How Does Obamacare Affect Me?

Written by Sandy Baker
Written by Sandy Baker

Health insurance blogger, Sandy Baker, has a long-term history online that includes publications with companies such as Marriott Hotels and The New York Times.

Updated
Stethoscope, pills, and healthcare application.

Many people simply want to know: How does the Affordable Care Act, also known as Obamacare, affect me personally? The new health care system is likely to affect most Americans, but in different ways. It's important to note that if you have employer-sponsored health care, you may or may not see changes to your health care coverage, based on costs and coverage options. In some cases, your employer may make changes to policies to meet the Affordable Care Act guidelines. The ACA affects people differently, depending on their age and circumstances.

How Will Obamacare Affect College Students Age 18 to 26?

As a college student, having health insurance is often necessary, especially if a parent's plan no longer covers the child. One of the changes the ACA initiated was the ability for parents to keep their adult children on their family health insurance policies until the age of 26. In many cases, if a parent moves to the ACA plan, a full-time enrolled college student is likely to maintain coverage in the same way he or she received it previously, such as through their parents' employers. If the student does not enroll in a college-provided health insurance plan or a parent's plan, the student can elect to obtain health insurance through the Affordable Care Act marketplace.

If young people enter the workforce rather than college and begin earning income, they will be required to maintain health insurance under the ACA either through their employer or the marketplace.

What Does a Young Adult Need to Do?

Keep the following in mind as you consider your health insurance options:

  1. Stay on a parent's plan as long as possible. This is the least expensive option for most students, if it is available to them. Paying the full premiums for an individual health insurance policy can be a burden for most college students.
  2. Choose a health plan through the school. Because premium costs are grouped together in these college-offered plans, they can be more affordable than other options. They are often ideal for older students unable to stay on a parent's plan.
  3. When purchasing from the subsidized health insurance options in the marketplace, you may qualify for the tax credits if your income is up to 400 percent of the federal poverty level. Take advantage of these tax cuts.
  4. Consider catastrophic coverage. College students appreciate these plans because they have low premiums and high deductibles. Keep in mind, however, that most plans have deductibles starting at $6,000 or more, making an accident a very costly situation. Also, you cannot use tax credits on catastrophic plans. Buy them as a last resort.
  5. Consider the options available through Medicaid. If you are a low income family, you may qualify for Medicaid. As a student under the age of 65 with income at or below 133 percent of the federal poverty level, you may qualify.

How Does Obamacare Affect Me Between Age 27 and 60?

According to Healthcare.gov the most significant changes that the Affordable Care Act initiates is lowering the coverage costs for Americans who could not afford to previously purchase insurance. Another significant reform due to the ACA is insurance companies can no longer deny coverage for preexisting conditions. In the Marketplace, where consumers can shop for insurance from a variety of providers and policies, new options to allow for preventive care, prescription drug coverage, doctor visit coverage and hospitalization are included, which may not have been available with previous policies.

Perhaps the most important change that many people don't realize is the requirement to have health insurance. Although the ACA does include some exceptions, most Americans are required to have some type of health insurance in place. This may include employer-sponsored plans. If the individual does not have a plan otherwise, the person can purchase a individual plan or a family plan through the Marketplace. If you fail to obtain insurance, however, you may pay a penalty for not having it. The IRS takes this penalty out of your income taxes.

What If You Don't Have Health Insurance?

If, for whatever reason, you decide not to have health insurance, you'll need to understand the implications. You may have to pay a fee and pay for all of your health care costs out of pocket. For 2014, open enrollment through the various state exchanges ended March 31. If you did not have insurance as of that point, consider the following:

  • Fees will change year to year. For 2014, you'll pay one percent of your yearly household income, or $95 per person for the year (whichever is higher).
  • Even if you pay this fee, you do not have health insurance. You remain responsible for 100% of your medical costs.

It's also important to know that there are minimum essential coverage requirements for Obamacare. That is, to avoid the penalty, you have to have specific levels of health coverage. The following health insurance plans do meet the ACA's minimum coverage requirements:

  • Policies found through your state exchange or marketplace
  • Medicaid
  • Medicare
  • The Children's Health Insurance Program
  • TRICARE (for service members and families)
  • Peace Corps Volunteer plans
  • Veterans health care programs, which include the VA Civilian Health and Medical Program, the Veterans Health Care Program and the Spina Bifida Health Care Benefits Program.
  • Employer-provided health insurance

If you are unsure if your current plan includes the ACA's minimum requirements, you can ask your health coverage provider for information.

Watch Out: These Types of Plans Are Not Enough

There are several types of insurance plans out there that do not meet the specific requirements of the Affordable Care Act. If you have these, and only these, you may still have to pay a penalty.

  • Coverage that only includes vision care or dental care
  • Workers' compensation plans
  • Discount plans - plans that offer discounts for specific medical services
  • Specific disease or condition coverage
  • Health Savings Accounts

If you have relied on these types of medical coverages in the past, they may not be sufficient to avoid paying the tax penalty and you will need to seek additional coverage.

How Does Obamacare Affect Me If I Am over Age 60?

According to WhiteHouse.gov, senior citizens asking the question "What does Obamacare mean to me?" will find a variety of benefits. The ACA promises to reduce the costs associated with Medicare and to provide better long-term care. It also promises to provide affordable, high-quality health care for seniors, reduce nursing home abuse and promote better hospital care.

What You Need to Know as a Senior

If you are a senior, and on Medicare, you do not need a separate policy from the Marketplace. Medicare is not part of the Marketplace. Even more importantly, the Marketplace will not sell Medigap policies, or supplemental policies you can use with your Medicare. Seniors will still get their coverage through Medicare, either through the Medicare Advantage plans or fee-for-service plans. Private health insurance plans that are Medicare-approved also provide adequate coverage under the ACA.

Here are a few more things you need to know as a senior:

  • You'll get more preventive care visits under Medicare through the new law, including colorectal screenings, wellness visits and mammograms.
  • If you are a higher-income Medicare beneficiary, you may have to pay more for your drug coverage. If you earn more than $85,000 per year, you'll pay more for Medicare Part B premiums and Medicare Part D coverage.
  • Seniors can elect to shop and use the Marketplace if they would like to do so. This can help some who are purchasing private insurance plans to get a lower cost on the policy.

How Does Obamacare Affect Immigrants?

No matter what your age, the ACA may play a role in your life if you are an immigrant, according to the National Immigration Law Center. If you are a naturalized U.S. citizen, you are given the same access and coverage requirements as any U.S.-born citizen. If you are lawfully present in the country, such as with a green card, or work visa there are some limited federal coverage options. You may be exempt if you are low-income. It is possible to enroll in a qualified health plan through state exchanges. Additionally, immigrants of this status are eligible for many of the same coverages, including preexisting condition insurance plans and basic health plans. There are no waiting periods for enrollment in state exchanges and premium tax credits.

Do You Need a Plan?

For many Americans, the reality is the ACA affects them because of the requirement to obtain health insurance of some type. Navigating the state exchanges and trying to find affordable medical coverage is still difficult, despite the reforms and efforts at the state and national levels. You don't have to attempt to find health insurance alone, however. Knowledgeable, independent insurance agents on the Trusted Choice network are always available to answer your questions. These agents are experienced in finding the best coverage at the most affordable rates and are up-to-date on all new health care laws. Trusted Choice agents do not work for the government or the insurance companies, and therefore have only your best interests in mind. Contact a Trusted Choice agent near you who can help find you a number of policies with a variety of coverage options at rates you can afford.

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