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ObamaCare Facts: Facts on the Affordable Care Act
ObamaCare Facts 2013 - We Tell you the Facts, Not The Talking Points
We present the facts on Obama Care (ObamaCare), the health care plan for America. Our goal is to help you understand the Affordable Care Act. Decide for yourself what you think about the new health care law, based on the facts and not the talking points.
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The official name for "ObamaCare" is the Patient Protection and Affordable Care Act (PPACA). It is also commonly referred to as Obama care, health care reform, or the Affordable Care Act (ACA).
The Affordable Care Act was signed into law to reform the health care industry by President Barack Obama on March 23, 2010 and upheld by the supreme court on On June 28, 2012.
ObamaCare's goal is to give more Americans access to affordable, quality health insurance, and to reduce the growth in health care spending in the U.S. What is ObamaCare?
The Affordable Care Act expands the affordability, quality, and availability of private and public health insurance through consumer protections, regulations, subsidies, taxes, insurance exchanges, and other reforms.
The fact is ObamaCare does not replace private insurance, Medicare, or Medicaid.
If you like your plan, you can keep it. Americans who like their health insurance can keep it until 2015 at which point all non-grandfathered health plans must meet the requirements of the ACA or be switched to a new plan. On November 14th, 2013 the President announced a "fix" that lets insurance companies renew plans and extend coverage of existing plans, that don't comply with the ACA, until the start of 2015. Some States have rejected the fix due to it creating two risk pools which will potentially drive up the cost of new plans. Learn more about keeping your insurance under ObamaCare.
ObamaCare doesn't regulate your health care, it regulates health insurance and some of the worst practices of the for-profit health care industry.
ObamaCare offers a number of new benefits, rights and protections including provisions that let young adults stay on their plan until 26, stop insurance companies from dropping you when you are sick or if you make an honest mistake on your application, prevent against gender discrimination, stop insurance companies from making unjustified rate hikes, do away with life-time and annual limits, give you the right to a rapid appeal of insurance company decisions, expand coverage to tens of millions, subsidize health insurance costs, and require all insurers to cover people with pre-existing conditions.
Ten Essential Health Benefits including emergency care, hospitalization, prescription drugs, maternity, and newborn care must be included on all non-grandfathered plans with no annual or lifetime dollar limits.
Free Preventive services including yearly check-ups, immunizations, counseling, and screenings must be included on all non-grandfathered plans at no out-of-pocket costs.
Many of Obamacare's numerous provisions have already been enacted. The rest of the program starts in 2013-2014 and continues to roll out until 2022.
The Affordable Care Act contains ten titles that span over 1000 pages, but most of it's key provisions are in the first Title. The first title is about 140 pages long (these pages are mostly white space with about 450 characters per page). If you would like to read the whole title, would like a summary of the title, and/or a summary of the provisions within check out our Summary of the Patient Protection and Affordable Care Act.
Over 100 million Americans have already benefited from the new health care law. This includes more than 105 million people who accessed critical preventive services for free that had previously been subject to out-of-pocket costs, billions of dollars saved for seniors from the gradual closing of the Medicare Part D "Donut Hole", billions saved from new accountability measures for insurance companies, and much more.
The Affordable Care Act also includes new taxes. Most new taxes are on high-earners, large businesses, and the healthcare industry. However, there are some tax related provisions every American should be aware of: Tax Credits to subsidize costs for low-to-middle income Americans and small businesses starting 2014, an Employer Mandate for large employers to provide health insurance to full-time employees by 2015, an Individual Mandate for individuals and families obtain health insurance by 2014, and lastly new limits to medical deductions.
In exchange for the new rights and protections most Americans must obtain health coverage by 2014, get an exemption, or pay a fee. Learn more about the ObamaCare Individual Mandate.
The CBO estimates that in 2016, after the major provisions of health care reform are implemented, 24 million people will be exempted from the Individual Mandate. In most cases if you don't think you can afford health insurance, you may be exempt and eligible for cost assistance.
