ObamaCare Facts 2019 – We Tell you the Facts, Not The Talking Points
We provide up-to-date facts on ObamaCare (the Affordable Care Act), health care reform, and the health insurance marketplace.
What is ObamaCare?
ObamaCare is a nickname. The official name for “ObamaCare” is the Patient Protection and Affordable Care Act (PPACA), sometimes called Affordable Care Act (ACA) for short.
- The ACA was signed into law to reform the healthcare industry by President Barack Obama on March 23, 2010.
- The ACA was amended by the Health Care and Education Reconciliation Act on March 20th, 2010.
- The ACA was upheld by the Supreme Court on June 28, 2012, and has since been subject to a number of changes over time due to executive, legislative, and judicial action.
- Currently the fate of the ACA is somewhat uncertain as a Texas federal judge ruled the Affordable Care Act (Obamacare) unconstitutional on Dec 14 2018. For now nothing changes as the legal process play out (especially since a stay was issued). However, there could be real consequences down the road. We will let you know if anything changes. For now, despite the changes, ObamaCare is still “the law of the land.” Learn more about the 2018 ObamaCare ruling.
FACT: People generally refer to the final amended version of the law with all its subsequent changes as The Patient Protection and Affordable Care Act (PPACA, Affordable Care Act, ACA, and/or ObamaCare).
FACT: The nickname “ObamaCare” was given to the Affordable Care Act by critics of the law in an effort to associate then President Barack Obama with healthcare reform efforts. The name was used because Obama championed healthcare reform as a candidate in 2008 and then as a President before signing the ACA into law. The name stuck, and Obama embraced it over time at one point saying, “I kind of like the term ‘Obamacare.’ Because I do care. That’s why I passed the bill.” Today many people know the Affordable Care Act by its nickname, “ObamaCare.”
What Does ObamaCare Do?
The goal of the ACA is to is to give more Americans access to affordable, quality health insurance and to reduce the growth in U.S. health care spending.
In other words, the goal of the ACA is:
- To expand patient protections. For example, by stopping insurers from charging more for pre-existing conditions and setting dollar limits on care.
- To make health insurance more affordable. For example, by expanding cost assistance based on income to lower health insurance premiums and out-of-pocket costs and by expanding Medicaid to all adults based on income.
- To improve the quality of health insurance and healthcare. For example, by requiring essential benefits on all plans and rewarding hospitals for quality over quantity.
- To curb healthcare costs. For example, via regulations and taxes on those who benefit the most from healthcare reform like insurers and drug companies.
The ACA attempts to accomplish this by expanding the affordability, quality, and availability of private and public health insurance through consumer protections, regulations, subsidies, taxes, insurance exchanges, and other reforms.
See the video below from HealthCare.Gov, the official Health Insurance Marketplace used to sign up for health plans with cost assistance during open enrollment. Or, keep reading to learn about the Affordable Care Act’s benefits, rights, and protections.
IMPORTANT: Don’t forget to get covered at HealthCare.Gov during open enrollment so you can take advantage of cost assistance options! Open Enrollment 2019 ran from November 1, 2018 to December 15, 2018. Plans sold during Open Enrollment started January 1, 2019. Open enrollment for 2020 starts Nov 1st 2019. Those with lower-incomes and children should note that Medicaid and CHIP enrollment is offered 365 days a year. Find out what to do if you missed open enrollment.
IMPORTANT: A number fo things have changed under the Trump Administration. For example, the fee for going without health insurance has been reduced to $0 on a federal level for 2019 forward and short term health insurance is being expanded. However, some states are implementing their own individual mandate starting in 2019.
ObamaCare’s Key Benefits, Rights, and Protections
Below is a quick rundown of the most important benefits, rights, and protections in the Affordable Care Act. Decide for yourself what you think about the health care law, based on the ObamaCare facts and not the ObamaCare talking points.
ObamaCare offers some new benefits, rights, and protections:
- Letting young adults stay on their parents’ plan until 26
- Stopping insurance companies from denying you coverage or charging you more based on health status
- Stopping insurance companies from dropping you when you are sick or if you make an honest mistake on your application
- Preventing gender discrimination
- Stopping insurance companies from imposing unjustified rate hikes
- Doing away with lifetime and annual dollar limits
- Giving you the right to a rapid appeal of insurance company decisions
- Expanding coverage to tens of millions by subsidizing health insurance costs through the Health Insurance Marketplaces (HealthCare.Gov and the state-run Marketplaces)
- Expanding Medicaid to millions in states that chose to expand the program
- Providing tax breaks to small businesses for offering health insurance to their employees
- Requiring large businesses to insure employees
- Requiring all insurers to cover people with pre-existing conditions
- Making CHIP easier for kids to get
- Improving Medicare for seniors
- Ensuring all plans cover minimum benefits like limits on cost sharing and ten essential benefits including free preventive care, OB-GYN services with no referrals, free birth control, and coverage for emergency room visits out-of-network
FACT: Between 2010 and 2016 the Affordable Care Act helped lower personal bankruptcies by nearly 50%! This is just one example of the ways that ObamaCare is working.
FACT: ObamaCare gives tens of millions of 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.
FACT: Despite rate increases, each year the majority of market place users are able to get a plan for $100 or less due to the ACA’s Advanced Premium Tax Credits cap premiums based on “household income and family size.” Learn more about how cost assistance works with the Affordable Care Act.
FACT: As of 2019 over 20 million have been covered between the Marketplace, Medicaid expansion, young adults staying on their parents plan until 26, expanded employer coverage, and other coverage provisions. The uninsured rate fell to the lowest rate in recent history under the Affordable Care Act.
