"Obamacare" is the popular name for the Patient Protection and Affordable Care Act of 2010. Whether you purchase Obamacare insurance or not, the Act has already affected you in ways that no one has told you. Use these facts to get all the benefits you can from this comprehensive piece of legislation.
1. The Real Goal of the ACA Is to Lower the Cost of Medicare and Medicaid
The federal government spends $1.27 trillion on healthcare alone, more than any other budget item. According to the fiscal year 2021 budget, it includes Medicare benefits of $722 billion and Medicaid at $448 billion. The U.S. Department of Health and Human Services (HHS) manages the programs at a current budget of $96.4 billion. As a result, healthcare costs the U.S. government more than Social Security at $1.15 trillion, or the military budget at $933 billion.
The problem is getting worse. By 2030, spending for Medicare and Medicaid benefits is projected to rise to almost $1.9 trillion. If there's one thing politicians don't like, it's having their hands tied when it comes to spending. That's the real reason they agreed to reform healthcare in 2010.
2. It Is Changing How Healthcare Is Delivered
The ACA mandated that hospitals, doctors, and pharmacists work together in ways they never did before. First, all medical records must be recorded electronically instead of on paper. Computerized records allow doctors to easily share their diagnoses and treatments.
Second, Medicare pays hospitals based on how well you get, instead of how many tests and procedures doctors prescribe. As a result, healthcare costs should drop.
Third, healthcare providers are forming Accountable Care Organizations, which coordinate your care between your doctor and your specialists. You probably thought that was already happening. It's not. In fact, miscommunication between doctors was the biggest cause of unanticipated deaths among patients in 2010. Thanks to the ACA, the healthcare industry recognizes that integrated care is the way of the future, and they are already making the shift in that direction.
3. It's Already Improved Healthcare and Your Insurance Plans
These improvements include:
- All plans must provide 10 essential health benefits.
- Plans can no longer exclude those with pre-existing conditions.
- Companies can no longer drop those who get sick.
- Parents can add their children up to age 26 on their plans.
- Lifetime limits are eliminated.
- Annual limits are eliminated.
4. The ACA Benefits the Middle-Class More Than the Poor
Obamacare subsidies for those who sign up on the health insurance exchanges will cost the federal government $1.039 trillion between 2015 and 2024. Expenditures are 30% less, or $792 billion, on expanded Medicaid and on the Children’s Health Insurance Program. The ACA subsidies go to families that earn roughly between $47,000 and $94,000 a year or 400 percent of the federal poverty level. The median family income in the United States for a family of four was $79,698, a figure that’s smack dab in the middle. These subsidies would have become state block grants in Trump's plan to replace Obamacare.
5. 60% of Those Who Are Eligible for Obamacare Subsidies Don't Even Know It
Seventeen million people qualified for subsidies because they did not have insurance from their employer. Although they made too much money for Medicaid, they are legal residents of the United States. But only 6.6 million did sign up. Don't be one of the 10.4 million people who don’t. Make sure you know how to get Obamacare.
6. It Adds Benefits to Those on Medicare
If you have Medicare, the "doughnut hole" gap in coverage is being subsidized. There are many other ways that Obamacare affects people differently depending on their situation.
7. It Doesn't Provide Health Insurance to Illegal Immigrants
Immigrants in the United States illegally cannot receive Obamacare. But the ACA does expand community health clinics to serve them. Why? So they will get preventive care for chronic illnesses. As a result, they will use expensive emergency rooms less, lowering healthcare costs for everyone.
8. You Must Get Health Insurance for at Least 9 Months Each Year or Be Subject to a Tax
Millions of people receive exemptions. For example, if you declared bankruptcy, you are exempt. The Tax Cuts and Jobs Act repealed the tax, effective in 2019.
9. The ACA Has 10 Sections in All, and Most Do More Than Provide Insurance
Did you know the ACA legislation has also implemented the following programs?
- It created the National Prevention Council, which coordinates all federal health efforts to promote active, drug-free lifestyles.
- It funds scholarships and loans to double the number of healthcare providers in five years.
- It cuts down on fraudulent doctor/supplier relationships.
- It requires background checks of all nursing home staff to prevent abuse of seniors.
Frequently Asked Questions (FAQs)
When is open enrollment for Obamacare?
Open enrollment typically starts in the fall. In 2021, for example, Obamacare participants chose their health insurance plans at some point between November 1, 2021, and January 15, 2022.
What is the income limit for Obamacare?
Anyone can sign up for an Obamacare health insurance plan, but income limits do apply to premium tax credits. The income limit depends on where you live and whom you live with. You can use the premium estimation calculator to get a sense of what you might qualify for, and you'll get exact numbers after you complete an application.