ObamaCare helps to cover working families who don't have access to health insurance. Come 2015 large employers will have to insurance full-time workers, while small businesses will get tax breaks for offering coverage. ObamaCare and Small Business.
ObamaCare creates State specific health insurance marketplaces (also known as exchanges) where individuals, families and small businesses can shop for subsidized health insurance and find out if they qualify for Medicaid, CHIP or Medicare. NOTE: If you have coverage through work, you can't get subsidies on the marketplace. What is the Health Insurance Marketplace?
Americans making less than $45,960 as individual or $94,200 as a family of 4 may be eligible for free or low-cost health insurance due to cost assistance subsidies like Tax Credits that reduce premium costs and cost sharing subsidies that lower cost sharing on copays, coinsurance and deductibles.
The CBO estimates the average marketplace subsidy per subsidized enrollee will be $5,290 in 2014.
There are three ways to save money on your health insurance through ObamaCare's marketplaces: Advanced premium tax credits which lower your monthly premium costs, cost sharing subsidies which lower your out-of-pocket costs for copays, coinsurance and deductibles, and Medicaid which does both. Learn more about ObamaCare Cost Assistance.
Over 15 million men, women and children will be eligible for Medicaid in State's that participate in Medicaid Expansion.
There are 4 types of Qualified Health Plans (sometimes called metal plans) available on the marketplace. Each one has the same benefits, rights and protections, but different networks and cost-sharing. Don't buy health insurance without understanding actuarial value and deductibles, the cheapest option won't always be the best one for you and your family. Learn about the Types of Health Plans sold on the Marketplace.
Wondering how health insurance works? You pay a premium for every month you have coverage. The higher the premium the less out-of-pocket expenses you are responsible for and the larger network of doctors and providers you can utilize. All plans starting after 2014 are required to offer the same benefits, rights and protections but difference out-of-pocket costs. Learn more about how health insurance works and how to buy health insurance for 2014.
Coverage purchased through the marketplace before December 23rd doesn't start until January 1st, 2014. This is because many of ObamaCare's benefits, rights and protections don't kick in until 2014. Apply for coverage now to see what your options are. You can enroll at anytime after filling out an application. Even if you plan to buy insurance some other way, it is still smart to know your options.
The opening of the SHOP "Small Business Health Options Program" (the part of the marketplace small businesses use to buy employee health plans) has been pushed back to November 1st, 2014. Small businesses can still buy a SHOP plan through an agent now and claim tax breaks up to 50% of their share of employee premiums starting January 1st, 2014. Learn more about the ObamaCare SHOP Small Business Health Options Program.
Aside from the "key provisions" of the Affordable Care Act (ObamaCare) there are hundreds of little talked about provisions that are very effective, but rarely talked about. For example, Section 3022 of the PPACA includes guidelines for the establishment of accountable care organizations (ACOs) under the Medicare Shared Savings Program. ACOs are doctors who band together and get paid based on their patients’ medical outcomes rather than on how many tests and procedures they perform. Learn more about ObamaCare and Medicare Reform.
Find Out What the Affordable Care Act Means for You:
The ObamaCare website, healthcare.gov, is the place you can sign up for subsidized health insurance. As of December 1st, 2013 the ObamaCare website seems to be working well with many of it's initial technical issues ironed out. The "fix" gives everyone time to sign up before the December 23rd, 2013 for coverage that starts on January 1st, 2014. Get the latestObamaCare Website Updates.
The Fact is ObamaCare gives 47 million women access to preventive health services and makes it illegal to charge women different rates than men. Get more ObamaCare Women's Health Services Facts.
Up to 82% of nearly 16 million uninsured young U.S. adults will qualify for cost assistance or Medicaid through Obamacare's marketplaces.
The amount of young people who sign up for insurance will greatly impact the effectiveness of the program, as healthy young adults are the least likely to use costly health care services. Find out How ObamaCare Affects Young People.
