ObamaCare Explained as Simply As Possible

Here it is, ObamaCare explained. We’ve been explaining ObamaCare in detail, but here’s the short version of ObamaCare explained for your convenience.

ObamaCare, officially called the Patient Protection and Affordable Care Act, is a health care reform law signed in 2010 by President Barack Obama. Many of the law’s provisions are already in effect and the rest continue to roll out until 2022.

Beyond the new benefits, rights, and protections to curb healthcare spending and improve healthcare and health insurance, important Affordable Care Act provisions include: a mandate for most Americans to have insurance by 2014, a mandate for large employers to provide insurance, the expansion of Medicaid, and the opening of Health Insurance Marketplaces to help subsidize private insurance.

This video discusses lots of aspects of the ACA in a pretty clear cut way.

ObamaCare in 100 Words

The Affordable Care Act (ObamaCare) increases the quality, accessibility, and affordability of health insurance. In exchange most people, who can afford to, must Obtain Health Coverage by 2014 or pay a per month fee. The law eliminates pre-existing conditions, stops insurance companies from dropping you when you are sick, protects against gender discrimination, expands free preventative services and health benefits, expands Medicaid and CHIP, improves Medicare, requires larger employers insure employees, creates a marketplace for subsidized insurance providing tens of millions individuals, families, and small businesses with free or low-cost health insurance, and decreases healthcare spending and the deficit.

obamacare explained

ObamaCare Simplified Explanation in Bullet Points

Here is a simplified ObamaCare explanation of what every American should know about our new health care law. The Affordable Care Act (ACA) does a lot, luckily most of us don’t need to know the details, let’s take a look at what we do need to know:

• ObamaCare doesn’t create health insurance, it regulates the health insurance industry and helps to increase quality, affordability and availability of Private Insurance.

• Most people who currently have health insurance can keep it (see more on keeping your grandfathered health plan).

Young adults can stay on their parents plan until 26.

• If you don’t have coverage, you can use the new Health Insurance Marketplace to Buy A Private Insurance Plan.

• You can Obtain Private Health Insurance during each year’s annual open enrollment period in the Health Insurance Marketplace. Open enrollment for 2015 goes from November 15th, 2014 to February 15th 2015.

•You won’t be able to obtain most types of private coverage that protect you from the fee outside of open enrollment since insurers have adopted the health insurance marketplace’s enrollment periods.  Medicare and employer based insurance have unique enrollment periods.  Medicaid and CHIP can be obtained at anytime.

• If you don’t obtain coverage and maintain coverage throughout each  year, or get an exemption, you must pay a per-month fee on your federal income tax return for every month you are without health insurance.

• Due to a coverage gap exemption that applies to all Americans you can go without insurance for up to 3 months in a row without coverage.

• Beyond the coverage gap exemption there are around 20 other exemptions that you can qualify for.

Insurance Purchased by the 15th of each month will start on the first of the next month.

• In 2014 the fee is $95 per adult ($47.50 per child) or 1% of income, whichever is higher. The family max is $285. The fee increases each year.

• The cost of your marketplace health insurance works on a sliding scale. Those who make less, pay less.

• American making less than $45,960 as individual or $94,200 as a family of 4 may be eligible for premium tax credits through the marketplace. Tax credits subsidize insurance premium costs.

• If you are able to get qualified health insurance through your employer you won’t be able to receive marketplace tax credits unless the employer doesn’t cover at least 60% of your premium cost, doesn’t provide quality insurance, or provides insurance that exceeds 9.5% of your families income.

• Up to 82% of nearly 16 million uninsured young U.S. adults will qualify for federal subsidies or Medicaid through the marketplace.

• You don’t have to use the marketplace to Buy Insurance, but you should fill out an application to see if you qualify for assistance before shopping for insurance outside of the marketplace.

• The ACA does away with pre-existing conditions and gender discrimination so these factors will no longer affect the cost of your insurance on or off the marketplace.

• You can’t be denied health coverage based on health status.

• You can’t be dropped from coverage when you are sick.

• Health Insurers can’t place lifetime limits on your coverage. As of 2014 annual limits are eliminated as well.

• All new plans sold on or off the marketplace must include a wide range of new benefits including wellness visits and preventative tests and treatments at no additional out-of-pocket cost.

• All full-time workers who work for companies with over 50 employees must be offered job based health coverage by 2015. Employers who do not offer coverage will pay a per-employee fee.

• Small businesses with under 50 full-time employees can use a part of the marketplace called the SHOP (small business health options program) to purchase group health plans for their employees.

• Small businesses with under 25 full-time employees can use the marketplace to purchase subsidized insurance for their employees.

• Medicare isn’t part of the marketplace. If you have Medicare keep it!

• Medicaid and CHIP are expanded to provide insurance to up to 16 million of our nations poorest.

• When you apply for the marketplace you’ll find out if you qualify for free or low-cost coverage from Medicaid or the Children’s Health Insurance Program (CHIP). You’ll also be made aware if you qualify for Medicare.

