Understand Affordable Care Act (ACA) - Obamacare

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The Affordable Care Act, which is also referred to as ACA or Obamacare, was signed into law by President Barack Obama in 2010. The act was a major overhaul of the U.S. healthcare system, reducing the amount of uncompensated care the average family pays for. Obamacare originally required everyone to have health insurance and offered cost assistance to those who could not afford a plan on their own.


Watch our video to understand how Obamacare works 

How does Obamacare work? The individual mandate

The original coverage requirement in Obamacare included a tax penalty for those that did not purchase a health insurance plan. This is known as the individual mandate. The penalties were designed in part to offset the cost of paying for the health care of people without health insurance, due to hardship situations or other exemptions.

In December 2017, the Trump administration passed a tax bill repealing the individual mandate. This repeal is still in effect in 2020, eliminating the fine for those without health insurance plans in most states. A few states do have their own mandates in 2020, including California, Connecticut, Hawaii, Maryland, Minnesota, Rhode Island, and Washington. Click here to find health insurance plans in your state.

Obamacare explained: Cost and subsidies

When you enroll in a health insurance plan, you typically pay a monthly premium to keep that plan. Obamacare includes subsidies to help lower income individuals cover the cost of their plans. These subsidies, also known as tax credits, are still in effect in 2020.

Obamacare also provided payments to insurance companies to keep their deductibles low. The Trump administration has cut those payments, although the law currently requires companies to continue to keep deductibles low. At this time, you may still apply for a subsidy to lower the cost of health insurance for you and your family.

Finding the right insurance plan at the right price is easier with eHealth. Although pricing is regulated in healthcare, the expertise and experience of the eHealth brokers helps individuals find the best coverage for their need. You may purchase your insurance plan through a phone call, chat, or online, with certified licensed brokers in every state. Check out all your options for individual and family health insurance!

What does Obamacare cover?

The specific coverage you receive with your plan under Obamacare will vary based on the plan you choose. However, the act has required coverage for some medical services, including:

  • Preventative care
  • Emergency care
  • Outpatient care when you are not admitted to the hospital
  • Hospitalization
  • Pregnancy and newborn care
  • Services for mental health and substance use disorders
  • Rehabilitative services
  • Pediatric care
  • Laboratory services

Under Obamacare, insurance companies cannot refuse you coverage or charge you more for your plan if you have a pre-existing condition. A pre-existing condition is one that was diagnosed before your new insurance coverage began.

Obamacare Open Enrollment Period

The Open Enrollment Period (OEP) is the time when you can shop for a new health insurance plan for the upcoming year. The OEP for 2021 plans will run from November 1, 2020 to December 15, 2020. If you do not enroll in a plan during the OEP, you may not be able to purchase ACA-compliant coverage unless you experience a qualifying event, such as:

  • Loss of a job
  • Move to a new coverage area
  • Birth of a child
  • Loss of existing coverage
  • Family event, such as marriage, divorce, or death

If you find yourself without insurance and are not eligible for a qualifying event, you may be able to enroll in a short-term plan depending on the state where you live. Contact eHealth to learn more about your choices in short-term plans that can provide you with the coverage you need until the next OEP.

See all of your options for ACA-compliant health insurance with eHealth! Our team of licensed insurance agents can help you navigate all possible plans and find a plan that provides the amount of coverage you need for an affordable price.


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