The Affordable Care Act, more commonly known by its common acronym Obamacare, is a healthcare reform law designed to make affordable health insurance available to Americans while protecting them against tactics used by insurance companies that drive up costs or limit coverage.
Individuals can enroll in Affordable Care Act plans during either open enrollment period or after certain life events occur, and receive help with paying their premium tax credit payments.
1. People with pre-existing conditions
Prior to the Affordable Care Act (ACA), people with preexisting conditions were often denied health insurance coverage, particularly on the individual market where insurers would often deny applications or decline coverage entirely – leaving cancer patients and even those suffering less severe conditions like high blood pressure uninsured; those who did receive coverage often faced skyrocketing premiums or deductibles for coverage altogether.
Now, beginning in 2014, all new major medical health plans offered both inside and outside exchanges must be guaranteed issue – meaning your health status cannot be used against you or charged more. Premiums may only be determined based on age, zip code, tobacco use or family size – no longer medical underwriting will be permitted. Furthermore, The Affordable Care Act offers groundbreaking new benefits, rights and protections for people living with pre-existing conditions; those not qualifying can seek coverage through Medicaid programs in all 50 states and territories or purchase short-term health plans not subject to the ACA rules.
2. People who are unable to afford health insurance
Even with all of the Affordable Care Act’s consumer protections and efforts to make healthcare affordable, some people still find it challenging to afford health coverage. A survey conducted by West Health and Gallup showed that more than half of non-elderly adults without health coverage cited affordability concerns as their reason for remaining uninsured; those without insurance are more likely to struggle paying medical bills and experience financial strain due to medical debt.
The Affordable Care Act was intended to make health coverage accessible and affordable for all Americans regardless of income. Individuals whose household income falls between 100-400% of federal poverty level may qualify for premium tax credits that lower their cost.
However, many New York residents are ineligible for financial assistance due to a variety of reasons; either because their state did not expand Medicaid, immigration status has made them ineligible for the marketplace, or they cannot afford an Affordable Care Act plan. Whatever their circumstance, many worry whether they can afford health insurance in future.
3. People who do not qualify for Medicaid
An essential aspect of the Affordable Care Act (ACA) is providing financial aid for low-income people who lack affordable health coverage. Medicaid coverage for individuals earning under 138% of poverty; Marketplace plans offer financial assistance up to 400% of poverty levels;
However, some states have chosen not to expand their Medicaid programs, leaving many adults without access to coverage. As of 2021, nearly two-thirds of uninsured nonelderly adults cited cost as the main reason for not signing up for insurance coverage.
To qualify for Medicaid, individuals must meet certain nonfinancial criteria. They must reside within their state, be U.S. citizens or qualified noncitizens and meet a minimum income threshold. There is also a cap on assets owned by Medicaid beneficiaries; individuals with too much income could lose eligibility altogether. In addition, some Medicaid users must renew their enrollment each year – though involuntarily disenrolled due to renewal requirements have occurred in the past.
4. People who do not qualify for a tax credit
Although the Affordable Care Act (ACA) has enabled millions of Americans to gain affordable health coverage, not everyone benefits. Some opt-out while others don’t qualify for credit and cannot afford premiums; additionally, under this system ACA requires uninsured persons to pay an arbitrary penalty fee that many find unfair and intrusive.
Individuals whose income falls between 100-400% of the federal poverty level could qualify for subsidies to help pay for marketplace plans. They can select bronze, silver, gold or platinum plans – with more expensive plans providing the most comprehensive coverage.
The Affordable Care Act also offers consumer protections such as banning discrimination based on preexisting conditions and mandating health plans to offer cost-sharing reductions for some of the most frequently utilized services like deductibles and copayments. While its impact under President Donald Trump remains to be seen, regardless of this, ACA has helped make health insurance more accessible to millions of Americans while saving lives.