The Basics of Getting Coverage and Cost Assistance Under the Affordable Care Act
The Affordable Care Act’s annual open enrollment period is the only time of year in which individuals and families who don’t qualify for other coverage (like Medicare or Employer coverage) can enroll in Minimum Essential Health Coverage without qualifying for special enrollment.
- Every year at the end of the year there is an open enrollment period for health insurance.
- ObamaCare’s 2019 Open Enrollment period for 2019 health plans ran from November 1, 2018 to December 15, 2018. Plans sold during Open Enrollment started January 1, 2019.
- During open enrollment, individuals and families can enroll in a health plan that is eligible for cost assistance based on income and family size.
- Outside of open enrollment options are mostly limited to Medicaid/CHIP and short term health insurance.
- Until the end of 2018, if you didn’t get and maintain Minimum Essential Coverage or obtain an exemption for each month of each year, you would owe a fee for each month you or a tax dependent doesn’t have coverage or an exemption.
- For 2019 forward, the fee for not having coverage is reduced to zero in most states (i.e. make sure to check if your state has the fee or not).
- Although the fee has been reduced to zero in most states for 2019 forward, those doing taxes for previous years and those in states that still have a fee will be happy to know that very family automatically qualifies for a “less than three month” short coverage gap exemption each year. Other exemptions can be found on form 8965.
- Each coverage type has its own enrollment period. Employer coverage and Medicare have their own enrollment periods. Medicaid and CHIP can be enrolled in 365 days a year. Short-term health insurance is an option all year round, but it won’t protect you from the fee.
- Even though individuals and families can shop outside of the marketplace for health plans, for example through a health insurance broker or agent, only health plans sold on the Health Insurance Marketplace are eligible for cost assistance. Luckily, any qualified agent or broker outside the marketplace can help you enroll in a marketplace plan (in other words, as long as you shop during open enrollment, you have options as to where you shop).
- Those who use the marketplace may qualify for one or more of three different types of assistance based on family size and income. First, premium tax credits lower premiums. Second, out-of-pocket cost assistance lowers out-of-pocket costs on Silver plans. Third, Medicaid and CHIP are free or low-cost health insurance for low-income individuals and families.
- Make sure to brush up on some tips for getting the best health plan. You’ll want to consider metal tier plans, premiums, coinsurance, copays, deductibles, out-of-pocket maximums, networks, and HSAs. See our guide to buying health insurance and our guide to comparing plans for information on all those terms and more.
Remember, options outside of open enrollment are limited to Short-Term Health Insurance, Medicaid, and CHIP. Keep in mind employer coverage and Medicare have unique enrollment periods. Learn more about enrollment periods.
TIP: If you are getting cost assistance and your income changes throughout the year, make sure to update the Marketplace. If you take too much or too little of Advanced Premium Tax Credits, you’ll have to adjust them at tax time using form 8962.
FACT: Americans with private health insurance now have access to preventive services with no cost sharing because of the new minimum standards of ObamaCare. Only those who qualify for cost assistance can get premium tax credits and out-of-pocket assistance, but the rest of the Affordable Care Act’s benefits are offered to anyone on a major medical health plan obtained after 2014.
Last year those who shopped around and switched plans saved more. You can shop for quotes on health plans with the help of HealthCare.Gov or a Qualified broker. Are you covered? See tips and tricks related to getting the right health plan.
- In 2015: 1 in 6 Americans got a Health Insurance Marketplace plan for $100 or less after cost assistance. Meanwhile, 87% of people who selected a marketplace plan got financial assistance!
- In 2016: 7 out of 10 returning Marketplace customers could get a plan for less than $75 a month, and 8 in 10 could get one for $100 or less.
- For 2017: Despite rate increases, 7 out of 10 Marketplace customers were still be able to get a plan for less than $75, and 8 out of 10 less than $100!
- For 2018, 2019, and beyond: America can expect the same low rates after assistance. Learn more about how cost assistance works.
FACT: ObamaCare does not replace private insurance, Medicare, or Medicaid/CHIP. If you have Medicare or Medicaid/CHIP, you don’t need to worry about open enrollment and marketplace plans. You are considered to have Minimum Essential Coverage.
FACT: ObamaCare doesn’t regulate your health care; it regulates health insurance along with some of the worst practices of the for-profit healthcare industry.
The video below will tell you Everything You Need to Know About ObamaCare in under 7 minutes. The video below was made in 2014, but everything outside of a few dates is still applicable.
Tips on Taking Advantage of ObamaCare in 2019 – 2020
As noted above, we are currently outside of open enrollment and a repeal and replace plan is possible given the tensions in Congress and the status of the ACA in the courts.
With that in mind, since the future is somewhat uncertain, if you have a plan, you may want to maintain coverage until we reach more certain times. Meanwhile, you might want to consider renewing your plan or switching to a new plan during each year’s open enrollment.
Below are some more facts that will help you take advantage of the Affordable Care Act this year:
- For any time of the year, we suggest learning more about how health insurance works and how cost assistance works to make sure you get the best health plan for you and your family. We can hardly cover everything here. Please see the links on this page for further reading and lots of useful tips.
- For those who stay covered on a marketplace plan each year, you need to change plans and verify your information by December 15th (subject to extensions) each year to ensure your cost assistance is correct and the plan of your choice starts by January 1st (or after you pay your premium). If you don’t verify your information, you might not be re-enrolled or might be re-enrolled in a different plan (if your insurer or region stops offering the plan for example).
- Even if you miss Dec 15 deadline, you should still verify your plan and info. If your income changes or you have a life change (like getting married or having a baby), then you may be eligible for different cost assistance amounts. There is no wrong time to update your Marketplace information; this will ensure you avoid owing back excess tax credits.
