1-877-752-4737

Health Care Reform Insurance

The Short Definition

Health Care Reform insurance, also known as the Patient Protection Affordable Care Act (PPACA) or “Obamacare” in the United States, was passed in 2010. This law makes health insurance mandatory, outlaws denials, requires free preventative care services (including birth control), levies penalties on the uninsured and offers up-front tax credits to low income individuals and families who enroll through health insurance marketplaces, called exchanges.

Summary of the Affordable Care Act

The Obama Health Care bill created a timeline for the roll out of massive changes to health care in the nation. The law called for the creation of health insurance exchanges where Americans can shop for their health care coverage online and receive monetary help if they qualify. The exchanges allow applicants to shop and compare plans in an easier to understand way.

The law calls for the creation of Open Enrollment Periods. During this three month window of time (which may later be shorted to 45 days), applicants can sign up or change plans without having any qualifying life event. In 2017, Open Enrollment will be from November 1, 2016 to January 31, 2017. This will be the 4th Open Enrollment Period. So far, we have had Open Enrollments for 2014, 2015 and 2016 effective dates. Outside of this enrollment window, Americans can apply for coverage during the Special Enrollment Period (SEP) if they have a qualifying life event such as getting married, having a baby, moving to California, etc.

The ACA allows for individuals who already have health insurance coverage to keep their “grandfathered plans”. However, many health insurance companies have discontinued some or all of their grandfathered plans.

California consumers can learn how much of a tax credit they will qualify for and obtain instant quotes on the Covered California website. They can also view benefits and compare plans between private insurance carriers.

What Insurance Carriers are available through the Marketplace in my State?

There are a variety of private health plans available on the various Marketplaces across the nation. To view metallic plan options and general pricing, see Obama Care Plans and Prices.  Some of the commonly known companies include Anthem Blue Cross, Blue Shield, Health Net, Kaiser Permanente and Molina. Your residence address will determine which carriers are available in your area.

It’s easy to find out which carriers are available to you. You just need to visit your state’s marketplace and get a quote. If you live in California, click California health insurance quotes to view rates in your area. If you are outside of California, visit Healthcare.gov to find out if your state has a Marketplace.  If your state does not have a health insurance Marketplace, then you can get a quote on the Federal Marketplace

How do the Insurance Companies participate in the Marketplaces?

Insurance companies enter into a contract with a Marketplace and must provide plans that meet certain guidelines. The plans must include the essential health benefits set forth by the ACA.  The plans also have to follow certain rules such as no lifetime or annual limits for the essential health benefits and preventative services must be free.

When you qualify for a tax credit, the Federal Government pays this tax credit directly to your insurance company each month. This way you will receive a bill from your insurance company showing how much your plan costs at the full charge, the tax credit being applied for you, and the final amount that you must pay for your monthly premium. 

Does the Marketplace offer Government Insurance or Private Insurance?

It depends on your income and the program you qualify for. If your income is low, then you may qualify for the Medicaid program. Medicaid is a government program that provides medical services for free or at a low cost to you.  If your income is above the Medicaid limit, then you can enroll through a private insurance company that is offered in your area on the Marketplace.

For additional information and articles on Health Care Reform in the golden state, see California Health Care.