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Affordable Care Act Facts

The Affordable Care Act is an enormous law that has made many changes to the health care industry. Below are some facts you need to be concerned with.

Affordable Care Act Facts

What is the Affordable Care Act?

The Affordable Care Act is a federal statute signed into law by President Barack Obama on March 23, 2010. It aims to increase the quality and affordability of health insurance coverage for Americans, and reduce the costs of health care for individuals and the government. Other names heath care reform is commonly called: ACA, PPACA, Obamacare, Affordable Care Act.

What insurance carriers are available on Covered California?

The selection of health insurance carriers available on Covered California can change year to year. If you receive financial help with premiums and your carrier opts out or is not selected the following year to participate on Covered California. You will have to choose a new health insurance carrier and plan that is available on the exchange to continue receiving federal subsidies. Click here, to view health insurance carriers available on Covered California for 2017.

Do I Have To Get Health Insurance?

Most people will be required to obtain basic health insurance coverage or pay a penalty until they do. However, individuals may be eligible for an exemption if affordable coverage is not available.

When Can I Enroll?

Open enrollment for purchasing coverage through the exchange begins on November 15th. The health plan will be effective January 1st of the following year. If you miss open enrollment, your ability to enroll in health insurance may vary from state to state. It may be limited to the occurrence of a “qualifying life event”, such as the loss of a job, a marriage or divorce, a move, or the birth of a child.

Can I Be Declined For Pre-Existing Medical Conditions?

Insurance companies are not allowed to discriminated based on preexisting conditions. They are allowed to discriminate based “on age (limited to 3 to 1 ratio), premium rating area, family composition, and tobacco use (limited to 1.5. to 1 ratio).”

What Is The Penalty For Not Having Health Insurance?

The tax penalties will begin in 2014. If you’re uninsured for more than three months in 2014, you could incur the tax penalty, which would be applied when you file your 2014 income tax return. The penalty is phased-in over a three year period.

  • In 2015, the penalty will be the greater of 2.0% of taxable income or $325 per adult and $162.50 per child (up to $975 per family).
  • In 2016, the penalty will be at the greater of 2.5% of taxable income or $695 per adult and $347.50 per child (up to $$2,085 per family).

After 2016, the penalty will be increased annually by the increase to the cost-of-living. People may qualify for an exemption to the Affordable Care Act’s mandate to purchase qualifying health coverage, in which case they would not be subject to a tax penalty.

Penalty Exemptions

Will Obamacare Affect My HSA?

Some changes were made to Health Savings Accounts (HSAs) and how they work as a result of the Affordable Care Act. First, people will no longer be able to use money in their HSA account to buy over-the-counter drugs. Also, if you withdraw funds from your HSA for something other than a “qualified medical expense”, the early withdrawal penalty increases from 10% to 20%.

How Do I Know If I Am Eligible For Medicaid?

Families making less than 133 percent of the poverty line — that’s about $29,000 for a family of four — will be covered through Medicaid. Between 133 percent and 400 percent of the poverty line — $88,000 for a family of four — families will get tax credits on a sliding scale to help pay for private insurance.

What Is The Medical Loss Ratio (MLR)?

The law requires insurers to spend between 80 and 85 percent of every premium dollar on medical care (as opposed to administration, advertising, etc). If insurers exceed this threshold, they have to rebate the excess to their customers. This policy is already in effect, and insurers are expected to rebate $1.1 billion this year.

At Your Service…

Affordable Care Act Overview and Guide

We are here to help every step of the way. If at any time you have questions about a health plan, a qualifying life event or just want to double check something, can help you find health coverage that fits your needs, as well as see if you qualify for a government subsidy to help pay for it.

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