- The best way to make sure you keep your insurance is to make sure you pay your premium every month. Consider putting your premium payment on auto-pay. If you miss a premium payment, you could get dropped from coverage and be left without options beyond filing an appeal.
FACT: Aside from the HealthCare.Gov website, you can also sign up for the marketplace by mailing in an online application (read these instructions first), get in-person help, or call the 24/7 helpline (800) 318-2596. Learn more about other ways to sign up for health insurance.
On TrumpCare: A few things changed in 2017 – 2018 under the Trump administration (including an executive order that impacted the mandates and a set of new rules that shortened 2018 open enrollment, allowed for higher out-of-pocket costs, and allowed for narrower networks). There has not however been a repeal and place plan passed through Congress. Until further notice, ObamaCare is still “the Law of the Land.” Repeal and replace attempts in 2017 included the American HealthCare Act, the Better Care Reconciliation Act of 2017, and the Graham-Cassidy Proposal. See those links to understand what healthcare reform could look like in the future.
TIP: Keep in mind, we could see another repeal and replace effort in the future. That means we could see a push to reconsider Republican-favored provisions featured in past bills. Republicans have favored tax credits based on age, expanded HSAs, privatizing “block-grants” for Medicaid, defunding Medicaid, having flexibility to create stricter rules for Medicaid (such as work requirements), bringing back high-risk pools, defunding of Planned Parenthood, the eliminating the individual and employer mandates, eliminating of out-of-pocket cost assistance, and taxes on industry.
Is ObamaCare Working?
Although statistics on the ACA change each year, we can look at some past data to show the ACA is working.
By the end of open enrollment 2016 there was estimated to be as many as 12.7 million in the marketplace, and very roughly 20 million total covered between the Marketplace, Medicaid expansion, young adults staying on their parents plan, and other coverage provisions. Today in 2019, despite some fluctuations, over 20 million are covered.
Numbers aside, new data is coming out each month that helps to show that key provisions of the ACA are working (like the 50% reduction in bankruptcies from 2010 to 2016).
If you ask Obama himself about the ACA and the Future of US Health Care, he’ll tell you that most of the program is working better than expected, but there is still more work to be done. This message is mirrored even by some of his biggest critics.
With that in mind, there are parts of the ACA that need more help, and even supporters of the law are in favor of real reforms that improve coverage and costs without increasing the uninsured.
We can summarize the pros and cons of the Affordable Care Act as:
- Great coverage expansion for the sick and poor.
- A struggle for those in the middle class who don’t get cost assistance (especially considering those who can only afford high deductible plans, but can’t afford to fund an HSA up-front).
- Lots of cost-curbing and benefits in the healthcare sector.
- Some frustrating sticking points like the family glitch that require immediate attention (and which Democrats have campaigned on addressing at times).
In all, the latest news is good news about total costs and coverage.
For example, a June 2016 study by the Urban Institute shows the latest long-term spending projections are $2.6 trillion less than the original post-ACA baseline forecast through 2020 — a reduction in projected spending of almost 13%. Read more. Meanwhile, the uninsured rate was estimated to hit an all-time low fell to 9.1% in 2015 according to a 2016 report. Another report demonstrated a steady falling trend under the ACA but estimated it at an all-time low of 11%.
Meanwhile, a 2019 report from the Trump administration shows the ACA is working despite recent changes.
TIP: A good way to find out about how the Affordable Care Act is working is to check out the 100 page 2016 White House Report. See our summary of the ObamaCare White House Report December 2016. For something more recent, see the 2019 report.
NOTE: See the current marketplace sign up numbers here; despite ebbs and flows throughout the year, the enrollment numbers are growing consistently on average.
FACT: Studies have shown that anywhere from 20,000 to 44,000 Americans died each year from lack of health insurance before the ACA.
FACT: Poor working families were, and still are the most likely to be uninsured.
Other milestone achievements of the ACA over the years include:
- A January 2015 report by the Commonwealth Fund showed a reduction in the number of uninsured Americans and an increase in affordability and access to care under the Affordable Care Act. In some cases, numbers of uninsured people are the lowest they’ve been since 2001, especially for those who are young or have a low-income. This means that fewer Americans are putting off care or struggling with medical debt.
- According to another January 2015 report by the Commonwealth Fund, the growth of costs related to employer-sponsored health plans, including premiums and deductibles, had risen faster than the average income since 2003. However, in 31 states, that growth slowed since the ACA was signed into law. That trend generally has continued in many states, but inflation in healthcare is still outpacing increases in workers’ incomes (causing workers to in some cases “feel the pinch” of rising healthcare costs).
- Due to the ACA’s cost-curbing provisions, health care spending in 2014 grew at the slowest rate on record (since 1960). Meanwhile, health care price inflation was at its lowest rate in 50 years in 2014 as well.
- By 2015, 8.2 million seniors have saved more than $11.5 billion on their prescription drugs since 2010 – an average of $1,407 per beneficiary.
- By 2015, the ACA’s provisions have helped save $19.2 billion in fraud – about a $10 million increase from the five years before that.
- Preliminary data gathered in 2015 showed that between 2010 and 2013, due to new ACA provisions, about 1.3 million fewer events occurred that could cause hospital-acquired conditions such as pressure ulcers, infections associated with central lines, and falls and traumas. As a result, it was estimated that between 2010 and 2013 50,000 fewer people lost their lives, and there was a $12 billion in cost savings.
- Due to ObamaCare’s focus on quality over quantity, re-admissions among Medicare beneficiaries were driven down by 150,000 by 2015.
- Medicaid expansion and increased coverage have combined to reduced unpaid medical bills, resulting in less medical debt for consumers and fewer unpaid hospital bills, which hurt hospitals and state taxpayers. Hospitals’ uncompensated care costs were estimated to be $7.4 billion (21%) lower in 2014 than they would have been in the absence of coverage expansions.
