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What is ObamaCare?

ObamaCare (AKA The Affordable Care Act) is a US law aimed at reforming the American health care system. ObamaCare’s main focus is on providing more Americans with access to affordable health insurance, improving the quality of health care and health insurance, regulating the health insurance industry, and reducing health care spending in the US. ObamaCare is the unofficial name for The Patient Protection and Affordable Care Act which was signed into law on March 23, 2010.

 

What Does ObamaCare Do?

ObamaCare’s health care reform does a number of important things including offering Americans a number of new benefits, rights, and protections in regards to their healthcare. The law also expands Medicaid, improves Medicare, requires you to have coverage in 2014 and beyond, and contains some new taxes and tax breaks, among other things.

 

What is it, and What Does it Mean for American Health Care?

So what is ObamaCare and what does it mean to you? There are really only a few things you need to know about the Affordable Care Act.

  • The Affordable Care Act contains over a thousand pages of reforms to the insurance and health care industries in order to combat rising health care costs and to provide affordable health insurance to more Americans. Despite its length and complexity, most of the important reforms are contained within the first 140 pages of the law.
  • Before the law you could be denied coverage or treatment because you had been sick in the past, be charged more because you were a woman, be dropped mid-treatment for making a simple mistake on your application, and had little or no way to fight insurance company appeals. Today all Americans have access to a large number of unprecedented new benefits, rights, and protections.
  • As of 2013 there were around 44 million Americans who went without health insurance (about 16% of the population). The majority of uninsured are working families and those who simply cannot afford health insurance. One of the major things ObamaCare does is help these individuals to get health insurance through expanding Medicaid eligibility and offering cost assistance. By the end of open enrollment 2014 less than 13% of Americans were uninsured.
  • Cost assistance subsidies for reduced premiums and reduced out-of-pocket costs are available to individuals and families making less than 400% of the Federal Poverty Level via their State’s health insurance marketplace. Small businesses with less than 25 full-time equivalent employees making less than $25,000 in average annual wages.
  • As of 2016 large employers will have to provide health coverage to full-time workers. This will help to provide coverage to those who aren’t covered by subsidized private insurance or the expansion of Medicaid. Contact us to learn more about employee health plans for your business.
  • Most Americans will have to have health insurance by 2014 or pay a per month fee on their year-end federal income taxes for every month they go without coverage. Many Americans will be eligible for subsidized health insurance costing anywhere from 0% – 9.5% of their Modified Gross Adjusted Income. Come to our office to learn more about the “individual mandate” that requires you to obtain coverage or pay a fee.

Beware of Scam Artists!

To avoid scams buy insurance only through the Health Insurance Marketplace or from an accredited and licensed agent. We are professional insurance agents who have passed exams and are one of the following qualifications:

  • Registered Health Underwriter (RHU)
  • Health Insurance Associate (HIA),
  • Registered Employee Benefits Consultant (REBC),
  • Certified Employee Benefits Specialist (CEBS), or
  • Chartered Life Underwriter (CLU).

I am uninsured (16%)

About 50 million nonelderly individuals were uninsured for at least part of 2012.  Going without coverage can have serious health consequences because the uninsured receive less preventive care, reducing the chance that disease will be detected early. Delayed care often results in more serious illness requiring expensive treatment and in many cases leading to permanent disability or death.

I don’t need health insurance, so why should I have to pay for it?

  • Everyone needs health insurance sometime in their lives! You may be perfectly healthy and fit today but who knows what tomorrow will bring? You may get run down by a car, fall and break a leg, or get beaten up in a bar fight. Even fit high school and college football players suddenly have heart attacks. Or a sudden pain may turn out to be cancer, requiring very expensive treatment. We all underestimate the chances of this happening to us, until it does.
  • The whole point of insurance (whether it is fire insurance on your home, auto insurance, or health insurance) is the sharing of risks. Consider home insurance: in most years you pay far more in premiums than you receive back but then comes a year when a fire, hurricane or tornado demolishes your home, and you will be glad to have insurance. Similarly your state requires you to have car insurance, even though you hope won’t have an accident this year. When we get very sick, medical bills sky-rocket and the only way we can afford to treat those seriously ill is if the healthy share the cost. So employer based insurance shares the burden of caring for the sick across all employees and each employee knows that if he gets sick he will be taken care of.
  • If only the sick bought health insurance, premiums would be unaffordable. The Affordable Care Act brings new benefits like the prohibition on pre-existing condition exclusions and the guarantee that no one will be denied coverage when they need it.  These protections are only possible if healthy individuals purchase insurance and do not wait until they fall sick.
  • Emergency Rooms have to treat everyone, whether they can pay or not. So currently people who don’t have insurance rely on emergency rooms, which is a very expensive way to provide treatment.  The cost of caring for the uninsured is pushed on to other patients and ultimately to the tax payer. Even if you are healthy, all the new health insurance policies offer free preventative care, designed to detect conditions such as diabetes,  heart disease or cancer that if untreated could lead to serious illness, disability or death. Early treatment might save your life!
  • If you are under 30 you can just opt for “catastrophic” health insurance, designed to cover unforeseen emergencies.
  • You still have a choice whether to get insurance or not: if you choose not to get insurance even though you could afford it, you have to pay a “Shared responsibility payment”, which will be 1% of your income (or $95 if that would be less). This percentage will rise every year.
  • You are exempt from paying this penalty if are not required to file a tax return, earn less than 138% of the Federal Poverty Level, or if the lowest “Bronze” insurance available in your area would cost more than 8% of your income. You are also exempt if you are here illegally, incarcerated, a member of an Indian tribe, a member of certain religious groups that provide their own health care, or live outside the USA.