If you’re like many Americans, the thought of dealing with the complexities of the Affordable Care Act, and trying to understand Obamacare, is terrifying. It’s a complicated health insurance plan that, according to a survey of more than 12,000 people, 60% of people simply don’t understand. We’re here to assist you in comprehending Obamacare.
More than half of those polled by Health Affairs who would sign up for Obamacare do not fully understand many key concepts of the plans.
According to another Carnegie Mellon University study, more than 80% of Americans aged 25 to 64 are not only perplexed by Obamacare, but are also put off by the prospect of dealing with health insurance details. According to the lead author, George Loewenstein, “research has shown that when consumers are given too much choice, they can become overwhelmed and make poor decisions.”
So, where do you go from here? It indicates that you have some homework to complete.
Political squabbles over Obamacare will undoubtedly continue for years, and the ACA may well be the most misunderstood social program in history. We hope to provide you with important information about how the law currently operates in plain English. We also want to provide some truth that is not influenced by the political debates that dominate the news.
According to experts tasked with assisting customers in signing up for the plan, the vast majority of their contacts begin by asking very basic questions about insurance before they’re ready to confront details such as “premium tax credits” and “cost-sharing reductions.”
The ACA was enacted primarily to ensure that Americans have access to affordable health insurance, and it provides consumers with discounts – or tax credits – on government-sponsored health insurance plans. It also expanded the Medicaid assistance program to assist those same people with health-care costs. The plan altered the rules that guide insurance companies regarding pre-existing conditions such as diabetes, which would have resulted in customers being denied coverage. The idea was to combat exorbitant coverage costs and keep you from being turned down for any reason. The general idea was that the plans would eventually help to reduce costs.
If you live in a state that participates in the federal program, you can get your Obamacare plan from healthcare.gov; if your state does not, you can get it from your state’s healthcare webpage if the federal plan is not available.
Bullet Points on ObamaCare:
- The Affordable Care Act is intended to improve factors such as health insurance quality, accessibility, and affordability for all Americans. It was designed to fix major flaws in the previous system.
- Insurance companies can no longer refuse coverage or raise prices for preexisting condition treatment.
- Insurance companies can no longer refuse to cover anyone who becomes ill.
- The law contains “gender discrimination” elements.
- Certain “preventative services” and other health-related benefits are included in the plans for free.
- Medicaid and CHIP have both been expanded and improved.
- Certain large employers are required by the ACA to insure their employees.
- The ACA established a “marketplace” to create subsidized insurance. It now provides free (or low-cost) health insurance to tens of millions of individuals, families, and small businesses.
One more advantage? According to experts, it has reduced healthcare spending and reduced the budget deficit.
Keep in mind that if you already have insurance through your employer, you are exempt from these requirements. The ACA was primarily aimed at individuals and small groups who were forced to pay for their own health insurance.
In terms of the bottom line, if you meet the income requirements, you are eligible for tax credit discounts on health insurance costs. Assume your household income is between one and four times the federal poverty line. If it does, the plan states that your basic needs – food, shelter, and so on – qualify you to use the credits to lower your monthly insurance bill premiums. You can also wait until the end of the year to declare the credits on your tax return. It’s fairly simple to find an online calculator that will tell you where you fall on the income scale and if you qualify for these tax credits.
Making too much money to qualify for the credits will not prevent you from purchasing a plan through the federal insurance marketplace or your state, but it will prevent you from receiving discounts. According to experts, this does not mean you will not get a good deal, so the plans are worth investigating. Furthermore, it’s possible that you’ll be eligible for Medicaid or other government assistance.
This is where things get dicey. Plans are divided into four “tiers,” each named after a different metal. From Bronze to Platinum, the levels are classified based on price and cost-sharing percentages. The “Bronze” plan is the most affordable, but it only covers 60% of total medical costs. While the “Platinum” plan range is the most expensive, it does cover up to 90 percent of your medical costs.
You’re now faced with the task of selecting a plan that not only meets your requirements, but also allows you to continue seeing your favorite doctors in a network. You should also choose a plan that covers the cost of filling your most frequently used prescriptions.
Assume your income falls into the category of people who earn one to 2.5 times the federal poverty line. According to experts, you should go with a “Silver.” This plan will cover 70% of your medical bills, but you may also be automatically upgraded to a “Gold” plan. If this occurs, you will be entitled to an 80 percent payment of your medical bills at no additional cost.
And, regardless of any conspiracy theories you’ve heard, if you don’t sign up, you won’t go to jail.
If you meet certain income requirements, you are required by law to have insurance, Medicare, or Medicaid. If you do not, you will be penalized when you file your tax returns.
If you are a senior citizen on Medicare, you are one of the fortunate few who can avoid the ACA and Obamacare.
Now that we’ve covered everything, be prepared for change, as politicians are planning to overhaul or repeal the ACA and Obamacare if they can find enough support.