Frequently Asked Questions About Obamacare

A man and woman engage in a conversation while seated, discussing frequently asked questions about Obamacare.

Obamacare, the Affordable Care Act (ACA) and Health Care Reform are three different ways of referring to same federal law that changes how Americans get health care. State health care exchanges open on October 1, 2013 and the full law goes into effect on January 1, 2014. The new law will affect everyone in some way, shape or form, so it’s important that you find a health insurance consultant that you trust. Primary Care Insurance Solutions is available to help you navigate through the process and determine what the best option is for you, your family and/or your business. Here are several commonly asked questions regarding the recently enacted legislation.

  1. What is the Patient Protection and Affordable Care Act? Obamacare? Health Care Reform?All three are different terms referring to the same federal statute that was signed into law by President Obama on March 23, 2010. The goals of the new law are to reduce the number of uninsured Americans and the overall cost of health care in the United States. In order to meet these goals, a number of multi-faceted changes are being implemented such as employer and individual mandates, tax credits to businesses and subsidies to individuals. Insurance companies will be required to cover all Americans at the same rates regardless of health history or gender. State insurance exchanges will open on October 1, 2013. Individuals can shop for insurance coverage that will go into effect on January 1, 2014.
  2. Am I required to buy insurance?Yes. Starting in 2014, the Affordable Care Act requires nearly all U.S. citizens and legal residents to have health insurance.
  3. What if I can’t get insurance? I’ve been denied coverage in the past.All Americans will be able to enroll in some form of insurance coverage, regardless of age, gender, or health status that may have made it hard to get insurance before.
  4. What if I have a pre-existing condition?Starting in 2014, all Americans are eligible for insurance even if they have a pre-existing health condition.
  5. What if it’s not within my financial means to purchase health insurance? You can get help paying for it. The Affordable Care Act offers subsidies to help individuals cover the cost of health insurance. An online calculator tool will be available starting October 1, 2013  to help you determine whether your income qualifies you for a government subsidy to buy insurance. Until October 1, you can get a rough estimate of costs and savings by using the Kaiser Family Foundation calculator.
  6. If I choose not to have health insurance, will I be required to pay a fine? If you are not enrolled in a health insurance plan for the year 2014, you will be obligated to pay a penalty when filing your federal income tax. In 2014, the penalty for individuals is either $95.00 or one percent of income, whichever is higher. The fines will escalate annually.
  7. I have Medicare. Do I need to enroll in coverage through the Marketplace?No. Medicare isn’t part of the Health Insurance Marketplace, so you don’t need to do anything. If you have Medicare, you are considered covered and your benefits won’t be changing.
  8. My adult son just graduated college but doesn’t have a job yet. Will he get coverage under the new law?Before the new law, most insurance plans covered only adult children who were full-time students, lived with their parents, were disabled, or considered a dependent for tax purposes. In 2014, all young adults can stay on their parents’ plan until age 26. The young adult does not need to be in school or claimed as a dependent on tax return and can be married and/or living outside of the home.
  9. What if I need help from an insurance agent? Will I have to pay more for coverage?Health Insurance brokers/consultants are paid the by the carriers and the state exchange to help businesses and individuals find the best health insurance solutions for their employees and families. There is no cost difference in your premium if you get assistance from a licensed consultant.

Frequently Asked Questions

Are Obamacare, the Affordable Care Act (ACA), and Health Care Reform different laws or terms?

Obamacare, the Affordable Care Act (ACA), and Health Care Reform are three different terms referring to the same federal statute signed into law by President Obama on March 23, 2010. The law aims to reduce the number of uninsured Americans and the overall cost of health care in the United States.

Is it mandatory to purchase health insurance under the ACA?

Yes, starting in 2014, the Affordable Care Act requires nearly all U.S. citizens and legal residents to have health insurance.

Will I be able to get insurance if I have a pre-existing condition?

Yes, starting in 2014, all Americans are eligible for insurance even if they have a pre-existing health condition.

What assistance is available if I cannot afford health insurance?

The Affordable Care Act offers subsidies to help individuals cover the cost of health insurance. An online calculator tool was available starting October 1, 2013, to help determine whether your income qualifies you for a government subsidy to buy insurance.

Will I be penalized if I choose not to have health insurance?

Yes, if you are not enrolled in a health insurance plan for the year 2014, you will be obligated to pay a penalty when filing your federal income tax. In 2014, the penalty for individuals is either $95.00 or one percent of income, whichever is higher. The fines will escalate annually.

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