The cost of Obamacare varies based on your age, income, family size and plan type. Fortunately, the law offers subsidies that can help lower these costs.
The law also encourages states to expand Medicaid and sets strict requirements for health insurers, which reduce spending in the healthcare system and decrease the number of people without coverage.
Costs
Your health care costs under the Affordable Care Act will vary based on your age, income and family size. But you can get a plan that fits within your budget by doing some research and finding one that offers plenty of choices.
Under the Affordable Care Act (ACA), all individuals and families are required to purchase health insurance or pay a penalty based on their income level. Individuals are charged $95 per month or 1.0% of household income, whichever is higher; families pay either $295 per month or 2.5% of household income, whichever is greater.
Costs vary based on the type of coverage you select. Obamacare provides four metal tiers, with Bronze plans having cheaper premiums but higher out-of-pocket expenses when receiving medical care.
Another type of Obamacare health plan is catastrophic coverage. These plans are tailored for people with poor health who don’t have access to other insurance options and have low monthly premiums but high deductibles, which must be met before your health insurer covers most of your medical costs.
Subsidies
The Affordable Care Act (ACA) offers various subsidies to assist people in affording health insurance coverage. One such subsidy, called Premium Tax Credits (PTC), helps reduce the cost of a plan by helping offset taxes.
The Affordable Care Act (ACA) also offers cost-sharing reductions (CSR), which help lower out-of-pocket expenses such as copayments, deductibles and other out-of-pocket costs. Unfortunately, CSRs may not be available for all plans so it’s essential to understand their eligibility criteria and rules.
If you’re currently enrolled in an Obamacare plan through the ACA Marketplace, then you may qualify for Obamacare premium subsidies based on your expected 2022 income level. Here’s how to determine your subsidy eligibility and see how much money can be saved on premiums in 2021.
In the past, those with incomes above 400% of the poverty level faced a “subsidy cliff.” But thanks to the American Rescue Plan and Inflation Reduction Act, there is no income cap on premium subsidy eligibility through 2025; this means even those with earnings exceeding 400% can get assistance if they contribute towards either a health savings account or pre-tax retirement plan.
Taxes
The Affordable Care Act has introduced several new taxes that must be paid in accordance with its provisions. These include an individual mandate, health insurance premium tax credits and taxes on high-income families.
These tax changes were intended to expand coverage, reduce costs, and fund health care reform. Furthermore, the Affordable Care Act made changes to the income tax deduction for medical expenses which will be limited to 10 percent of taxable income starting in 2021.
One of the more contentious elements of Obamacare is the so-called “subsidy cliff”, which stands at 400% of federal poverty level. This limit prevented those with incomes over 400% from qualifying for premium tax credits.
In 2021 and 2022, the American Rescue Plan (ARP) eliminated this cliff; further, the Inflation Reduction Act extended it until 2025. As a result, people’s subsidies continue to decrease gradually over time.
John and his wife make $100,000 in 2021 and purchase a benchmark plan, they are eligible for an $8,456 premium tax credit. They can choose to take it in advance which will lower their monthly premium payments, or they can wait until after filing taxes and receiving their refund.
Enrollment
Enrolling in a marketplace health insurance plan begins November 1 and runs until January 15. People looking to sign up for 2021 coverage must do so by December 15 if they would like it to begin at the start of the new year.
Your premiums are determined by several factors, including income and where you live. In certain circumstances, you may qualify for a subsidy to help cover insurance costs which could reduce your overall premium.
One way to reduce costs is by selecting a cheaper health plan that includes all essential benefits and leaves out some frills. Doing this means less out-of-pocket expenses for you and your family, which could amount to substantial savings over time.
Another alternative is enrolling in a low-income SEP, which is now available this year. This program allows those with incomes up to 150% of the poverty line ($20,385 for individuals or $34,545 for families of three) the opportunity to purchase Marketplace plans throughout the year.