Obamacare Facts: 9 ACA Facts That You Don't Know

Here's How These 9 Facts Apply to You

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Stick to the facts about the ACA, not the rumors. Photo: Ariel Skelley/Getty Images

Obamacare is the popular, and frequently misunderstood, 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 no one has told you. Use these facts to get all the benefits you can from this comprehensive and complicated piece of legislation. 

1. The real goal of the ACA is to lower the cost of Medicare and Medicaid. 

The federal government spends $1.05 trillion on health care alone, more than any other budget item. According to the FY 2018 budget, it includes Medicare ($582 billion) and Medicaid benefits ($404 billion). The Department of Health and Human Services manages the programs ($65.7 billion). Health care costs the U.S. government more than Social Security ($1.005 trillion) or the military budget ($824 billion). 

The problem will only get worse. By 2027, spending for Medicare and Medicaid benefits were projected to rise to more than $1.6 trillion. It doesn't leave much for Social Security, defense, the interest on the national debt, or the rest of the U.S. government. If there's one thing politicians don't like, it's having their hands tied when it comes to spending. It's the real reason they agreed to reform health care.

2. It is already changing how health care itself is being delivered

The  ACA mandated that hospitals, doctors, and pharmacists must 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, health care costs should drop.

Third, health care providers are forming Accountable Care Organizations, which coordinate your care between your doctor and your specialists. You probably thought this 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 health care industry recognizes that integrated care is the way of the future, and they are already making the shift to integrated care.

3. It's already improved health care and your insurance plans.

These improvements include: 

  • All plans must provide 10 essential health benefits.
  • Plans can not 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. It spends 30 percent less ($792 billion) on expanded Medicaid and CHIP. 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 -- smack dab in the middle. These subsidies will become state block grants in Trump's plan to replace Obamacare.

5. Sixty percent 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, made too much money for Medicaid, and are legal residents of the United States. However, only 6.6 million did sign up. Don't be one of the 10.4 million people who didn’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 use expensive emergency rooms less.  

8. You must get health insurance for at least nine months each year or be subject to a tax.

But millions of people receive exemptions. For example, if you declared bankruptcy, you are exempt.

9. The ACA has 10 sections in all. Most do more than provide insurance.

Did you know the ACA legislation has also implemented the following programs? It created the National Prevention Council that coordinates all federal health efforts to promote active, drug-free lifestyles. It funds scholarships and loans to double the number of health care 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. 

More on Obamacare

How Does It Work? | When Does Obamacare Start? | Cost of Obamacare to the Nation | Obamacare Explained - Simple Enough So Your Child Will Understand It | Summary | The Truth About Obamacare | Obamacare Pros and Cons | What Is Wrong With Obamacare? 

For more little-known Obamacare facts, see my book The Ultimate Obamacare Handbook (2015 - 2016).