1 in 2 Americans have a "pre-existing" condition that they could be denied health insurance for. ObamaCare chips Away at pre-existing conditions until 2014 when there are no more pre-existing conditions for anyone, including high-risk customers. This means you can no longer be denied coverage or treatment or charged more for health status. Find out more about pre-existing conditions.
54 million Americans with private health insurance now have access to preventive services with no cost sharing due to the new minimum standards of ObamaCare.
ObamaCare doesn't ration health care; it protects consumers from the health care rationing that insurance companies have been doing for ages.
ObamaCare reduces the growth in healthcare spending, it's currently the slowest it's been in five years. The current $2.8 trillion U.S. healthcare system costs almost $9k a year for every man, woman, and child.
The Defund ObamaCare movement led to a Government Shutdown on October 1st, 2013 as House Republicans refused to pass a budget unless it included repealing, removing, delaying, or defunding parts of the Affordable Care Act such as the medical device tax and employer mandate. The shutdown lasted until October 18th. Get the facts on the Government shutdown and the Repeal ObamaCare Movement.
We've created a detailed ObamaCare Facts timeline of every protection, benefit, and tax laid out by the Affordable Care Act from 2010 to 2022. Health Care Reform Timeline
ObamaCare is a hot button political issue and both sides of the aisle will try to persuade you to be for or against it. Get THE FACTS on ObamaCare and American Health Care Reform.
About 15% of Americans are uninsured, which is a little less than 50 million men, women and children.
The primary reasons for Americans being uninsured are cost and job loss.
Both the individual mandate and the health insurance marketplace only affect uninsured Americans.
For the 85% of Americans with health coverage almost all of ObamaCare's changes are already in place.
• 7 million Americans are projected to purchase private insurance on the marketplace this year.
• 9 million Americans are projected to enroll in Medicaid or CHIP (you can apply for Medicaid and CHIP through the marketplace).
• The number of uninsured has dropped every year since the Affordable Care Act was signed into law.
• The Congressional Budget Office is projecting the rate of uninsured will drop by 14 million people in 2014.
• The 101.5 million already enrolled in government health programs like Medicaid, Medicare, CHIP won't need to use the marketplace.
• The 170.9 million already covered by employer insurance won't need to use the marketplace.
In 2010 16% of uninsured were full-time workers or their dependents.
In 2010 only 53.8% of private sector firms offered health insurance.
Poor working families are the most likely to be uninsured.
The "employer mandate" means come 2015 larger employers will have to insure their full-time employees and their families or pay a per employee fee. Learn more about the Employer Mandate.
In 2013, the average annual total cost of employer-sponsored family coverage was $16,351, and the share of the premium paid by workers was 29%. Between 2003 and 2013, premiums have increased by 80%.
Small businesses can now get better benefits, cost-assistance and better buying power to provide employee health insurance via the SHOP (part of their State's Health Insurance Marketplace).
A CBO report on the Affordable Care Act from December 2013 shows only around one-fifth of federal spending for the major health care programs (i.e. Medicare, Medicaid, CHIP, and marketplace subsidies for individuals, families, and small businesses) will finance care for able-bodied nonelderly people; about one-fifth will go toward care for blind and disabled people; and about three-fifths will go to care for other people who are age 65 or older. Learn more about the Cost of the Affordable Care Act.
Want more facts about uninsured Americans? Learn more about uninsured Americans from the Kaiser Family Foundation (one of the best resources on health care reform) and how ObamaCare helps.
The video below will tell you everything You Need to Know About ObamaCare in under 7 minutes.
Most Americans must obtain qualifying health insurance by January 1st, 2014, get an exemption or pay a fee for every month they are without insurance. The fee is paid on your federal income tax return. This fee is commonly referred to as an Individual Mandate and is part of the shared responsibility provision. Learn more about the ObamaCare Individual Mandate.
Most Americans will have the option to stay on their current healthcare plans. No one who can afford it or who have access to a subsidized plan, including seniors, will be forced not to have healthcare. That's an ObamaCare fact.
