How Will Obamacare Affect Me?

obamacareUnless you’ve been living in a trailer down by the river in the middle of Nowhere, USA – you’re probably well aware of the Affordable Care Act (or Obamacare as its been so lovingly referred to as) which went into affect October 1st. What you might not be as acquainted with is how it may affect you



While I’m no expert on Obamacare – I have done a little bit of research about it and want to share some of those insights here. If you are more familiar with it and can add to the discussion here – I’d love to get your input in the comments section. Our hope is that the post can be a resource for many of you looking to find out a little more about the Act and how it will affect you and your family.

Depending on your situation, Obamacare will affect everyone differently AND each state is handling the new mandate a little differently. I want to present life situations here and hopefully you fit one of the profiles. It’s important to note how many of us are covered (or not) in America.

  • About 50% of us are covered by private health insurance (employer plans, ie)
  • A third are covered under government plans (Medicare, Medicaid)
  • 1 in 10 will purchase insurance themselves
  • And just under 1 in 10 are not insured at all (roughly 30 million)

Employed Betty

Betty is an office manager at a large law firm and she is enrolled in her company’s health insurance program. She gets pretty good coverage too where the employer pays almost 90% of all her health care costs. While not everyone has it as good as Betty – many of us have some form of coverage provided by an employer.

Here are some of the new benefits that Betty may encounter with Obamacare:

  • Free preventative care (Check-ups, screenings and vaccines must be covered by providers for free)
  • Coverage for young adults (living at home?) until they hit 26 (about 6.6 million Americans)
  • In 2014, insurance companies cannot charge you more or deny coverage because you’ve been sick
  • No cancellations or lifetime limits on coverage when/if you get sick
  • Rebates if the insurance provider spends too much of your premiums on overhead
  • No more big booklets of whats covered and not – but short, plain-language summary of benefits

Other than the mentioned, Betty shouldn’t see much of a change in her insurance coverage. Still, many employers are starting to move to “employee-driven” healthcare plans (code for “getting out of the business of providing health insurance for their employees”) so Obamacare could spur more businesses to continue this trend. There are companies out there who are railing against Obamacare. Hobby Lobby is actually suing the government for some of the mandates the new Act will enforce on employers.

Uninsured Ron and Business-owner Pete

Ron is a 24-year old recent college grad who works as a contract designer for a large tech company. Due to his age and good health, Ron has elected to not purchase health insurance. He figures he could use that money for paying off his school loan.

Pete owns a chimney repair business and purchases a health insurance plan for he and his family through an online insurance broker. It’s an expensive plan that takes a big chunk out of their monthly budget – but needs good coverage with a newborn and wife who has a lot of medical issues.

Both Ron and Pete may have the option of participating in the Health Insurance Marketplace. This is online marketplace where private insurers compete for your business. You can choose 3 different plans ranging from Bronze Level (cheaper premiums – high deductibles) or Platinum Level (more expensive premiums – lower deductibles). These plans also come with the same benefits as those listed above.

Should Ron decide to stay uninsured, he will face a penalty of $100/1 year.  This is a lot lower than opting for one of the lower-tiered plans (which could run about $100/month).

What should I do next?

As Obamacare gets rolled out and implemented into everyday life – the bugs will likely get worked out. It is not a perfect plan and many folks are none to pleased with its implementation (as we are currently seeing with the Government Shutdown).

Business-owners and corporations will likely feel the brunt of many of these changes as they may be forced to provide healthcare insurance to their employees if they employ more than 50 people. Added to that, many believe that insurance companies – with their inability to limit and deny coverage to “higher utilizing” people may cause them to raise overall rates for coverage to businesses who provide insurance for their employees. And, only the future can tell how that may affect the economy as a whole.

If you are looking for more information – check out the video below put out by the White House.

If you’d like to learn more about Individual or Family coverage from the Health Insurance Marketplace – visit the following links:

https://www.healthcare.gov/marketplace/individual/ 

https://www.healthcare.gov/families/

And, to find out if you could be covered under the Affordable Healthcare Act

How do you think the new Act will affect you?

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14 comments

  1. Great and informative post, Aaron – thank you! Since Rick is employed by a large company, we’re hoping the Act won’t have much of an affect on us directly, but we are worried about how it will affect his company, and how those affects will hurt the employees themselves eventually, whether through raising healthcare costs or minimizing pay increases, increasing layoffs, whatever.