FACT: 74,424,652 individuals were enrolled in Medicaid and CHIP in June 2017. See June 2017 Medicaid and CHIP Enrollment Data Highlights.
FACT: According to the CDC, 75% of all healthcare expenditures go toward treating chronic diseases, many of which are preventable. Chronic diseases cause 7 in 10 deaths each year in the United States.
Why did we need healthcare reform? ObamaCare was enacted to address the “healthcare crisis” (a term that describes the fact that premiums were rising faster than inflation, that healthcare spending was raising as a percentage of GDP, and that the uninsured rate was increasing because of this). The ACA was a first step to solving our problems and their effects like bankruptcy due to medical debt, but it wasn’t the final step. There are still “sticking points” that need to be “fixed.” So far, the biggest gains have been made in states that embraced ObamaCare. The states that rejected key provisions like Medicaid Expansion and the exchanges bring down the national average as their costs are higher, their choice of insurers are fewer, and their uninsured rates are higher. The conscious effort to obstruct ObamaCare at a state and federal level has been actively contributing to the ability of critics of the law to spin the “death spiral” talking point. See facts on how the ACA is working and more facts on the healthcare crisis before the ACA and why we needed reform.
Free Preventive Services and Ten Essential Benefits
Above we covered the ACA’s main benefits, but let’s talk about them in detail.
ObamaCare’s new benefits, rights, and protections include the requirement that most non-grandfathered (or non-grandmothered) health insurance plans cover preventive services and services from at least ten categories of essential health benefits with no annual or lifetime dollar limits. Learn more about grandfathered health plans.
The Ten essential health benefit categories include outpatient care, emergency care, hospitalization, maternity and newborn care, mental health services and addiction treatment, prescription drugs, rehabilitative services and devices, lab services, pediatric dental and vision, and free preventive services.
- A minimum amount of services from the Ten Essential Benefit categories must be included in all non-grandfathered plans as “covered services.” Covered services are services your plan covers in-network at the plan’s cost sharing amount.
- Free preventive services including a yearly check-up, immunizations, counseling, and screenings must be included in 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 continues to roll out until 2022. See our Affordable Care Act timeline for more information.
- The Affordable Care Act contains ten titles that span over 1000 pages, but most of its key provisions are in the first title. The first title is about 140 pages long. These pages are mostly blank space with about 450 characters per page. If you would like to read the whole title, would like a summary of the title, or would like a summary of the provisions within one, check out our summary of the Patient Protection and Affordable Care Act.
FACT: As of 2015 over 100 million Americans had already benefited from the Affordable Care Act. This includes more than 105 million people who accessed critical preventive services for free that had previously been subject to out-of-pocket costs. Seniors saved billions of dollars from the gradual closing of the Medicare Part D “Donut Hole.” Billions more were saved from new accountability measures for insurance companies, and that isn’t even the end of the savings from the ACA.
FACT: Before the ACA about 60 percent of all personal bankruptcies in the US are related to medical bills. The ACA has since helped reduce bankruptcies by about 50%. The health care law helps protect you from medical bankruptcy by ending annual & lifetime limits. Find out more health care facts.
FACT: ObamaCare provides free preventive women’s services, including mammograms, as one of the 10 essential benefits covered under every new insurance plan.
ObamaCare, Taxes, Shared Responsibility, and Exemptions
The Affordable Care Act also includes a lot of benefits, but it also includes new taxes.
Most of the 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.
These are: tax credits to subsidize costs for low-to-middle income Americans and small businesses, which started in 2014; an Employer Mandate for large employers to provide health insurance to full-time employees by 2015/2016 or pay a fee; an Individual Mandate for individuals and families obtain health insurance or pay a fee which started in 2014; and lastly, new limits on medical deductions.
NOTE: Remember, the mandate’s fee is reduced to zero for 2019 forward. With that said, since it is still relevant in past years, below are a few more ObamaCare facts about the fee.
ObamaCare creates state-specific and federal health insurance marketplaces (also known as exchanges) where individuals and families can shop for subsidized health insurance based on income.
- When you fill out a Marketplace application, you’ll also find out if you qualify for lower costs on coverage, Medicaid, CHIP, or Medicare.
- If you or a dependent has coverage through your employer, you can’t get subsidies on the marketplace.
- ObamaCare’s official health insurance marketplace is HealthCare.Gov. However, many states set up their own marketplaces. Find your state’s marketplace here.
- Apply for the health insurance marketplace early. Applying and enrolling are not the same thing. Although for many of us the application process will only take a few minutes, the verification process can take time. Once your application is verified, you have until the last day of open enrollment each year to enroll in a plan. Learn more about how to sign up for health insurance – ensure you don’t miss the annual deadlines!
- Remember, insurance purchased by the 15th of each month starts on the 1st of the next month after you pay your premium. If you sign up during the second half of the month, your coverage won’t start until the second month. Please check with your insurer for specific start dates.
ObamaCare and Minimum Essential Coverage
Only certain types of major medical health insurance protected you from the Individual Mandate’s shared responsibility fee (the fee for not having coverage) when it was applicable. This type of coverage is called minimum essential coverage.
- All insurance bought on the Health Insurance Marketplace, major medical plans outside the Marketplace, Medicare part A and C, Medicaid and CHIP, and most employer-sponsored plans are considered minimum essential coverage.
- Most private individual and family health insurance sold outside of open enrollment (like short-term health insurance) is not considered minimum essential coverage, and won’t protect you from the fee.
From 2019 forward Minimum Essential Coverage doesn’t mean as much regarding the fee, but it is still a standard that denotes coverage that meets the standards of the ACA.