Want to explore the ACA in more detail? See our summary of every provision in The Patient Protection and Affordable Care Act here and learn more about getting health insurance through your state’s health insurance marketplace here.

Watch the following video for a simple and complete explanation of ObamaCare basics.

What Does ObamaCare Do?

ObamaCare helps tens of millions of Americans get access to affordable health insurance through expanding Medicaid and CHIP, improving Medicare and setting up a “Health Insurance Marketplace” where Americans making under 400% of the federal poverty level can purchase subsidized health insurance. ObamaCare’s reforms also increase the quality of care and help to curb the growth in healthcare spending among other things.

ObamaCare’s provisions regulate insurance companies and health care standards, but they don’t regulate your health care or replace private insurance. ObamaCare lowers what most middle-to-low income Americans pay for health insurance and their out-of-pocket health care costs (by means of cost-assistance offered through the marketplace), decreases the deficit and improves government run health care programs like Medicare by cutting out wasteful spending. ObamaCare also expands Medicaid in some States to cover 15.9 million uninsured seniors and low-income individuals.

ObamaCare Explained: Individual Mandate. Most Americans will have to buy insurance by 2014. Those who aren’t covered under Medicaid, CHIP or Medicare will have the option to buy private insurance, obtain insurance through the workplace, pay a small tax to not have health insurance (this helps it remain affordable for the rest of us) or buy private insurance through the their State’s Health Insurance Exchange. (There are other types of coverage that count as having insurance and will ensure you avoid the fee these include things like TRICARE and COBRA)

ObamaCare Explained: Your State’s Health Insurance Exchange / Marketplace. The ObamaCare exchanges are state or federal run (depends on the state) online marketplaces where health insurance companies compete to be your provider. Getting insurance through the the marketplace is as easy as applying for a plan, finding out if you qualify for subsidies and then comparing competing health plans. A State’s “Exchange” is commonly referred to as “Health Insurance Marketplace”

ObamaCare FactObamaCare Explained: How to Buy Health Insurance. You can obtain private coverage inside or outside the marketplace during open enrollment in your State’s “Health Insurance Exchange Marketplace”.   During open enrollment all eligible Americans will be able to use the marketplace to purchase Federally regulated and subsidized health insurance through private providers using side-by-side benefit, rate and network comparisons of plans. When you sign up for the marketplace you’ll also find out if you or a family member qualify for Medicaid, CHIP or Medicare. 82% of uninsured young people are expected to qualify for free or low cost health insurance. Check out our Health Insurance Marketplace Guide.

You can also purchase private health plans through a broker or direct from the provider. If you qualify for Medicaid or Medicare you can sign up through the official .gov sites.

ObamaCare Explained: Businesses. Small businesses with the equivalent of 25 full-time employees making less $250,000 a year can get access to tax breaks through the SHOP marketplace to provide insurance to their workforce. Those with the equivalent of 50 full-time employees will have to provide coverage for their full-time workers by 2015. 3% of small businesses will pay an increased Medicare tax on profit over $250,000 as well. The rest of the small businesses, mom and pops specifically, will have better access to cheaper healthcare for them and their employees. If they do decide to provide insurance for their employees they will receive generous tax breaks. Over half of all small business owners and their employees go without insurance each year and small businesses have historically struggled to provide the same quality of benefits as larger firms. ObamaCare’s provisions give small business a fair shake.

ObamaCare Explained: Seniors. Seniors greatly benefit from the $716 billion of wasteful spending cut from Medicare and the closing of the donut hole. The money is reinvested in Medicare and ObamaCare to improve coverage and to insure tens of millions of more seniors. Medicare parts A, B, C and D have all had changed and almost all for the better. Find out more about ObamaCare and Medicare.

ObamaCare Explained: Rights and Protections. ObamaCare includes a number of protections for Americans including better access to preventive services, expands coverage to millions saving countless lives, ensures people can’t be denied for preexisting conditions, stops insurance companies from dropping you when you are sick, letting young adults stay on their parents plans until 26, regulates insurance premium hikes, approves the appeals process and more.

Why We Need Health Care Reform Explained?

The health insurance and health care industries are for-profit industries. As such they put profit before health, therefore it is left up to laws to regulate their practices. Truly understanding the law requires an understanding of the health insurance and health care industries, lots of research, and a little experience.

The necessary complexity of the law and the 2.8 trillion dollar U.S. healthcare system defies any type of simple explanation. Suffice to say: We need health care reform to help America focus less on convenience and profit and more on wellness, prevention and health.

ObamaCare Explained Summary

Obama Care helps save millions of lives, billions of dollars, and gives American workers more freedom by not being dependent on their employers or insurance companies for care. Health care is now in your hands, it’s your health care, not the governments. The government just makes sure you get a fair shake and the insurance companies play by the rules. Thanks for checking out our quick ObamaCare explained breakdown. Check out the site for a more detailed explanation of ObamaCare.


ObamaCare Explained