  2. Steph says:

    Great post. My employer started not covering spouses who could get insurance through their employer without penalty this year-not sure if Obama care or just rising health care costs ( my husbands employer already had this policy).

    The big winners with Obama care are those who didn’t have insurance through work and had preexisting conditions-they were uninsurable. A friend of mine 23 with diabetes was uninsurable on the open market prior to Obama care (she didn’t have the financial resources to consistently pay for insulin and testing strips), now she can get insurance. The people worse off by Obama care are the young and healthy (particularly male) who got by without insurance and now have to pay.

    It really is a compromise- not perfect for everyone.

    • Aaron says:

      Hi Steph. I’ve heard of similar stories too – employers raising premiums or changing how they handle coverage as a result. I’m sure it will only continue. No plan would be perfect, for sure.

  3. Andy says:

    Great post! Not a hint of bias or lack of understanding. Just straight talk. It’s why I keep coming back to this blog. Nice job.

  4. Crystal says:

    What I’m not seeing mentioned anywhere is how this impacts folks 55 and over with incomes below the 138% FPL who are forced onto Medicaid. I realize not all states opted to expand Medicaid but mine did and anyone 55 and over that receives benefits under the program will be subject to estate recovery for all money paid out on their behalf, which could happen even if they NEVER use it if they’re part of a managed care organization (the only option in my area).

    What this means is that the heirs of people who managed to amass a few assets despite their low income will be penalized. Think about it. You live below you meager means and acquire a few things during your life and along comes the ObamaCare mandate that funnels you into Medicaid. Now the state has the right to recover from your estate for something you didn’t want and wouldn’t have willingly signed up for. And yes, you do have three options to avoid this:
    1) Stay uninsured and pay the penalty instead
    2) Figure out how to increase your income above 138% FPL
    3) Buy health insurance yourself for $400-$500/month (at least in my area)

    If you live in a state that didn’t expand Medicaid, I believe you may be exempt from the penalty if the cost of insurance is over a certain percent of your income. I haven’t really looked into the exemptions because they don’t apply in my state.

    • Aaron says:

      Great points Crystal and thanks for mentioning this group. I found the plan for this age group to be a little confusing, so appreciate your shedding some light on the subject. Seems to be different from state-to-state.

  5. kg says:

    We’ve been told our rates will be going up. Currently the portion we is pay $40/week, we have a $5000 deductible, $50 co-pay, costs are split 70/30 (we pay 30%) and preventative care is covered unless they find something wrong, then you have to pay for the test. Also anybody who is overweight, smokes, or has a chronic disease pays more. It’s difficult to find out how much tests and care costs before the bill comes. I think all costs should be posted so we can shop around easier to find the cheapest yet ok care. Also hospitals and doctors now want you to pay your bill off in one year which is tough when your portion of their bill approaches your yearly income. It’s gotten to the point where we avoid going to the doctor.

  6. It does seem to me that this program is mostly geared toward those in very difficult situations, but I think it’s going to create very difficult situations for the middle class. The Act claims to provide stipends to reduce the amount a person has to pay for coverage up to 400% of the poverty level, but even using the government’s calculator (http://kff.org/interactive/subsidy-calculator/) and being told I’m at well under the 400% poverty level, young, a non-smoker and in good health, I don’t qualify for any sort of subsidy. Instead my insurance rates will increase about $2,300. Which is sort of insane to me.

    I suppose the idea is for me to be unable to save for anything or put away for retirement and have to rely on the government for everything forever? No thanks. I’ll pay the $100/year fine.

  7. EasySimpleHealth says:

    I think people should calm down. This is the best thing for everybody. We are a nation who comes together in crisis. Well our healthcare system and people are in need of this change. Lets keep in mind our country and not just ourselves. We have insurance on our houses and cars why not our bodies. People should be responsible for the own healthcare. Increasing the pool of people who do makes it better for everyone. Pay the fine if you don’t care about yourself or your loved ones.

    • nomoresoundbytes says:

      Thank you for the common sense, Easy. I think extremists have become so loud that they drown the rest of us out. We are a society…

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