In New Health Law, a Bridge to Medicare Juanita Stonebraker, 63, is retired. She is diabetic, so insurers won't cover her. The new law will force them to. THE sweeping federal health care law making its major public debut next month was meant for people like Juanita Stonebraker, 63, from Oakland, Md., who retired from her job in a hospital billing office a year and a half ago. She was able to continue her health insurance coverage from the hospital for a time, but when she tried to find an individual policy on her own, none of the insurers she contacted would cover her because she was diabetic. "I didn't even get to tell them about the heart attack," said Ms. Stonebraker, who has been without health insurance since July. She is a little over a year away from qualifying for Medicare, the federal insurance program for people 65 and older. She now worries a recent hospitalization will leave her several thousand dollars in debt. Under the Affordable Care Act, or Obamacare, insurers must now offer coverage to people like Ms. Stonebraker, and they will not be able to set the premiums they charge on the basis of someone's health. Starting Oct. 1, she and millions of other Americans are expected to be able to buy one of the plans available through newly created online state marketplaces, or exchanges, for coverage that begins in 2014. For those with low incomes, subsidies are available to help pay premiums. "The state and federal exchanges create a great opportunity for pre-65 retirees to get coverage like never before," said John Grosso, a senior executive overseeing retiree health care for Aon Hewitt, a benefits consultant. While older people could pay up to three times as much as younger people buying coverage, because rates can take account of age, the marketplaces could allow them to buy a policy for much less than they would pay today in some states, particularly those people with expensive medical conditions. Early retirees are "the big group of winners in this equation," said Edward A. Kaplan, a senior benefits consultant at the Segal Company, who said many of the premiums he had seen so far in the states that had made them public were relatively low, with subsidies making them even lower. "You may get significant relief," he said. For those who are already well insured, through Medicare or private coverage, the law seems like a threat. Even after its long and rocky rollout, the 2010 law continues to face strong opposition from many Americans, especially older people who worry that their Medicare benefits will be cut to pay for coverage for the uninsured. While the Affordable Care Act seeks hundreds of billions of dollars in savings from the Medicare program over 10 years, the benefits of people covered under the program were essentially untouched by the law; instead, the law focuses on curbing payments to providers and insurers, which could make them less inclined to accept Medicare patients in the future. But the growth in health care spending has slowed since the law was passed, making it less likely that Congress will try to cut back the program significantly anytime soon. Nor have payment cuts to date been particularly disruptive for hospitals and the private insurers participating in Medicare Advantage plans. At contentious town hall meetings held by lawmakers before the law's passage, critics also claimed that "death panels" would sharply limit care at the end of life. But the focus of the ire of many, the Independent Payment Advisory Board, a government body created to try to control costs, has yet to get off the ground. Many lawmakers still seek to eliminate the board altogether. It could be years before it is clear how well, or poorly, the law works, and many people do not understand how the law will affect them. "Most of the conversations so far that have been in the public have been about the politics of it," said Ron Pollack, the executive director of Families USA, a Washington consumer advocacy group that has supported the law and is working to persuade people to enroll. The idea is to enroll enough young and healthy people to spread the costs over a sufficient number. But people could ignore the requirement that they buy insurance, because the penalty for not doing so is low ($95 or 1 percent of family income for adults in the first year, whichever is higher, versus potentially thousands of dollars a year for a policy without any subsidies). If proportionately too many old and sick people sign up for coverage, premiums, even if they are moderate so far, could easily skyrocket, especially in those states with low enrollments. And the law's subsidies could end up costing the government too much at a time when lawmakers are trying to tame the federal budget. The law's many skeptics argue that people, including early retirees, could be disappointed. The most affordable plans require substantial out-of-pocket spending and may not offer much in the way of a choice of hospitals and doctors, said Robert Laszewski, who heads a health policy consulting firm in Alexandria, Va. Even with the subsidies, many people will not feel as if the money is worth it, he said. The problem with the less expensive plans is they are "going to be a Medicaid-style plan," he said, referring to the state and federal government program for the poor.