ObamaCare and Cost Assistance
Above we touched on the basics of getting covered and getting cost assistance; below, we’ll offer some additional details.
There are three ways to save money on your health insurance through ObamaCare’s marketplaces. First, Advanced premium tax credits, which lower your monthly premium costs. Second, Cost Sharing Reduction subsidies, which lower your out-of-pocket costs for copays, coinsurance, deductibles, and out-of-pocket maximums. Lastly, Medicaid and CHIP, which do both. Learn more about ObamaCare cost assistance.
- Cost assistance is only offered through your state’s health insurance marketplace, although some private health insurance brokers and providers work with the marketplaces to assist you in getting subsidies.
- Americans making less than 400% of the federal poverty level may be eligible for free, low-cost, or reduced cost health insurance due to cost assistance subsidies like Tax Credits, which reduce premium costs, and cost-sharing subsidies, which lower cost sharing on copays, coinsurance and deductibles.
- Cost Sharing Reduction subsidies (CSR) are only available on Silver plans.
- Tax Credits can be applied in advance (in part or in full) to lower your premiums or can be adjusted on your federal income taxes.
- If your income changes, report it so the marketplace can adjust your subsidies. You may qualify for bigger credits if your income decreases and you will save yourself from potentially having to repay advanced tax credits.
- Make sure cost assistance is right, but, when in doubt, aim low. You don’t have to pay back Cost Sharing Reduction subsidies or Medicaid, but you could end up owing Advanced Premium Tax Credits back up to the limit for your income level when you file taxes. See Tax Credit form used to pay back Tax Credits for details on filing and limits.
FACT: KFF.org estimated that 3.5 million people qualified for an estimated average premium subsidy of $2,890 per person in 2014. The CBO estimated that the average subsidy in 2015 would be $3,900. In 2017 the average premium subsidy was about $4,452 according to KFF.org. These numbers help us to understand that each year cost assistance ensures that those who qualify for assistance will pay low rates, even when premiums increase! This is due to the way cost assistance caps premiums and out-of-pocket spending based on family size and income.
FACT: Medicaid and CHIP are types of cost assistance. Medicaid and CHIP enrollment in 365 days a year. That means there is never a wrong time to apply for Medicaid and CHIP!
MAGI and FPL
Cost assistance is based on Modified Adjusted Gross Income (MAGI). That means the cost is based on your income after most deductions. Once you know your MAGI, you can use the Federal Poverty Level (FPL) Guidelines to determine your assistance amount.
As long as you have the right documents, you can simply fill out a marketplace application, and it will calculate cost assistance for you. However, knowing how MAGI and the Federal Poverty Guidelines work will allow you to make smart choices about how many advanced tax credits to take up front.
Each year you’ll use last year’s guidelines for determining this years assistance amounts. For example, 2018 Federal Poverty Guidelines are used to determine cost assistance for marketplace coverage for 2019. Don’t worry though; the marketplace can help you figure out your assistance amounts. They are calculated when you sign up and give your information!
TIP: If you don’t have access to cost assistance or want to see other private plan options available, you can shop for health insurance quotes outside of the marketplace too. Qualified health insurance brokers and agents outside of the marketplace can even help you shop for marketplace plans. Just make sure you choose a marketplace plan if you want cost assistance, and of course, make sure you choose a broker or agent who is qualified to help you enroll in one if this is the direction you want to go.
Medicaid and CHIP
ObamaCare Expanded Medicaid and CHIP to millions of Americans. You can apply for Medicaid or CHIP at any time of the year.
If you miss open enrollment, you can still sign up for Medicaid and CHIP, but you won’t be able to use the marketplace to do so. Medicaid / CHIP eligibility differs in each state because many states did not expand Medicaid.
There are millions of Americans eligible for Medicaid who simply haven’t signed up yet. Keep spreading awareness and educate yourself about which states have expanded Medicaid eligibility under Medicaid Expansion.
- Over 15 million men, women, and children are eligible for Medicaid in states that participated in Medicaid Expansion.
- More states are expanding Medicaid every year. Find out if your state expanded Medicaid.
- 5.7 million people were uninsured in 2016 because 24 states had not expanded Medicaid. See America’s Uninsured Rate is on the Rise.
ObamaCare and Employers
ObamaCare helps to cover working families who don’t have access to health insurance.
- In 2015, large employers with 100 full-time equivalent employees or more had to begin insuring full-time workers.
- In 2016, employers with 50-99 full-time equivalent employees had to insure their full-time workforce as well.
This new rule is unofficially called the employer mandate. Here are some more facts about ObamaCare and business.
- Since 2010, small businesses with 25 or fewer employees have been able to get tax breaks for offering coverage (tax credits have been retroactive since 2010). ObamaCare and small business.
- The opening of the SHOP “Small Business Health Options Program” (the part of the marketplace small businesses use to buy employee health plans) began on November 15th, 2014. Small businesses can buy a SHOP plan through an agent and claim tax breaks for up to 50% of their share of employee premiums (this was true in 2014, even though they couldn’t officially use the marketplace).
- Small businesses can use a paper application or apply online for employee health coverage through the SHOP marketplace at any time.
- The small business health care tax credit may be carried back and applied retroactively to previous tax years. It can also be carried forward to future tax years. Learn more about the ObamaCare SHOP Small Business Health Options Program.
- The greater availability of health insurance and the employer mandate have contributed to a net reduction in full-time equivalent hours, a boost in part-time hours, lower uninsured rates, and have helped to eliminate “job-lock.”
- As of August 2015, we have seen 58 consecutive months of net job growth since October of 2010 under the Affordable Care Act. Learn more about ObamaCare and jobs.
- According to the January 15, 2015, report by the Commonwealth Fund: the growth of costs related to employer-sponsored health plans, including premiums and deductibles, have risen faster than the average income since 2003. However, in 31 states, that growth slowed since the ACA was signed into law.
