The Uninsured's Guide to Health Reform

The Affordable Care Act (ACA) - often called Obamacare - is a new law helping more Americans get health insurance.

Use this guide to learn more about how this law affects people without health insurance.

How ACA impacts the uninsured:

You are required to have health insurance, or pay a penalty. Unless you qualify for an exception, you'll pay a penalty if you don't have qualified health insurance starting in 2014. Qualified health insurance could include job-based coverage, private health insurance, Medicaid, or another government-sponsored insurance plan. 

Do you not have insurance because of a pre-existing condition? Before ACA, private health insurance companies could turn you away because of a pre-existing condition. That left millions of Americans with no access to health insurance because they didn't qualify for any government-sponsored plans or have access to job-based coverage. 

ACA changes that. Now insurance companies cannot decline you because of a pre-existing condition. Insurance companies also cannot charge you extra premium because of a pre-existing condition. 

Do you not have insurance because it's too expensive? For many people, health insurance premiums became completely unaffordable in recent years. Millions of Americans were forced to drop their coverage -  not because they didn't need it -  but because they couldn't afford it. 

Under ACA, you can qualify for tax subsidies based on household income and family size to lower your costs. A tax subsidy is the amount of money paid by the government to your private, brand-name insurance company to lower your monthly insurance premium or your out-of-pocket costs when you use your plan. If your household income is beneath 400% Federal Poverty Level (about $94,000 a year for a family of four), then you'll probably qualify for a tax subsidy.

Use our Subsidy Calculator to see how much discount you might qualify for. Or, contact us - we're trained and authorized to walk you through the process. 

ACA cuts DSH funding. Many of us are used to the idea of going to the hospital to get treatment if we don't have insurance, but that might change. Disproportionate share hospital (DSH) payment cuts are included in the new law. DSH payments help provide money to hospitals to treat people without health insurance. 

The assumption behind the cuts was that when Medicaid was expanded to cover more people, less DSH funding would be needed because more uninsureds would be covered under Medicaid. However, many states did not expand Medicaid, so they will see deep DSH cuts. The law requires $18.1 billion in total reductions between 2014 and 2020, which cuts the uninsured's safety net in almost half. 

If you're younger than age 26, you can be covered on your parent's insurance plan. ACA allows young adults to stay on their parent's health insurance plan longer. And it doesn't matter if you're married, a full-time student, or if your parent claims you as a dependent. You can be covered under a parent up until your 26th birthday - no questions asked.  

Get covered to avoid the penalty 

Consider the lowest cost option. Since you're not used to having a health insurance premium, you might want to consider the lowest cost option. That way, you'll avoid the penalty for not having insurance, avoid bankruptcy if you get back sick, and get great benefits like free preventive care. 

For most people, the Bronze plan will be the lowest cost option. But if you're under 30 years old, it will be the "catastrophic" plan. These plans have higher out-of-pocket costs when you use your insurance, but they have the lowest monthly premiums. 

You get the power of choice. Even if you qualify for a tax subsidy to reduce your costs, you can still choose your plan and your brand-name insurance company from all the ones available in your area. Be sure to consider whether or not your doctor accepts that insurance plan, too.

Be sure to check out our GUIDE to help you choose between the Platinum, Gold, Silver, or Bronze plans.

And if you're overwhelmed, don't worry, we're here to help. We are tried and authorized to walk you through your options.