Back to Resources

Seniors and the ACA

posted on Wed, Aug 1 2012 12:00 am by Southeastern Region

One recent question came from a state public health official who asked about the applicability of the Affordable Care Act to individuals over the age of 65. The requestor specifically asked whether the provision prohibiting the denial of coverage based on pre-existing conditions would apply to individuals of all ages and whether the penalty applied to individuals who do not purchase insurance would affect people over 65 who do not qualify for Medicare or Medicaid. The requestor also asked what options exist for elderly individuals without Medicare or Medicaid coverage to purchase insurance. 

In regards to provisions surrounding pre-existing conditions, the Network informed the requestor that, after January 1st, 2014, no individual may be refused coverage because of a pre-existing condition, no matter their age. Rates can be affected to some degree, however, as insurers are permitted to take the age of an individual into account when setting premiums.

The Network next responded to the requestor's second question. The response stated that generally any individual who earns enough income to file a tax return is subject to the penalty applied to those who do not meet the minimum coverage requirement. Individuals who do not qualify for Medicaid or Medicare may still be able to receive subsidies to purchase insurance through Exchanges, which are provided by the federal government to people between 100 percent and 400 percent of poverty. The Network referred the requestor to a brief by the Henry J. Kaiser Family Foundation for more information on Exchange subsidies.