The Affordable Care Act is an unprecedented policy change, helping millions of people gain health insurance – including Texans.
Though its promises were lofty, the Affordable Care Act (ACA) has caused numerous complications in Texas. Many have struggled to obtain coverage and some may have been denied plans they otherwise would have preferred.
What is Obamacare?
Obamacare, passed in 2010, made health insurance more accessible for more people, including Texas residents who previously didn’t have it.
The law protects you against discrimination based on pre-existing conditions, prohibits insurers from charging more for women than for men, and assists low-income families pay for coverage. According to an analysis by Kaiser Family Foundation, these protections have helped lower Pennsylvania’s uninsured rate by over five percentage points since 2014.
Texas residents who were uninsured prior to the Affordable Care Act can now obtain health coverage through a federal marketplace plan, choosing from among various plans offering different benefits and prices.
Plans vary greatly in their costs and coverage levels, with higher-cost plans providing less coverage at higher costs. Some Texans may even qualify for subsidies to help afford their plans; these subsidies cover part of your premium costs as well as out-of-pocket expenses like deductibles and copayments.
How does Obamacare work?
The Affordable Care Act makes affordable health insurance accessible to people who may otherwise not have it, including consumers with preexisting conditions and children whose plans do not cover them. Furthermore, it promotes healthcare services which reduce costs while simultaneously improving quality.
This law also promotes comparison shopping and increases competition between insurers by mandating they offer multiple coverage levels and price points; additionally, they must cover preventive care without incurring out-of-pocket expenses.
Critics of the Affordable Care Act have claimed that it strains medical systems and supplies of primary care physicians. Furthermore, wait times increase and lengthening times can add years to visits to doctors offices.
The Affordable Care Act has enabled over 16 million Americans, particularly young adults who previously lacked coverage, to gain health coverage through healthcare plans available through it.
How do I get Obamacare?
If you are seeking Obamacare in Texas, two ways are available for signing up: through the federal Marketplace or licensed brokers. Subsidies may also be available but only apply to silver-level plans (please refer to our chart for further clarification).
Open enrollment occurs annually from November 1 – December 15, and it is the ideal opportunity to enroll in an Affordable Care Act health plan. Each ACA plan must offer 10 essential benefits such as emergency services, maternity care and prescription drugs.
Some individuals can sign up for Obamacare outside of Open Enrollment if they experience certain “qualifying life events”, such as marriage, having children or losing employer-sponsored health coverage.
Low-income Texans may qualify for Medicaid and CHIP programs funded by both state and federal governments; these provide coverage for children up to 26 years of age, and qualifying participants may even receive subsidies to assist with costs.
Do I have to get Obamacare?
Dependence on Obamacare depends on your family circumstances. Under its terms, you have two options for enrolling: you can purchase an affordable health plan or enroll in state programs like Medicaid or CHIP.
The federal government is providing aid for some Americans’ healthcare costs by offering financial assistance that reduces premiums and out-of-pocket expenses. You can find out if you qualify by using eHealth’s subsidy calculator.
Texas Department of Insurance estimates that during its open enrollment period for 2023 health coverage through its exchange, approximately 2.4 million individuals signed up – which would rank second highest nationally and mark an increase of 16 percentage points over last year when rate laws were still in place.