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Obamacare Begins Tuesday; A Brief Overview

By Brandon Moseley
Alabama Political Reporter

Polls show that as many as 60% of the American people oppose implementation of President Obama’s controversial new healthcare plan, the Patient Protection and Affordable Care Act, better known as Obamacare. However, the President and Congressional Democrats are still supportive of the controversial plan’s rollout on Tuesday.

Beginning on Tuesday Americans will be able to purchase Affordable Care Act compliant insurance policies effective on January 1, 2014. Americans regardless of weight, health status, or illness will not be denied. Millions of Americans with existing coverage will see their policies renew into Patient Protection and Affordable Care Act Policies over the next year.

Many will see their premiums go up. Many have already seen an increase in premiums. People who purchase policies on the insurance marketplaces will receive some level of premium subsidies through a tax credit if their income is less than 400% of the federal poverty line (that is $94000 in adjusted gross income for a family of four).

Families and persons who make less than 250% of the federal poverty line are also eligible to receive additional cost sharing assistance if they purchase their own insurance and they purchase a silver plan.

Silver plans cover an estimated 70% of the average policy holder’s estimated medical needs (~a $6950 value).

Gold plans cover 80%, Platinums 90%, and Bronze Plans 60%. Only persons under the age of 30 who can demonstrate that purchasing a compliant policy would be a financial hardship can purchase catastrophic coverage.

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For some individuals and families their insurance premium could be as low as $0 a month.

The government will pay the insurer with the anticipated tax credit, however if in 2015 when the 2014 taxes are calculated, that taxpayer could be eligible to repay the subsidy if they under-estimated their 2014 income. Likewise if they overestimated their income and did not collect the level of tax credit that they were entitled to, they can apply that money to their 2014 taxes in 2015.

You can not purchase coverage on the exchange if your employer or your spouse’s employer provides healthcare coverage, you are eligible for Medicaid, or you are eligible for other coverage such as Tricare or Medicare. If you qualify for coverage on the marketplace you can not purchase policies off the marketplace. There is no asset test for qualifying for the health insurance tax credit, so persons with high net worth but a modest income are eligible for the premium subsidies.

Individuals who are eligible to receive Medicaid (~less than $15,000 per year) can not purchase on the exchange. However, since Alabama did not agree to expand Medicaid as of press time, it is our understanding that those persons may not purchase coverage on the exchange and will still have no coverage.

All Americans are required now to obtain healthcare coverage the penalty for not having creditable coverage is $90 or 1% of your adjusted income, whichever is greater and that penalty will increase over time.

Every county in American will have at least one Exchange product to select from. Many rural counties will only have one insurer to select from. As of press time (and this is subject to change) Blue Cross Blue Shield of Alabama will offer an approved marketplace product available in every county in Alabama. Humana will offer coverage in Shelby, Jefferson, and Madison Counties. Persons and individuals with higher incomes who purchase coverage off of the marketplace will have more options.

In July, the Obama Administration announced it would delay until 2015 enforcement of the Affordable Care Act’s employer mandate, which requires businesses with 50 or more employees to offer healthcare coverage or face tax penalties. House Republicans are arguing that individuals deserve the same break.

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For more specific information about your situation contact your licensed local health insurance agent.

Written By

Brandon Moseley is a former reporter at the Alabama Political Reporter.

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