- A Republican-backed bill called the”Save American Workers Act of 2015,” was introduced in 2015. The bill’s purpose was to change the definition of full-time employees from 30 hours to 40 hours. The bill could have increased the full-time workforce but would have likely left millions uninsured. Learn more about the pros and cons of changing the definition of full-time hours.
UPDATE: The Trump administration has made some changes to the way the ACA affects businesses. Please see a professional for the latest rules and regulations.
FACT: Only roughly the top 3% of small businesses have to pay their portion of the additional 0.9% ObamaCare Medicare tax increase. Meanwhile, only 0.2% of businesses had over 50 full-time equivalent employees and didn’t already offer insurance to their full-time workers before the ACA.
FACT: Over half of all uninsured Americans are small business owners, employees or their dependents. Learn the truth behind the ObamaCare small business taxes and how they affect America’s biggest job creators.
ObamaCare and Medicare
ObamaCare gives seniors access to cheaper drugs and free preventive care, reforms Medicare Advantage, and closes the Medicare Part D ‘donut’ hole. The fact is, the Affordable Care Act focuses heavily on ensuring better care for seniors and keeping Medicare strong for years to come. Learn about how the Affordable Care Act affects Medicare.
Medicare isn’t part of the Health Insurance Marketplace. If you have Medicare, keep it.
Do you want to get a better idea of how the Affordable Care Act affects Medicare, Medicare Advantage, Part D, or Medigap policies? Or perhaps you have questions about how Medicare works or how Medicare enrollment works. Look at our section on ObamaCare and Medicare for the Facts on ObamaCare and Medicare reform.
FACT: Aside from the “key provisions” of the Affordable Care Act (ObamaCare), there are hundreds of 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 (MSSP). 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.
FACT: ObamaCare’s new Medicare Value-Based Purchasing Program means hospitals can lose or gain up to 1% of Medicare funding based on a quality vs. quantity system. Hospitals are graded on a number of quality measures related to the treatment of patients with heart attacks, heart failures, pneumonia, certain surgical issues, re-admittance rate, as well as patient satisfaction. Learn more about ObamaCare and Medicare.
Qualified Health Plans
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 each has different networks and cost-sharing.
As a rule of thumb, the more “valuable” the metal, the higher the premium and lower the out-of-pocket costs. Don’t buy health insurance without understanding actuarial value and deductibles. The cheapest up-front cost option won’t always be the best, or least expensive overall, one for you and your family. Learn about the Types of health plans sold on the marketplace.
Aside from the 4 basic “metal” health plan types, a “catastrophic” health plan is available through the health insurance marketplace for people under 30 and people with hardship exemptions. Catastrophic health plans tend to have a low premium, but very high out-of-pocket costs.
How Health Insurance Works
Have you been wondering how health insurance works? You pay a premium for every month you have coverage. The higher your premium, the smaller your out-of-pocket expenses (copays, coinsurance, deductibles, out-of-pocket maximums) will be and the larger network of doctors and providers you can utilize.
FACT: Since 2014 all plans sold have had to offer the benefits, rights, and protections regarding cost and coverage, but each plan can offer unique cost-, networks, and benefits within those limits. Learn more about how health insurance works and how to buy health insurance each year.
- Each metal plan or private health plan has another plan type. These are HMO, PPO, and EPO plan types. If you are traveling out-of-state, go with a multi-state plan. If you want to limit upfront costs and know that the doctor you want is in the HMO network, consider an HMO. If you want flexibility, go with a PPO.
- It’s very important to understand the difference between in-network and out-of-network. Typically, your plan only pays full cost-sharing amounts for covered benefits in-network. Check your plan summary to see what services are covered and how.
- If you are considering getting a high deductible plan, try pairing it with a Health Savings Account (HSA).
- You don’t have coverage officially until your premium is paid! Remember to follow up with your insurance company if you don’t receive your welcome packet and make sure all premiums are paid on time.
FACT: 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. Because of this provision, networks are very important to consider when choosing a plan as they can affect what in-network providers you have access to.
For those who want to dig deeper into the PPACA, below are some things to consider.
- The ACA (ObamaCare) isn’t just one thing. It’s two laws, changes to other healthcare laws, hundreds of provisions, and additional rules and reforms called for by related legislation.
- The PPACA itself contains ten different titles, each addressing a different aspect of HealthCare reform. Most of what you hear about in the media is Title I Quality, affordable health care for all Americans.
- The most popular talking points are based on very short sections on subsidies, mandates, and the elimination of preexisting conditions. Most of the rest of the law is made up of hundreds upon hundreds of uncontested reforms that improve healthcare delivery and curb healthcare spending.
- “ObamaCare” also refers to the health care related sections of the Health Care and Education Reconciliation Act of 2010 signed into law shortly after the PPACA.
- The non-healthcare sections of the Health Care and Education Reconciliation Act of 2010 discuss Pell grants and student loan reform. All reforms are currently postponed.
- See a full summary of provisions in the PPACA, a summary of the Health Care and Education Reconciliation Act, or read the official compilation of the laws here.
- Aside from the laws that make up ObamaCare, additional rules and regulations called for by the PPACA and related healthcare laws are regularly released. This included updates from the IRS, CMS, HHS, and other agencies granted the power by assorted healthcare related laws. Important updates can be found in the Federal Register.
- Those who want to keep up what is happening with the ACA are well advised to keep an eye on Congress, the CBO, and the Kaiser Family Foundation. If you get current information from those sources, you’ll get a good sense of what is happening to the law each year.
