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- Obamacare requires a minimum income and refers others to low or no cost programs
- Obamacare reforms include essential health benefits
- Obamacare adds no-cost benefits to all qualified health plans
- Obamacare adds no-cost benefits to Medicaid, Medicare, and all qualified health plans
There are many instances of free health coverage under Obamacare and the major programs it improved or reformed. The related programs include Medicare, Medicaid, and the Children’s Health Insurance Programs or CHIPs. Obamacare incorporated preventive care into every qualified health plan. These services come at no additional charge to consumers and include physical exams, screenings, diagnostic tests, lab work, and vaccinations. Comparison shopping will help consumers decide the best approach
Comparison shopping will help consumers decide the best approach among Obamacare health plans, Medicare, and Medicaid programs. Comparison shopping can focus on the services that matter most and those which might require the greater amount of consumer costs. Compare health insurance rates now by using our FREE tool above!
Essential Health Benefits
Qualified health plans, Medicaid, and Medicare provide essential health benefits required by the Affordable Care Act. Every health plan that meets the requirements for the individual mandate provides essential benefits without additional costs to the consumer. In the case of Medicare recipients, these essential benefits provide a new source of no-cost medical care, preventive care, and wellness programs for a population largely dependent on fixed incomes.
Obamacare includes Medicaid expansion that increased the number of people eligible for low cost or no cost health care. Medicaid expansion changed the cut-off for Medicaid from the poverty line to 138 percent of the federal poverty line.
The change increased the number of eligible persons by 21 million and provided funds to help states administer a broader healthcare program for the poor and limited income residents.
In the initial years of the ACA, nearly all the states with Republican Governors and some with Republican legislatures rejected the funds and coverage for their low-income residents. The Congress clearly centered the benefits of Medicaid expansion for persons in need of low or no-cost coverage and medical care. The expansion also went to the core of the overburdened public health systems, too many uninsured persons were unable to pay their medical bills.
Benefits of Medicaid Expansion
Across the US, costs of care to low-income patients have burdened both urban core institutions and rural hospitals. Many institutions have closed or have made dramatic reductions in services due to unpaid bills that result from care to low-income residents. Without routine medical care, many patients conditions worsened to the point of needing emergency care.
The expensive care needed to save lives and treat severe illness exceeded the ability of many low-income persons to pay. Health care providers were left with a growing mountain of unpaid bills. In some states like Georgia, many rural hospitals closed due to lack of funds and a significant factor was the unpaid bills of low-income patients. The closure of needed rural institutions placed additional burdens on those that remained in service including providing care to uninsured low-income patients. Closures in rural areas hit particularly hard when sick people were forced to travel long distances for emergency medical treatment such as in a heart attack or seizure.
- Reduced the amount of unpaid hospital and medical bills
- Strengthened local health care institutions
- Reduced closings of rural caregivers, clinics, and hospitals
- Improved medical for low-income residents
- Added no-cost preventive care including screenings tests and checkups
- Added wellness programs at no added cost to consumers
Obamacare provides many benefits to consumers that purchase health insurance plans through healthcare.gov or any of the state-operated health insurance exchanges. These no-charge benefits are not free healthcare coverage, but they are valuable services that do not require any additional payment from consumers beyond the monthly premiums.
Insurance Company Payments
Qualified health plans have deductibles in the agreements that consumers must meet before getting the agreed benefits from the insurance provider. Deductibles are out of pocket costs that subscribers pay up to a specified amount. Once past that threshold, insurance payments kick in. Once subscribers spend past the overall out of pocket limit, the insurance provider must pay all costs for benefits.
Health Care Costs and Obamacare
Obamacare offers four types of plans; they have metal names of bronze, silver, gold, and platinum. The types are plans with similar consumer value. The determining factor is the amount consumers must pay for the essential health benefits provided on the policies. Consumer payments take the form of insurance premiums, co-payments, coinsurance, the consumer paid out-of-pocket expenses.
Deductible limits determine when the insurance company must begin to pay.
Plans vary considerably in the items they provide as part of the essential health benefits. The law requires, at least, one service in each category and comparison shopping can reveal the items of most use to the individual or family situation. The below-itemized listing describes the proportion of consumer payment to insurance company payments.
- Platinum plans offer a 90 to 10 percent ratio of insurance paid to consumer paid costs.
- Silver plans pay 80 percent or more of plan costs, and the consumer pays about 20 percent.
- Gold plans consumers pay 20 percent and insurers handle 80 percent of benefits.
- Bronze plans provide 40 percent payment from consumers and 60 percent from providers.
Healthcare.gov and State Exchanges
Millions of US citizens and residents purchased health insurance on the federal website and through state insurance marketplaces. All of these policies provided health care benefits at no additional charge to consumers in the areas of preventive care and wellness.
Among the important reforms to the healthcare industry, the Affordable Care Act designated alcohol and drug addictions as treatable diseases. The law makes prevention, diagnosis, and early steps of treatment available without additional consumer payments. Comparison shopping is an excellent method for determining the best health insurance coverage for addiction services. All plans provide some services without charge; the insurers have discretion to choose the types of services to offer and the network resources to commit to treatment.
One feature of particular value to business owners is tax treatment of insurance premiums. Those filing as businesses may be able to deduct health costs and the expenses of health insurance premiums. In some instances, these deductions could render the net costs of health insurance at zero. Further, small business owners that qualify for income tax credits by paying a significant share of employee health insurance costs can get tax credits to apply to any tax year in which they have a profit.
The SHOP Program and Tax Credits
Small business owners can participate in health insurance programs that they sponsor. Small business group health insurance is a major source of health insurance for business owners too. The Affordable Care Act also provides tax incentives for small business owners to offer coverage to their employees.
The tax credits can equal up to fifty percent of the employee health insurance costs which the employer pays.
Small employers with ten or fewer employees get the maximum tax credit, and it scales down for a maximum of 25 employees. Small business owners can use comparison shopping to determine the best plans for themselves and their employees. The SHOP program provides a large buyer pool to get the best possible prices and service features.
Some People Get free Coverage under Obamacare
Employees can get free contraceptive services when their employers get exemptions for religious objections to the beliefs and practices of their employees. Medicaid coverage for millions of low-income residents provides free medical care for those with low incomes and qualified levels of need. The same is true for low-income infants, children, and teens that get no-cost care from the CHIPs service providers in the states. Comparison shopping is an excellent tool for identifying the no costs benefits of health insurance plans that meet the individual mandate. Enter your zip code in our FREE tool below to start comparing health insurance rates now!