Anyone can buy health insurance through the Affordable Care Act (ACA) Marketplace. Those who earn less than 400 percent of the federal poverty level (FPL) may qualify for financial assistance that lowers their premiums and out-of-pocket costs.
Subsidies are based on your estimated income during a coverage year. If your actual income is higher or lower, your subsidy will be adjusted.
1. Individuals
The Affordable Care Act, or Obamacare, is an initiative that seeks to expand the availability and quality of health coverage. It does this by implementing various consumer protections, regulations, subsidies, taxes, insurance exchanges and other reforms.
The ACA offers a variety of benefits to individuals, including free screenings and preventive services that typically have low copays or deductibles. This is done to encourage people to stay healthy and avoid expensive treatment later in life.
Another benefit of the ACA is that it helps individuals with preexisting conditions get insurance coverage. This is an important step toward reducing the number of Americans with uninsured status and ensuring that everyone has access to health care.
The ACA also offers premium tax credits to lower income consumers who purchase their own plans on the individual market. These credits are available to individuals with incomes between 100% and 400% of the federal poverty level.
2. Families
The Affordable Care Act (ACA) makes it easier for people to get health insurance. The law includes consumer protections, regulations, subsidies, taxes and insurance exchanges to make quality, affordable coverage more available.
The ACA requires large employers to offer self-only and family coverage that meets minimum value, which covers 60 percent of healthcare costs and provides substantial coverage of physician services and hospital services. Individuals and families who are offered employer-sponsored coverage that does not meet minimum value may still qualify for premium tax credits to buy a marketplace plan.
However, prior to 2023, a “family glitch” created by the Internal Revenue Service’s interpretation of the ACA’s firewall provision prevented spouses and children from receiving PTCs to purchase exchange coverage if their employer offers adequate, affordable, employee-only coverage. This created a dilemma for many families, who were forced to choose between going uninsured or using a large portion of their income to pay for employer-sponsored coverage.
3. Small Businesses
If you’re looking to improve health insurance coverage for your employees, the Affordable Care Act has several options that may be right for your business. For example, small businesses can qualify for a tax credit that helps offset the cost of health care premiums for their employees.
Alternatively, some small businesses choose to offer their workers new Health Reimbursement Account (HRA) options. These accounts allow employees to use pre-tax dollars to pay for individual coverage and other qualified medical expenses, which can reduce their overall healthcare costs.
The ACA has been an important step toward expanding healthcare coverage for millions of Americans, but it’s still in need of some work. The current administration has made changes that could undermine some of the law’s progress and threaten the stability of the marketplaces.
4. Self-Employed
Those who are self-employed may not qualify for obamacare, but they can use the individual market to purchase a flexible, high-quality health insurance plan that works well for them. This includes small businesses, individuals, and even self-employed professionals such as accountants and financial advisers.
Self-employed workers typically have a plethora of responsibilities that include managing a budget, finding clients and managing their time and effort. They also have to be creative in their business plan and find the best way to keep their costs under control while maintaining a positive cash flow.
There are plenty of advantages to being a self-employed individual such as flexible schedules, the ability to work from home and being in charge of your own pay. It’s also a great opportunity to learn new skills as you navigate the intricacies of your own business. The most important thing is to be sure you’re making the right decision and weighing the many pros and cons before jumping in with both feet.