If you like your doctor, and your health insurance provider includes your doctor in your insurer network, you can keep your doctor. Nothing in the ACA prevents you from keeping your doctor. Learn more about ObamaCare and Doctors.
• If you don't have coverage, you can use your State's new Health Insurance Marketplace to buy a private insurance plan. Many Americans will qualify for lower costs on monthly premiums and out-of-pocket costs through the marketplace. Please note that if you have access to employer based insurance you cannot get cost assistance through the marketplace.
Your State's Health Insurance Marketplace Opened Oct 1st, 2013 and closes March 31st, 2014. Insurance companies will compete to be your healthcare provider via your State's Health Insurance Marketplace, which is sometimes called a Health Insurance Exchange.
Americans earning below 400% of the Federal Poverty Level may be eligible for cost assistance on the marketplace.
6 in 10 Americans without health insurance can get health insurance for under $100 through their State's Health Insurance Marketplace. Many low income Americans will have an option for free health insurance when applying through the marketplace.
Should I buy insurance through the health insurance marketplace? Your options for obtaining coverage are changing. For some of us buying private insurance through the health insurance marketplace will be our best option, for others buying health insurance through a private broker will be the smarter move. Find out which option is right for you and your family. ObamaCare and health insurance plans.
Any insurance plan that starts after 2014 must follow new health insurance rules and include Ten Essential Benefits. All health plans sold through the health insurance marketplace adheres to these rules.
Policies issued before 2010 ("grandfathered" health plans) don't have to adhere to all the new rights and protections offered by the Affordable Care Act.
ObamaCare takes measures to prevent all types of discrimination in regards to your right to health care. Factors such as pre-existing conditions, health status, claims history, duration of coverage, gender, occupation, and small employer size and industry can no longer be used by insurance companies to increase health insurance premiums.
The only factors that can affect premiums of new insurance plans starting in 2014 are your income, age, tobacco use, family size, geography and the type of plan you buy. This applies to all plans sold through your State's health insurance marketplace.
The amount of out-of-pocket costs your health plan covers can affect your rates. Plans that cover more out-of-pocket costs like deductibles, coinsurance, and copayments also have higher premiums.
Starting 2015 in some States smokers can expect to pay up to 50% more than non-smokers for the same health plans. Subsidies are given before being charged a "tobacco surcharge" meaning that smokers could find affordable insurance being unaffordable. Get the facts on ObamaCare and smokers.
the Affordable Care Act includes a major focus on wellness including funding for programs that educate the public on health and wellness and new rules for employer wellness programs.
Did your health insurance premium go up? The fact is ObamaCare enacted a number of consumer protections, including a rate review provision, where insurance companies have to justify rate hikes above 10% to your State and post details online immediately. Yet, many Americans are still seeing their premiums rise at alarming rates. Learn more about ObamaCare Insurance Premiums
ObamaCare is the first step toward true health care reform in the US. The fact is about 60 percent of all personal bankruptcies in the US are related to medical bills. The health care law helps protect you from medical bankruptcy by ending annual & lifetime limits. Find out more Health Care Facts.
Other insurance reforms to curb the cost of premiums are already in effect as well. These include a Medical Loss Ratio policy and other accountability measures. Many more protections go into effect in 2014. So far, the average insurance premium has gone down. Americans saved $2.1 billion due to the new ObamaCare consumer protection provisions in 2012 alone.
ObamaCare states that "affordable insurance" means paying no more than 8% of your annual income on or 9.5% of family income if insurance is obtained through an employer. Please note ObamaCare does not guarantee "affordable insurance".
ObamaCare provides lower prescription drug costs for people on Medicare.
ObamaCare provides free preventive women's services, including mammograms, as one of the 10 essential benefits covered under every new insurance plan.
Young, healthy Americans and those making above 400% of the FPL are projected to pay more for insurance while many others are projected to pay significantly less.
ObamaCare ensures that there are no out-of-pocket costs on patients receiving mammograms and colonoscopies which are two of the most widely used forms of preventive health care.
