What Is Obamacare?

Obamacare, also known as The Affordable Care Act, is a health reform law that reimagines healthcare in the United States. Obamacare makes it easy for millions of Americans to have access to affordable health insurance.

Benefits Of ACA Obamacare

The Affordable Care Act aims to reduce the cost of health insurance for the majority of Americans. There are several mandates in place that allow ACA to function.

The ACA works according to the amount of income an individual or family makes. The lower the income the higher the tax credit they will receive. Tax credits have the possibility to cover the entire cost of someone’s health care or at least help.

The ACA makes it possible for people with pre-existing conditions to get coverage by not allowing denial of service. Previously having an existing medical condition would sometimes make it impossible to get insured.

The Affordable Care Act provides more benefits like:

• Essential benefits that are mandated to be offered in every plan that adheres to ACA
• Created the health insurance marketplace where you can find all your health insurance needs in one place
• Improves Medicare for seniors and people with disabilities
• Expands employer coverage
• Allowing young adults to stay on their parent’s plan until they are 26 years old.
• Prevents gender discrimination.

What Is The Marketplace?

The health insurance marketplace is an accessible online website where all health insurance plans and prices can be compared. Many states have their own health insurance marketplace but the ones that don’t use HealthCare.gov. Here is a list of states that have their own marketplace website:

• California
• Colorado
• Connecticut
• District of Columbia
• Idaho
• Kentucky
• Maryland
• Massachusetts
• Minnesota
• Nevada
• New Mexico
• New York
• Oregon
• Rhode Island
• Vermont
• Washington

Obamacare Subsidies And Cost Sharing Plans

Obamacare offers subsidies and cost-sharing plans. Tax credits are granted to individuals and families that are making between 100% and 400% of the federal poverty line. The federal poverty line is $12,760 for individuals and $26,200 for families.

Individuals of families making less than 138% of the poverty lines are eligible for Medicaid or CHIP.

• 100% of the poverty level is $12,760 for individuals and $26,200 for families
• 138% of the poverty level is $17,609 for individuals and $36,156 for families
• 400% of the poverty level is $51,040 for individuals and $104,800 for families

When And What Is The Obamacare Open Enrollment Period?

You can enroll in Obamacare insurance only during the Open Enrollment Period (OEP). OEP is generally from November 1st to December 15th. However, for 2021 it has been extended through August 15th.

Individuals and families that are not covered by their employer, Medicare, Medicaid, or CHIP need to enroll during OEP. If you have missed the deadline you may qualify for a Special Enrollment Period (SEP).

You may qualify for a SEP for 60 days during any of these life events:

Household Changes

• Marriage
• Adding to the family. Having a baby, adopting a child, or fostering a child.
• Divorce or legal separation
• Death in your marketplace plan. If there is someone in your plan that has passed away you qualify for a SEP

Changes In Residence

• Moving to a new home in a different zip code or county
• Moving to the U.S. from a foreign country
• Students that move for school
• Seasonal workers moving to or from work
• Moving to or from a shelter or other transitional housing

Other Qualifying Changes

• Loss of health insurance
• Gaining membership in a federally recognized tribe or status as an Alaska Native
• Claims Settlement Act Corporation Shareholder
• Becoming a U.S. citizen
• Leaving incarceration
• Starting or ending service as an AmeriCorps State and National, VISTA or NCCC member

What are the Essential Benefits?

One important aspect of the Affordable Care Act is the 10 essential benefits included in every plan. All of the following features are included under all insurance plans with no lifetime or annual limit:

1. Outpatient Care. This is any service that does not require hospitalization. For example a yearly check up is considered Outpatient care.




2. Emergency Services. Visits to the emergency room are covered by all ACA plans.




3. Hospitalization. Services that require hospitalization and services provided when hospitalized are covered.




4. Maternity and newborn care. Care that women receive during pregnancy, during labor, delivery, and post-delivery including care of new born babies.




5. Mental health services and addiction treatment. Inpatient and outpatient services needed to treat mental illnesses or substance abuse.




6. Prescription drugs. Medication that is prescribed by a doctor.




7. Rehabilitative services and devices. Rehabilitative and habilitative services and devices that help individuals gain or recover mental and physical skills lost to injury, disability or chronic condition.




8. Laboratory services. Laboratory tests provided to assist doctors assessment of a patient.




9. Preventive care, wellness services, and chronic disease treatment. Annual check-ups, immunizations, and flu shots, as well as certain tests and screenings, are just a few things that are covered.




10. Pediatric services. Care provided to infants and children is covered by the ACA as well.

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