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Obamacare 101: What happens starting Oct. 1? (+video)

Oct. 1 is the first day the uninsured can shop on the new online marketplaces, or 'exchanges,' for health-care coverage. Under Obamacare, they have until March 31, 2014, to enroll in a health plan, or opt to pay a penalty later.

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The ACA provides for the expansion of Medicaid by raising the income limits for eligibility, but expansion does not go into effect until Jan. 1. The US Supreme Court ruled in June 2012 that states could opt out of Medicaid expansion if they want; so far, 26 states have decided to expand eligibility for Medicaid, owing to the generous federal subsidies.  

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Could Oct. 1, the first day of enrollment on the health insurance exchanges, be chaotic?

There has been a lot of media coverage focused on problems and delays in implementing the law. In July, the Obama administration announced a one-year delay of the mandate for large employers to cover their workers. And on Sept. 26, the administration announced that online enrollment in the marketplace for small businesses (fewer than 50 employees) will be delayed until Nov. 1.

But Obama administration officials maintain that they’re ready for online enrollment for individuals and families to begin Oct. 1. Still, don’t expect a flood of enrollments right when the bell rings.

“October will be light for enrollment,” says David Simas, deputy senior adviser for communications at the White House. “November will be a little bit better. December, as people know [they] can now sign up and get coverage in a few weeks, will be better.”

Mr. Simas expects a dropoff in enrollment in January and February, with another increase in March right before the enrollment period ends.

What about immigrants?

People in the country illegally are not eligible to enroll in coverage via the exchanges. Legal immigrants, including people with green cards, are eligible. But they cannot enroll in Medicaid until they have been in the US for five years.

Also in the Obamacare 101 series:

What to know if you already have health insurance

How the federal subsidy works

• What to know if you opt out of buying health insurance

What owners of small businesses need to know

• When will the enrollment glitches be fixed?

What college students need to know

Seven ways you can sign up, despite Web woes

Enroll by March 31 to avoid penalty, White House clarifies


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