Health law means freedom for some

Already, one group of Americans -- the 19- to 25-year-olds -- is clearly on board with health reform. Millions of them, 6.6 million by one estimate -- have been able to stay on their parents' health insurance plan because of the Affordable Care Act.

While the landmark legislation still has many critics, and Republicans vow to repeal the law, "one demographic is very happy with health care reform -- young Americans," MainStreet says.

We can think of two other groups that will likely get a case of happy feet when health insurers are required, in 2014, to sell individual coverage to anyone who applies, regardless of their medical past -- and not charge them more because of it.

• Those who want to -- or are forced to -- retire early and will have to buy their own health insurance until they reach 65 and can enroll in Medicare.  
• Those who want to leave -- or have left -- a job and become self-employed, and fear they won't be able to find affordable insurance because of a pre-existing condition.

For both groups, health reform spells freedom to pursue a new life without that major worry, particularly now that U.S. Supreme Court has confirmed the act's constitutionality. That's huge.

Why? Said Generation X Finance blogger Jeremy Vohwinkle:

Anyone who is fortunate enough to have a full-time job that provides health benefits probably gives little thought to their health insurance other than grumbling about the premiums. But those who are self-employed, work part time, or otherwise don't have health insurance provided as a benefit are living in an entirely different world.

Of the two groups we mentioned in particular, how many folks are we talking about? According to The Commonwealth Fund, 9 million people between 50 and 64 didn't have health insurance in 2010. According to the federal government, the percentage of large companies that provide retiree health coverage fell from 66% in 1988 to 29% in 2009. (Post continues below.)

There's no way to count the people who are staying with a job they hate just for the health benefits, or those who are already on their own and relish the possibility of easily accessing insurance. But it's clear that going without is common. Blogger J.D. Roth at Get Rich Slowly relayed his difficulties in finding an insurer who would accept him when he had to buy individual insurance. 

I asked my self-employed friends what they do for health insurance. (Shocking but true answer: Most of them don't have health insurance. No joke.)

Marci Alboher got lots of feedback when she asked New York Times readers who were self-employed how they found insurance back in 2008. She wrote:

The unluckiest are those with chronic illnesses or the dreaded pre-existing condition that results in a denial of coverage. Many of these people abandon dreams of entrepreneurship altogether because they need jobs that come with a health plan and they cannot find a way to self-insure.

It's true that buying health insurance on the individual market can be affordable, even easy, if you're healthy and young. Otherwise, it can be daunting. According to a study by The Commonwealth Fund:

Nearly two-thirds (62%) of those who tried to buy individual health insurance policies in the past three years found it very difficult or impossible to find affordable coverage. Nearly one-third (31%) were turned down, charged a higher price, or had a condition excluded because of a pre-existing condition. Sixty percent of those who tried to purchase a plan on their own said they found it very or somewhat difficult to compare the benefits provided by different plans. Nearly half (45%) said they never bought a plan, mainly because of cost.  

The health care law does include some stopgap measures to help both groups -- the Early Retiree Reinsurance Program for retirees whose former employers opted to participate, and the Pre-Existing Condition Insurance Plan for those who haven't had insurance for at least six months.

But how much better it will be, come 2014, to buy individual coverage through a state health insurance exchange, with the knowledge that you can't be turned down or charged more because of health problems -- the same legal protections that people who get their insurance through work have had for years? No more worry and crazy hoops to jump through.

Sounds good so far. But can we get a ballpark on what this insurance will cost? We got some estimates from the Health Reform Subsidy Calculator provided by the Kaiser Family Foundation. Remember that the Affordable Care Act provides tax credits to enable those whose incomes are between 133% and 400% of the poverty line to afford the premiums. (Medicaid is supposed to pick up people with lower incomes.) 

We played around with some of the variables in the calculator. To keep it simple, we limited our examples to single adults who live in medium-cost areas, have no access to health care through work-based coverage, and purchase a silver plan. (Plans will range from bronze to platinum.)

• Example 1: A 60-year-old single adult with income of $30,000. The estimated cost of coverage is $10,172. Our 60-year-old would be required to pay $2,509 ($209 a month) of that premium (and get a tax credit for the balance), plus no more than $3,125 additional out-of-pocket under this plan.
• Example 2: A 50-year-old earning $70,000. That person would have to cover the full $6,978 annual premium ($581.50 a month), and up to $6,250 additional out-of-pocket expenses.
• Example 3: A 45-year-old earning $60,000. This person would pay the full $5,606 freight ($467 a month) for premiums, plus up to $6,250 in out-of-pocket expenses.

So, health insurance still won't be cheap, but it will be accessible. And health reform also limits how much more you can be charged for insurance as you age.

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Self-employed and uninsured right now? Kerry Hannon offered eight possible solutions on Forbes. And don't forget that if you pay for insurance now and you're self-employed, the premiums you pay for your individual policy are tax-deductible.

Do you plan to take advantage in 2014 by retiring early or quitting a job to start a brand-new enterprise? Are you looking forward to that?

More on MSN Money:

• Who benefits from health care ruling
• What health care ruling means to you
• How to save on college health care
• Best health insurance companies
• What Obamacare means for taxes
• 10 ways to slash your medical costs