More on Dying for Care

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THE PLAN
‘They will have to meet these standards’

Of the 19.5 million people living in New York State, 2.7 million do not have insurance. They would be eligible to either apply for the government-assistance program Medicaid or for a health plan through the state's new exchange.

About 1.2 million of the pool of uninsured New Yorkers would qualify for Medicaid.

How will the health care law change Medicaid?

When the greatest changes to the Affordable Care Act take effect in 2014, millions of Americans will become eligible for Medicaid. This includes 1.2 million New Yorkers. Here's how the eligibility rules will change.

Current Medicaid eligibility rules

For an individual

Maximum annual income must be $11,170

For a family of four

Maximum annual income must be $23,050

Another 700,000 people will be able to sign up for plans through the exchange. The health plans will cover a basic level of care that falls under the federal government's list of “essential health benefits,” said Peter Constantakes, spokesman for the state's exchange program. This includes preventative care, prescription drugs and emergency services, among others.

The state has been one of the fastest to move forward with building a health exchange. The exchange functions like a virtual shopping center where people can head online to a website called healthbenefitexchange.ny.gov to search for plans that are expected to be less expensive than what people can find now.

New York is using a health package provided to customers by the small-group plan Oxford EPO to serve as its model of what plans in the exchange should look like, Constantakes said.

“If they're going to want to participate, they will have to meet these standards,” he said.

The exchange will offer a range of plans.

People making up to 400 percent of the federal poverty level, about $44,680 for an individual and $92,200 for a family of four, will be able to get a federal subsidy to help pay for coverage.

So someone with a $30,000 income would be eligible for a $2,500 tax credit, Constantakes said. No one getting a subsidy would pay more than 9.5 percent of their incomes.

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