Obamacare Facts With the 9 ACA Facts That You Don't Know

Here's How These Apply to You

••• 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 Fiscal Year 2018 budget, it includes Medicare worth $582 billion and Medicaid benefits of $404 billion. The Department of Health and Human Services manages the programs totaling $65.7 billion. Health care costs the U.S. government more than Social Security at $1.005 trillion or the military budget at $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 Changing How Health Care Is 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 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. It spends 30 percent 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. 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. 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 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 get preventive care for chronic illnesses. As a result, they will use expensive emergency rooms less, lowering health care costs for everyone.

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. The Tax Cuts and Jobs Act repealed the tax effective 2019.

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.