's not just businesses that will be affected.
"The law has what's called an individual mandate and that means an individual that is an American citizen that cannot demonstrate an exemption, whether its religious or native American or otherwise, has to have health insurance, they have to prove it on their taxes beginning in 2014," McGuire said.
Sean McGuire runs E.D. Bellis, a consulting firm in Omaha that helps businesses and individuals understand the law.
"At the end of the day, it's on every single individual to purchase some sort of health insurance coverage effective January 1st, 2014," McGuire said.
The law is aimed primarily at decreasing the number of uninsured Americans and reducing the overall costs of health care.
But some feel, they simply won't be able to afford it.
"Being a single mom of three kids it's kind of a touchy situation," said Jenny Reed of Grand Island. "It's not really affordable for me, for myself and the three kids. It would ruin me, pretty much most of my paycheck every 2 weeks."
"You got to have it; otherwise you'll go bankrupt if you get a bad illness," said Leon Kyle of Grand Island.
Some say the insurance part could actually be a good thing for families.
"It would be beneficial for everyone to have insurance in order to be able to be seen by the doctor or get any kind of health issues taken care of," Reed said.
But say they shouldn't be required to have it.
"I don't believe it should be that way, I really don't," Kyle added.
Since becoming law, "Obamacare" as it's often referred to, has faced numerous challenges.
Opponents turned to the federal courts to challenge the constitutionality of the legislation, but the Supreme Court upheld the individual mandate.
Along with the mandate in 2014, health insurance exchanges will also take effect.
"Health insurance exchange is a market place that's created under the law where the uninsured individuals and small businesses can go purchase coverage," McGuire said.
As to just how the law will affect American, only time will tell.
"Because of the fact that it's still being written, and that fact that it's just now starting to roll out, I can't fully answer that question but I think there are some serious red flags and revisions that we know about now, that need to be addressed," McGuire added.
But there is one thing for certain.
"Like it, love it, it's here, it's not going away and it's going to be an evolving product over time," McGuire said.
In November, Gov. Dave Heineman announced Nebraska will participate in the Federal Health Care Exchange.
The Governor said a Federal Exchange would be far more affordable for the state, and would cost Nebraska about $470 million less than a state-run exchange.
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