ObamaCare reforms and expands Medicaid to over 15 million of our nation's poorest. That's 6.1 million less than the last estimate due to States opting-out out of providing coverage, despite 100% federal funding for the first 3 years and 90% thereafter. Learn more about ObamaCare's Medicaid Expansion.
States will have to spend millions on Medicaid over the next ten years regardless of whether they implement Medicaid Expansion. However, states that do implement ObamaCare's Medicaid Expansion will reap billions in additional federal dollars.
As a direct cause of Texas opting-out of Medicaid expansion over a million Texans will go without health insurance in 2014. This includes In 2010 25% of Texans didn't have access to health insurance this includes 1,247,300 children. Many of the State's who opted out have the highest uninsured rates in America.
ObamaCare's new Medicare Value-Based Purchasing Program means hospitals can lose or gain up to 1% of Medicare funding based on a quality v. quantity system. Hospitals are graded on a number of quality measures related to treatment of patients with heart attacks, heart failures, pneumonia, certain surgical issues, re-admittance rate, as well as patient satisfaction. Learn more aboutObamaCare and Medicare.
ObamaCare's insurance reform helps to insure millions of Americans each year. 48.6 million Americans went without insurance during all of 2011, compared to 49.9 million in 2010. The rate of uninsured decreased from 16.3% to 15.7%, the biggest percentage drop since 1999 due to the Affordable Care Act.
Obamacare mandates that Medicaid payments be raised to the same level Medicare pays doctors. While it varies from state to state, primary care physicians will see an average 73% pay increase. This will make it easier for new Medicaid recipients to find doctors willing to take Medicaid.
25 States have opted out of setting up a State Run Health Insurance Exchange. This leaves the federal tax payer responsible for providing care for their constituents. 19 are running State Exchanges, while 7 have set up Joint State / Federal Exchanges. Find out more about ObamaCare's State Run Exchanges.
ObamaCare makes it illegal for health insurance companies to terminate coverage for any reason other than customer fraud.
ObamaCare provides $20 billion in tax credits for as many as 4 million Small Businesses to offset the cost of purchasing insurance on the Health Insurance Exchanges.
Medicare and Medicaid both help to prevent "price gouging" by hospitals. ObamaCare's reforms strengthen these protections.
Only the top 3% of small businesses will have to pay the additional 0.9% ObamaCare Medicare tax increase.
Only 0.2% of businesses have over 50 full-time equivalent employees and don't already offer insurance to full-time workers. Providing these folks with insurance is the only "employer mandate" in ObamaCare.
Want single payer? By 2017, states will be able to get a waiver to set up their own approved health care solution, as long as it meets the standards of ObamaCare.
The CBO estimates 19 million Americans (of the 23 million estimated to use the exchange) will receive Tax Credits to Purchase Insurance on the Exchanges.
Due to Tax Credits and up-front assistance, Americans making less than 400% of the Federal Poverty Level (roughly $88k for a family of 4) could see up to a 60% reduction in the cost of health insurance premiums.
Uninsured Americans cost the American healthcare system an additional $49 billion each year. Only 12% of uninsured families pay their hospital bills in full, this includes families making over $88k a year. These costs affect the rising cost of insurance premiums; ObamaCare helps to reduce this spending drastically by eliminating dollar limits.
The cost of insurance premiums must be 8% or less of your modified adjusted gross income, when insurance goes on sale via the health insurance exchanges in 2014, to be considered affordable.
ObamaCare allows newly insured Americans to choose any available participating primary care provider, OB-GYN, or pediatrician in their health plan’s network, or emergency care outside of the plan’s network, without a referral.
ObamaCare prevents insurance companies from limiting the number of benefits a customer can receive in their lifetime.
Members of Congress will purchase their health care through the health exchange like the rest of us (who chose not to opt-out and pay a tax, are covered by Medicaid or choose to stay on their existing insurance) Get more facts about the ObamaCare Insurance Exchange.