More ObamaCare Facts
The facts below are our original “ObamaCare facts” from 2012 to 2014 (a few of which were highlighted above). This list will give you an idea of how things were then, and what some key provisions meant at the time. In other words, although this page has been around since 2012, and here in 2019 some facts from that time maybe aren’t as relevant, but we think they are still historically valuable and worth having access too!
It is easy to forget that time when women paid more than men for health insurance, or when you could be denied coverage or charged more for being sick in the past, or when there were lifetime and annual limits, or when there was 44 million uninsured. These facts below help serve as a reminder.
So remember when reading the rest of this page, what you’ll read below is a snapshot from the past (so some, but not all, figures would need to be updated to be accurate here in 2019).
• 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 number 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 have been denied health insurance for. ObamaCare chipped away at pre-existing conditions until 2014, so pre-existing conditions are no longer a barrier to insurance coverage for anyone, including high-risk customers. This means you can no longer be denied coverage or treatment or be charged more due to your 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 because of the new minimum standards of ObamaCare.
• ObamaCare doesn’t ration health care. It protects consumers from the health care coverage and cost-based rationing that insurance companies have been doing for decades.
• ObamaCare reduces the growth in healthcare spending. The current $2.8 trillion U.S. healthcare system costs almost $9k a year for every man, woman, and child.
• The new law affects everyone differently. Find out: how will the Affordable Care Act affect me?
After you get done reading the ObamaCare facts, check out our detailed summary of ObamaCare to get the facts on how Obama’s health care reform really works: health care reform summary
• You may have heard about the ObamaCare website glitches. The official healthcare.gov website had some technical issues at its launch, but those have been dealt with, and it is up and running well. Aside from the website, you can also sign up for the marketplace by mailing in an online application (read these instructions first), get in-person help, or call the 24/7 helpline (800) 318-2596. Learn more about other ways to sign up for health insurance.
UPDATE: The health insurance marketplaces are operational; over 8 million Americans had enrolled in marketplace plans after the first year’s open enrollment. 2017 has been a year of uncertainty, but as of September, all areas of the country have at least one insurer in the marketplace.
• When the ACA first began to be effective, some people in some states who bought insurance outside of the marketplace, due to technical issues with their states’ websites, despite qualifying for subsidies, could have retroactively signed up for a marketplace plan and received federal subsidies in 2014. Contact your insurance company for further details. ObamaCare subsidies.
• The Defund ObamaCare movement led to a Government Shutdown on October 1st, 2013 because the 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 Health care reform timeline of every protection, benefit, and tax laid out by the Affordable Care Act from 2010 to 2022.
• 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.
• Before ObamaCare’s first open enrollment period, 15% of Americans were uninsured – this is a little less than 50 million men, women, and children.
• Before the ACA, about 38 million Americans had inadequate health insurance.
• Studies have shown that anywhere from 20,000 to 44,000 Americans died each year from lack of health insurance.
• Given the above, before the Affordable Care Act, nearly one-third of Americans faced each day without the security of knowing that affordable medical care was available to them and their families.
• An April 2014 Gallup poll showed the uninsured rate dropped to 13.4%, the lowest in decades, during the open enrollment in the health insurance marketplaces. Under Trump, that rate edged upward. See US Uninsured Rate Edges Up.
• Both the individual mandate and the health insurance marketplace only affected uninsured Americans when in full effect.
• For the 85% of Americans with health coverage, almost all of ObamaCare’s changes are already in place.
• 7 million Americans were projected to purchase private insurance on the marketplace in 2014; in the end, more than 8 million people enrolled in a marketplace plan in 2014.
• 74,424,652 individuals were enrolled in Medicaid and CHIP in June 2017. See: June 2017 Medicaid and CHIP Enrollment Data Highlights.
• The number of uninsured people has dropped since the Affordable Care Act was signed into law.
• The Congressional Budget Office projected that 12 million more non-elderly people would become insured due the ACA.
• The 101.5 million already enrolled in government health programs like Medicaid, Medicare, and CHIP won’t need to use the marketplace.
• The 170.9 million are already covered by employer insurance and won’t need to use the marketplace.
• In 2010, 19.5% percent of uninsured were employed, and 14.7% maintained full-time employment for the entire year.
• In 2010, only 53.8% of private sector firms offered health insurance.
• Poor working families were, and still are the most likely to be uninsured.
• 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 had increased by 80%.
• The “employer mandate” means larger employers had until 2016 to insure their full-time employees and their families or pay a per-employee fee. Learn more about the Employer Mandate.
• Today, all small businesses with less than 25 full-time equivalent employees get better benefits, big tax breaks, and better buying power if they provide employee health insurance via the SHOP (part of their state’s Health Insurance Marketplace). Learn more about ObamaCare and small business.
• Under the Affordable Care Act tens of millions of people got health coverage through the marketplaces, through Medicaid and CHIP, and outside of the marketplace through private providers.
• A May 2014 Gallup poll shows, under ObamaCare (the Affordable Care Act), the uninsured rate is the lowest it’s been since 2008 when Gallup started polling the uninsured rate. Data from HHS on the uninsured in 2007 shows that this could be the lowest uninsured rate since before 1998. The uninsured rate for U.S. adults in April was 13.4%, down from 15.0% in March.
• States that moved forward with Medicaid expansion and established marketplaces saw the biggest reduction in the number of uninsured under the ACA; states that rejected both saw the smallest reduction. Learn more about how ObamaCare affects uninsured rates.
• Do you 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.
• Most Americans had to obtain qualifying health insurance that started by May 1st, 2014, get an exemption, or pay a fee for every month they were without insurance. The fee is paid on your federal income tax return. This fee was commonly referred to as an Individual Mandate and is part of the Shared Responsibility Provision. Learn more about the ObamaCare Individual Mandate.
