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Health Insurance Enrollment

Starting January 1, 2014 an estimated 32 million people will have access to health insurance1, with an estimated 11 million having a mental or substance use disorder, but that does not mean there is not a health insurance option for you today. Right now, you, your family members and your friends have a number of options for health insurance. Below are some public and private health insurance resources. Do not wait until 2014, get covered today!

Current Health Insurance Options

Medicaid and the Children's Health Insurance Program

Medicaid and the Children's Health Insurance Program (CHIP) provide health coverage to more than 31 million children, including half of all low-income children in the U.S. The federal government sets minimum guidelines for Medicaid eligibility but States can choose to expand coverage beyond the minimum threshold. Medicaid is a State and federal partnership, Medicaid provides coverage for people with lower incomes, older people, people with disabilities, and some families with children. Information on Medicaid in your State can be found at Medicaid.gov.

In addition, all States have expanded coverage for children through the Children's Health Insurance Program. The Centers for Medicare and Medicaid has extensive efforts underway, supported by the Children's Health Insurance Program Reauthorization Act (CHIPRA), to work with states and other stakeholders to find and enroll uninsured children who are eligible for Medicaid or CHIP, through the Connecting Kids to Coverage Challenge. More information is available in the CHIP section or on the Children's page.

Medicare

Medicare is health insurance for people age 65 or older, people under 65 with certain disabilities, and people of all ages with End-Stage Renal Disease. Check your eligibility for Medicare.

Preexisting Condition Insurance Plan

The Pre-Existing Condition Insurance Plan makes health coverage available to you if you are a U.S. citizen or reside here legally, you have been denied health insurance because of a pre-existing condition, and you've been uninsured for at least six months. For more information, check out SAMHSA's tip sheet on the Pre-Existing Insurance Condition Plan (PDF 1.04MB) or to find a plan in your State, check out healthcare.gov.

Health Insurance Options – Starting January 1, 2014

Expanded Medicaid

Starting January 2014, Medicaid eligibility will be simplified and expanded for individuals ages 19-64 at or below 133% of the Federal Poverty Level, which is currently $14,856 for an individual and $30,656 for a family of four. Many adults without children will be able to access insurance coverage for the first time through their State's Medicaid program. More information on expanded Medicaid can be found at medicaid.gov.

Affordable Insurance Exchanges

Starting in 2014, Exchanges will allow individuals and small businesses to compare health plans, get answers to questions, find out if they are eligible for tax credits for private insurance or public health programs, and enroll in a health plan that meets their needs. For individuals between 134-399% of the Federal Poverty Level, which is currently $14,968 - $44,568 for an individual and $30,887 - $91,970 for a family of four, subsidies for purchase of health insurance will be available on a sliding scale based on income. More information on Affordable Insurance Exchanges can be found at healthcare.gov.

Have general questions about how the health reform law affects you, your family or your small business? Check out healthcare.gov or Kaiser's Consumer Guide to the Health Reform Law exit disclaimer icon.

Important Populations

Young Adults

Young adults

Young adults (age 18-34) in the United States have one of the highest uninsured rates. Reasons for not having coverage include cost, difficult enrollment processes, and the culture of believing insurance coverage isn't necessary because they are young and healthy. While eligibility won't be completely expanded until 2014, there are many coverage options currently available.

Sustaining Coverage

Smiling older couple

While enrolling in an insurance plan is considered a first step, keeping that coverage is the important next step in living a healthy life. A national report found that 38% of the Medicaid population under age 65 experiences an interruption in health insurance coverage over a three year period. That same report shows that people with a mental or substance use disorder are more likely to have difficulty sustaining coverage.

Additional Resources

Resources for Providers

Smiling doctor

Providers will see an increase in people they serve and play an important role in the public education and enrollment efforts. If you are a provider or provider association, here are some resources that will help you or our other providers in preparing for expanded insurance coverage. More information on providers can be found on SAMHSA's provider resources page.

Resources for States

Courthouse with bell tower

As January 1, 2014 nears, states are preparing for expanded eligibility in Medicaid and the establishment of Affordable Insurance Exchanges at a State or Federal level. More information on enrollment best practices, processes, and regulations can be found on SAMHSA's State resources page.

  1. Congressional Budget Office. CBO's Analysis of the Major Health Care Legislation Enacted in March 2010. (March 20, 2011). Retrieved January 10, 2012 from www.cbo.gov/publication/22077