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- Medicaid Expansion to include more low-income Americans with no or low-cost coverage
- CHIPs to cover children and teens
- Young adults stay on parent’s policies
- Exemption for Individual Mandate for those below the tax filing threshold
- Exemption for those in areas that do not have affordable health plans
The individual mandate of the Affordable Care Act requires that every citizen, national, or lawful resident get health coverage unless exempt. Those that fail or refuse to get insurance coverage may have to pay a shared responsibility penalty. The law provides an exemption when available insurance is not affordable. Comparison shopping is the ideal solution to the sometimes confusing array of plan types and options. Start comparing health insurance rates now by using our FREE tool above!
Types of Obamacare Plans
Obamacare groups health plans by the actuarial value that interprets the amount paid by the insurers for plan coverage versus the amount paid by the consumer. In the rank order, the lower cost plans balance that with higher out of pocket costs and high deductibles. The itemized descriptions below are the affordability rank of Obamacare plans.
- Platinum and Gold Plans emphasize coverage by the insurer. They charge highest premiums and have deductibles that are significantly lower than the other bands.
- Silver has high premiums and extensive coverage by insurance.
- Bronze offers low premiums and high deductibles as the trade-off. These plans can get subsidy assistance to lower monthly premium payments.
- Catastrophic plans have very high deductibles and lowest priced premium payments.
Income-based Determination of Affordable
Plans that exceed eight percent of adjusted individual or family income are not affordable. Employer plans that exceed nine and one-half percent of adjusted income are not affordable. The government can grant a hardship exemption for up to three months of non-coverage.
Americans under 30 that have hardship exemption can qualify for Catastrophic Coverage. These are the lowest priced plans available in Obamacare. These qualified health plans offer protection with low premiums, but with high out of pocket costs.
Private insurers designed these policies to cover severe events and emergencies.
Consumers will cover the vast majority of expenses out-of-pocket and will not get subsidies. These policies do have the ten essential health benefits such as physicals and screenings.
Affordable Employer Plans Exemption
If a policy costs more than eight percent of household income, then the individual can claim an affordability exemption from the individual mandate. The IRS provides a worksheet to determine when an employer plan is not affordable. This triggers eligibility to purchase insurance on the Obamacare marketplace despite offered coverage from an employer.
Affordable Plans Exemption
When available health insurance costs more than eight percent of adjusted income, then the individual can claim a hardship exemption and avoid the uninsured penalty. Insurers offer plans based upon geographic areas. In a given locality, there are a limited number of plans. Fortunately, most areas have a large number of available plans, but some areas have few providers and small numbers of plans. If an area has few plans and the costs exceed eight percent of an individual or family adjusted income, the law provides an exemption.
Starting out can be difficult in an era of an expensive college education. The Affordable Care Act provides for coverage of children on parents policies up to age 26. Obamacare policies limit the time to add a dependent to the Open Enrollment. Exceptions for Life Events include the adoption of a child and childbirth.
Persons not required to file income taxes because of nontaxable income or income below the filing threshold are exempt from the Individual Mandate. They did not need to get coverage under Obamacare. The government does not charge the shared responsibility fee on income amounts below the annual filing threshold. Persons below the threshold may file and have a tax record to support qualification for Medicaid coverage.
Supplemental Security Income for blind, disabled persons with limited resources does not count as income for Obamacare purposes. Persons wishing to have health insurance coverage can qualify for Medicaid or CHIPs without a minimum income.
The government grants hardship exemptions for up to three months without coverage during the calendar year. One must file for further exemptions for events such as job loss or bankruptcy.
Medicaid and CHIP
People who cannot afford health plans through the Obamacare marketplace can sometimes qualify for Medicaid or the Children’s Health Insurance Program. One easy way to do this is to apply for a marketplace plan. Applicants that cannot qualify because of low-income get automatic referrals to state agencies that manage Medicaid and CHIP resources.
Helping Everyone Afford Obamacare
The goal of the Affordable Care Act was to provide cost-effective medical services to all Americans. The law recognized the extensive involvement of insurance companies in delivering medical services. Affordable health care must necessarily involve controlling the discretion and reach of insurance companies. The Affordable Care Act does this is some vital ways.
The ACA guaranteed essential benefits at no extra charge, and it eliminated insurance denials and particularly denials of sick people, arguably those that need health insurance most.
The ACA invests heavily in preventive medicine to reduce the terrible burden of preventable diseases; over the long-term, better health will reduce the costs of healthcare for everyone.
Where Allowed, Obamacare is Affordable
The range of coverage includes no-cost coverage under Medicaid and the CHIP for teens and infants. The holes in the system are due to Governors and legislators who refuse to let their citizens have the benefits that the ACA provides for them. Ultimately, such decisions deprive residents and create personal situations in which people earn too much for Medicaid and too little for Obamacare health plans. Price is a fundamental concern, and the ACA provides powerful tools for making insurance premiums more manageable including tax subsidies. Comparison shopping is a useful approach for finding the best price and value in health insurance plans. Start comparing health insurance rates and providers now by entering your zip code in our FREE tool below!