• According to the CBO: mostly due to exemptions, almost 90% of the 30 plus million Americans without insurance will not pay the penalty for not having insurance in 2016.
• Most Americans will have the option of staying on their current healthcare plans. No one who is currently unable to afford health insurance, or who has access to a subsidized plan (including seniors), will be forced to go without healthcare. That’s an ObamaCare fact.
• If you like your doctor, and your health insurance provider includes your doctor in your network, you can keep your doctor. Nothing in the ACA prevents you from keeping your doctor, although you may have to pick a network that your doctor participates in. Learn more about ObamaCare and doctors.
• If you don’t have coverage, you can use your state’s 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. Insurance companies 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.
• Read our complete guide to the health insurance exchange marketplaces and find out how you can get reduced premiums and lower out-of-pocket costs for copays, coinsurance, and deductibles.
• According to a 2013 HHS report, 6 in 10 Americans without health insurance could have gotten health insurance for under $100 through their State’s Health Insurance Marketplace.
According to the June 2014 report, 69% of individuals who selected Marketplace plans with tax credits in the Federally Facilitated Marketplace (FFM), HealthCare.gov, had premiums of $100 or less after tax credits. Another 46% had premiums of $50 or less after tax credits.
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 adhere 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. Insurance companies can no longer use factors such as pre-existing conditions, health status, claims history, duration of coverage, gender, occupation, and small employer size org industry 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 in 2015, in some states, smokers could 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 to be unaffordable. Get the facts on ObamaCare and smokers.
• According to the CDC, 75% of all healthcare expenditures go toward treating chronic diseases, many of which are preventable.
• Chronic diseases cause 7 in 10 deaths each year in the United States.
• The Affordable Care Act includes a major focus on wellness; this includes funding for programs that educate the public on health and wellness and new rules for employer wellness programs.
• Employers can use the SHOP marketplace or Small Business Health Options Program, a part of the health insurance exchange, to purchase affordable coverage for their workers. This saves employers up to 50% of low to moderate earning workers’ premiums in the form of tax credits.
• Did your health insurance premium go up? The fact is, ObamaCare enacted some consumer protections, including a rate review provision. Under this review insurance companies have to justify rate hikes above 10% to your State and post details online immediately. Nonetheless, 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 went into effect in 2014. So far, the average insurance premium has gone down, primarily due to subsidies and the 80/20. Americans saved $1.9 billion due to the new ObamaCare consumer protection provisions in 2013 alone.
• ObamaCare means 21 new taxes. Get the facts on how they will affect you, your family and your business. Get the ObamaCare taxes facts.
• ObamaCare states that “affordable insurance” means paying either no more than 8% of your annual household income for the cheapest health plan offered to you or no more than 9.5% of household income for employee-only coverage if insurance is obtained through an employer. Please note that 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 to patients receiving mammograms and colonoscopies, which are two of the most widely used forms of preventive health care.
• ObamaCare reforms Medicaid and expands it 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 result of Texas opting-out of Medicaid expansion, over a million Texans went without health insurance in 2014. In 2010, 25% of Texans didn’t have access to health insurance. This includes 1,247,300 children. Many of the States 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 vs. quantity system. Hospitals are graded on a number of quality measures related to the treatment of patients with heart attacks, heart failures, pneumonia, certain surgical issues, re-admittance rate, as well as patient satisfaction. Learn more about ObamaCare 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 on Medicaid patients.
• 25 States have opted out of setting up a State-Run Health Insurance Exchange. This leaves the federal taxpayer 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 or failure to pay premiums.
• 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 their full-time workers. Providing these folks with insurance is the only “employer mandate” in ObamaCare.
• Over half of all uninsured Americans are small business owners, employees or their dependents. Learn the truth behind the ObamaCare small business taxes and how they affect America’s biggest job creators.
• Do you want a single-payer plan? Starting in 2017, states were able to get a waiver to set up their own approved health care solution under the Affordable Care Act.
• 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. Unfortunately, the increasingly popular high-deductible health insurance plans have kept many insured people from being able to afford both insurance and healthcare.
• 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.
• When insurance goes on sale via the health insurance exchanges in 2016, the cost of insurance premiums must be 8% or less of your modified adjusted gross income 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. Get more facts about the ObamaCare insurance exchange.
• In 2011, ObamaCare helped around 86 million Americans who had previously been subject to co-pays or deductibles to use free preventive services.
• ObamaCare aims to improve community health care centers in an effort improve health care for those who cannot afford private healthcare.
• 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 could receive tax breaks of up to 35% (25% for non-profits) of the cost of their employees’ insurance premiums. In 2014, it increased to 50% (35% for non-profits).
• 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 worker’s compensation programs).
• ObamaCare won’t cause 650,000 jobs to be lost as some of its detractors claim (this 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 might have created is from employees who cut back their hours since they no longer had to rely solely on their jobs for their family’s health care. This has not been documented. In fact, ObamaCare’s projected effect on job growth in Government jobs and Health Care rivals its projected 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 with benefits.
• If you or your family chooses not to purchase healthcare through the Online Health Insurance Exchange, you can still buy private insurance, get insurance through your employer, or through Medicare or Medicaid. Those who chose not to 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 for millions of families and small businesses and provides billions of 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.
• 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 and dollars.
• 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 tries 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.
IN CLOSING: Despite some recent changes, ObamaCare is still “the law of the land.” With that said, as time has clearly illustrated, there are still many people who would like to see ObamaCare repealed. If ObamaCare is repealed and not replaced with equivalent protections, tens of millions of Americans could be without access to affordable 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 ObamaCareFacts.com to spread the facts about health care reform under the Affordable Care Act.
ObamaCare Facts 2019: ObamaCare; Helping Your Grandmother Since 2012