With the Affordable Care Act (also known as Obamacare) launched as of October 1, 2013 (and the government in turmoil because of it) ER-DOX wanted to offer a simplified explanation of the law for those with questions. The benefits of the law, the politics behind the law, the consequences of the law, those are all up for debate. But for those of you who want to know how it may impact you and whether or not you should be on the exchanges that opened up, we hope that this is helpful:
The Affordable Care Act is a national law with two goals:
1. Making health insurance better for people who already have it.
2. Getting health insurance for more of the 60 million people who are uninsured.
Who needs it?
1. If you already have private health insurance, mostly bought by employers, Obamacare matters only if your plan was miserly. Under the law, insurers must now pay for many things that used to be optional, like prescription drugs, having a baby, and mental health care, among other services. The law also blocks any extra charges for routine checkups, cancer screening, and some other stuff. Obamacare also limits your yearly out-of-pocket fees, such as co-pays for going to the hospital. It also forbids insurers from kicking you out if you get sick. One other thing: Starting in 2015, workplaces with more than 50 people must provide insurance to full-time workers. Another change: Your paycheck must show how much your boss pays for your health coverage, (shocking info).
2. The roughly one-third of Americans on Medicare (mostly for seniors) and Medicaid (for the poor and disabled), life won’t change much, other than having an easier time getting prescription drugs. However, Obamacare includes a big expansion of free health care for the poor, through Medicaid. Starting now, nearly all families making less than $31,000 yearly could get free Medicaid, which means 17 million of the 60 million uninsured could be covered (state dependent).
3. The remaining 20 percent who don’t have private insurance and don’t qualify for Medicare or Medicaid has to go buy health insurance from an online government superstore called an exchange. That’s what is opened Oct. 1st. You cannot be turned away, and depending on how much money you make, the government kicks in anywhere from nothing to more to help you out. In the end, 20 million Americans still won’t have insurance.
4. Obamacare cut payments to hospitals and created new taxes for rich people, pharmaceutical/ medical device makers, and health insurers to fund the law. People are mostly protected from the actual cost of health care as the amount taken out of your paycheck is just your small share of the premium. Your employer is kicking in hundreds and hundreds of dollars each month. Additionally, a large portion of your federal and state taxes pay for health care for the poor and elderly. According to one estimate, you’re actually paying $10,000 per year for individual health care and workers with families pay even more.
5. If you don’t have medical insurance, there are various choices with prices adjusted for your age and income, typically separated into platinum, gold, silver, and bronze options. If your income falls between $23,550 and $94,200 for a family of four, you’ll get a subsidy. If you’re up to age 26 and don’t have insurance through an employer, your parents’ insurance can cover you.
The information provided on our blog is not meant to replace the care or guidance of your medical provider. If you have specific questions please call or see your professional health care provider.