Obamacare will affect every corner of the health insurance world in America, and major components come in on October 1st.
What is Obamacare, and what does it mean for you? Here are the answers to your questions:
Obamacare is the sweeping healthcare legislation passed in 2010, when Democrats controlled the House and Senate. Originally called the Affordable Care Act (“Obamacare” is the scornful term used by Republicans, which Obama himself adopted after two years), Obamacare requires all Americans to have health insurance (or pay a fine), but makes it easier for them to get it.
What you need to do when Obamacare comes into effect
If you already have health insurance, you don’t need to do anything (unless your insurance coverage is so thin that it doesn’t meet the requirements set by Obamacare). Starting in 2015, employers with 50 or more employees will be subject to the “employer mandate,” which requires them to provide or help pay for employees’ health insurance to anyone working at least 30 hours a week.
In the meantime, anyone can go to healthcare.gov to shop for various plans on the health insurance exchanges.
The health exchanges and the fine for not having insurance
Obamacare establishes health exchanges in each state (some states set up their own, others, in a protest to Obamacare, made the federal government do it). These health exchanges create a marketplace for private insurers to sell their plans, which are categorized into “bronze,” “silver,” and “gold,” based on how extensive their coverage. Kaiser Permanente set up a helpful subsidy calculator to help you estimate how much you will pay, and what the government will subsidize for you. All Americans, with few exceptions, will be required to sign up for health insurance by March 31st, 2014, or pay a fine.
The 2014 fine under Obamacare is $95 or 1% of your family income, whichever is higher, with a family cap of $285. In 2016, with the employer mandate in effect, the fine jumps to $695 or 2.5% of family income, with a cap of $2,085. By then, it is very likely that people will opt for insurance instead.
What about the poor?
Medicaid is expanded under Obamacare to include anyone who makes under 138% of the federal poverty line—around $15,415 for an individual (though some states chose not to expand Medicaid. The federal government is footing most of the cost, so rejecting the Medicaid expansion is largely a protest against Obamacare). People who make too much money to be included in the Medicaid expansion (or who were left out to dry by their state legislature) will still be able to use government subsidies to cover much of their insurance plan.
The other big pieces
Obamacare requires insurance companies to spend 80% of their revenue on providing insurance. If they fail to do this, they have to send the difference back to their clients via check.
Dental and vision are not covered by Obamacare.
Parents may keep children on their insurance through age 26, which is a part of Obamacare already in place.
Obamacare means no co-pays for all sorts of preventative healthcare: check-ups, vaccines, mammograms, STD screenings and much more. Once people begin to experience these benefits of Obamacare, it is likely the law will become more popular.
And they will get that experience, because Obamacare will not be delayed or defunded while Obama is President, no matter what the Republican Party tells you.