Key Things You Need to Know About the Affordable Care Act in Texas

As a Dallas-Fort Worth personal injury lawyer, I know that the Affordable Care Act has the potential to make a huge difference to those Texans without any form of health insurance, who are confronted by huge medical bills in the wake of being injured in a motor vehicle accident that they have no hope of paying – especially if the negligent driver who caused their wreck didn’t have any auto insurance themselves.


To help all Texas residents understand exactly what the Affordable Care Act involves, including who is eligible for Tax Credits to Offset Premium Costs, our law firm has compiled the following information which we hope you find useful.


Health Insurance is Now Mandatory for All Texas

The Affordable Care Act makes health insurance mandatory for all Texas starting in 2014. However, it is up to you (either as a family or as an individual) to enroll for health insurance. If you don’t, you will be fined. Starting in 2015, people without health insurance the previous year will be fined $95 on their tax returns. This will increase to a $695 fine or 2.5 percent of their total income in 2016.


2.6 Million Texans Are Eligible for Tax Credits to Offset Premium Costs

Individuals and families with total household incomes of as much as 400 percent of the Federal Poverty Level may be eligible for tax credits to offset their health insurance premium costs. This means individuals earning up to $45,960 annually. For a family of four, the total household income can be up to $94,200. Within Tarrant and Parker Counties specifically, 191,330 people are expected to be eligible for these credits. In Dallas County, 291,960 people will be eligible. These credits are financed entirely by the federal government. The amount of credit available to you will vary depending on the size of your family, your total household income, and the level of plan you elect to enroll in.


Health Insurance Plans Available

Under the Affordable Care Act, insurers are prohibited from denying coverage to people with pre-existing conditions, and all packages must offer comprehensive coverage to include outpatient care, emergency care, hospitalization, prescription drugs, maternity and newborn care, mental health and substance abuse treatment, rehabilitative and habilitative care, laboratory services, preventative and wellness services, chronic disease management, and pediatric services (including dental and vision care.) There will be four levels of plan available, depending on how much you’re willing to pay on premiums, and how high of a deductible you want: the Bronze plan covers 60 percent of medical costs, Silver covers 70 percent, Gold covers 80 percent, and Platinum covers 90 percent.


Key Dates You Need to Be Aware of

Open enrollment begins October 1, 2013 and closes on March 31, 2014. In order for your coverage to start on January 1, 2014, you must enroll by December 15, 2013.


How to Enroll

Before you enroll, you need to have the following information completed and available:

  • Your social security number (or document numbers for legal immigrants without a SSN)
  • W-2 forms (or wage and tax statements for every family member who needs coverage)
  • Policy numbers for any current health insurance plans
  • A completed Employer Coverage Tool


Once you have all this information, you can enroll online at or call 800-318-2596.


To find a local health center that has been approved to offer assistance by the U.S. Department of Health and Human Services, click here.



Other Articles You Might Be Interested In:

Making Sure Your Hospital Bills Are Paid

Subrogation: Why You Have to Pay Back Your Health Insurance Company After an Accident

Car Accidents Cause Chronic Pain and Serious Injuries

Damages Recoverable in a Texas Personal Injury Claim

My Personal Care Physician Refused to Treat Me After My Accident

Mark A. Anderson
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Board Certified Personal Injury Lawyer in Fort Worth, Texas