In 2011, ObamaCare helped around 86 million Americans use free preventive services that had previously been subject to co-pays or deductibles.
ObamaCare aims to improve community health care centers in an effort improve health care for those who cannot afford private health care.
ObamaCare doesn't increase the deficit. It is projected to cut the deficit by over a trillion dollars over the next two decades.
ObamaCare offers countless benefits and protections that have been rolling out since 2010 and continue into 2022. Find out more about the Benefits of ObamaCare.
In 2013, American employers with 25 or less full-time employees may receive tax breaks of up to 35% (25% non-profits) of the cost of their employees' insurance premiums. In 2014, it increases to 50% (35%).
Employers with more than 50 full-time equivalent employees must insure their full-time workers or pay a tax (like the current state run unemployment and workers compensation programs).
ObamaCare won't cause 650,000 jobs to be lost as some of its detractors say (the number isn't even in the CBO report on The Affordable Care Act). The often misrepresented quote stated that part of the job loss ObamaCare creates is from employees who cut back their hours, since they will no longer have to rely solely on their jobs for their family's health care. In fact, ObamaCare's effect on job growth in Government jobs and Health Care rivals job loss in other markets.
Although ObamaCare hasn't resulted in job loss, the "employer mandate" has resulted in a number of full-time workers at large firms having their hours cut back to part time in order for employers to avoid providing their full-timers with health insurance. On the same note, many larger firms have moved workers from part-time to full-time to provide them will benefits.
If an you or your family chooses not to purchase healthcare through the Online Health Insurance Exchange, they can still buy private insurance, get insurance through their employer, Medicare, or Medicaid. Those who chose to not purchase insurance will pay an income "penalty" tax to help cover the rest of us. In other words, it is a tax, not a mandate; no one is actually forcing you to have health insurance.
Obamacare cuts $716 billion of waste from Medicare and reimbursements to private Medicare Advantage plans and reinvests it into Obama's health care reform. In other words $716 billion is saved and then $716 billion is reinvested back into ObamaCare and Medicare. Doctors and hospitals almost universally agree on this reform.
19 million Americans making under 400% of the Federal Poverty Level are estimated to receive tax credits to help pay for the cost of health insurance premiums.
ObamaCare reduces costs of premiums to millions of families and small businesses and provides billions dollars in tax relief.
The healthcare industry, specifically doctors, will be rewarded for quality over quantity.
• The Affordable Care Act allows religious institutions to choose to be exempt from providing controversial contraception and reproductive health services to women. Multiple businesses have also received an exemption after taking the ruling to court.
Although some businesses have won injunctions allowing them to avoid the "contraception mandate", there have been a number who have lost their cases including Hobby Lobby.
The Affordable Health Care Act doesn't just focus on insurance, it also reforms the parts of the healthcare system that aren't working, or are costing the tax payer money. For example, by focusing on preventive measures instead of just treatment, ObamaCare will save tens of billions of dollars and tens of thousands of lives.
The ObamaCare fact is the average American will save money under ObamaCare. In fact, many Americans are already paying less for health care services.
ObamaCare cuts the national deficit by over two hundred billion dollars during its first 10 years.
ObamaCare aims to make it easier for small businesses to provide coverage to workers by offering Tax Credits to employers who enroll their workers in private healthcare plans.
The Affordable Care Act (ObamaCare) is more than just a website. The ACA contains over a thousand pages of provisions that increase the affordability, quality, and availability of health insurance through consumer protections, regulations, subsidies, taxes, exchanges, reforms, and the expansion of Government programs.
MOST IMPORTANTLY: ObamaCare "the law of the land". There are many people who would like to see ObamaCare repealed. If ObamaCare is repealed, tens of millions of Americans will be without proper health coverage, and insurance companies will continue to be able to deny coverage for pre-existing conditions. Without healthcare reform America will continue to suffer the consequences of a health care system controlled by private for-profit companies, whose bottom line is money and not health. Help ObamaCare Facts to spread the truth about President Obama's health care reform.
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