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Obamacare Enrollment 2017

Updated 2/01/2017

Jan 31, 2017 is the last day to sign up for private health insurance nationwide.

If you called Healthcare.gov on January 31st and left your contact information on the voicemail system, you now have extra time to complete enrollment

Updated 1/27/2017

President Trump Instructs Healthcare.gov to Stop Outreach to Americans About Obamacare Deadline

President Trump has instructed CMS and Healthcare.gov, the federal healthcare exchange to no longer market the open enrollment deadline or to encourage people to sign up for health insurance coverage. This has been described as “sabotage” by some news outlets as well as those within government who oppose his decision, including former employees of Healthcare.gov.

While we do not agree with nor understand his decision, we have to face facts and accept it. While nothing has been announced and our preference is to not speculate on upcoming events. That said, based on his actions yesterday, we feel that it is very safe to assume that there will NO EXTENSION for open-enrollment.

We can not be any more clear than we are right now. Do not wait to enroll in a plan. If you do not wish to use the government health exchange that is fine, you can still sign up for coverage through a reputable third party health insurance website. Below is a form that will allow you to get pricing information on plans that comply with the ACA and are available in your area.

Updated Updated 1/25/2017

20th Century Fox Launches Viral Marketing Campaign That Is Confusing People Trying  To Sign Up For Obamacare

We received some emails from Americans who were either frustrated or confused by the website HealthcureGov.com, that they accidentally clicked on after searching for “Obamacare Enrollment” in Google. After replicating this same thing within Google, we can confirm that it seems that some marketing team involved with the promotion for the upcoming release of the movie A Cure For Wellness has clearly decided to take advantage of the hot button issue that is on the minds of tens of millions of Americans, “Obamacare”.

Running ads promoting a movie is one thing, but what you will find if you venture over to Healthcuregov.com which is obviously intentionally confusingly similar to Healthcare.gov, is a website that looks very similar to the government exchange. They’ve even gone so far as to create an almost 100% identical favicon.


This is really poor taste and it might not be exactly clear to 20th Century Fox marketing that this is not only going to upset a lot of people whose time they just wasted, but it could actually get them in a lot of trouble legally.

Registering the domain Healthcuregov.com is a violation of the cybersquatting law, which a single violation of can result in upwards of a $100,000 fine. You can also argue that the design of the site being so close to that of the actual government exchange, is violating copyright law and could not be considered “parody”.

Really the most troubling part of this for us, as advocates for Americans who are simply trying to get healthcare coverage, is that the website could actually lead to many people missing the enrollment deadline of January 31st.

Why is that? Because this website that is promoting a movie, a website that is clearly designed and using a domain name in order to trick people into thinking it is a government website about healthcare, is misleading people into thinking that the deadline to enroll is 23 days away. Why is that?

Well that’s because the release date for the movie A Cure For Wellness, comes out on February 17th, 2017.

This is incredibly irresponsible marketing on the part of 20th Century Fox and it is literally placing Americans lives in danger just to promote a movie. Domain registration records clearly indicate that 20th Century Fox registered the domain on January 18th of this year.

We’re reaching out to the company directly to ask them to take the reckless website down as well as their marketing campaign.

For the record, the deadline to enroll in a major medical health insurance plan under Obamacare is January 31st, 2017. If you need coverage you should enroll now.

Story Update – Since we wrote about this yesterday and subsequently began alerting others within the industry, apparently 20th Century Fox took notice and decided to kill off this terrible idea. The domain now redirects to the movies main website and is no longer confusing Americans about the enrollment deadline.

Second Story Update – As of 1/27/2017, 20th Century Fox has continued to market A Cure For Wellness in an even more aggressive manner. This is reckless and is literally putting peoples lives in jeopardy.

Updated 1/23/2017

Major News Outlets Are Encouraging People To Sign Up For Health Insurance

In case it hasn’t become clear over the last week, but as things stand now, without question your ability to sign up for health insurance, could become quite challenged. President Trump signed an executive order that could potentially lead to the collapse of the current health insurance marketplace. I’m not referring to Healthcare.gov either. No, the underlying market supported by insurance carriers and their policy holders. This is why it is 100% critical that you do not delay, and find a way to enroll. You can use a trusted private marketplace like the one below. Or you could use the government exchange website mentioned above. Just get enrolled before it is too late.

Updated 1/20/2017

Enroll Now – President Trump Has Signed An Executive Order For Obamacare

It Is Unclear How Much Longer You May Be Able to Get A Grandfathered Plan. Do Not Wait Any Longer To Get Coverage. Do Not Stop The Enrollment Process Until You Are Enrolled. This Is Urgent. Americans Must Take Action Immediately Or Face The Possibility Of Having Much Lower Quality Health Coverage Options.

Updated 1/14/2017

2017 Obamacare Deadline & Important Enrollment Dates

1-31-2017 is the last day to sign up for private health insurance nationwide. If you qualify for Medicaid or CHIP you can sign up for coverage any time of the year. Coverage will start of Feb. 1 if you sign up and pay your premium by Jan. 15.After that, coverage starts on March 1.

If you live in one of the following areas, your deadline for open enrollment may change.

State Deadline Date
California 2-04-2017
Colorado 2-03-2017 *
Connecticut 1-31-2017
D.C. 1-31-2017
Idaho 1-31-2017
Maryland 1-31-2017
Massachusetts 1-31-2017
Minnesota 2-08-2017 *
New York 1-31-2017
Rhode Island 1-31-2017
Vermont 1-31-2017
Washington 1-31-2017

* Extension granted to all Minnesotans so long as they purchase insurance through state exchange
* Deadline extended to 6 p.m. on Friday for any Coloradoan who started the enrollment process on January 31st, but was unable to pick a plan and complete the application.

Special Enrollment Periods (SEP) are triggered by qualifying life events, like losing job-based coverage or having a baby, and typically last for 60 days after the event. Because of the potential repeal of Obamacare, you are better off to expect that there will not be any SEP following 1/31/2017.

Our advice is to enroll now because you have nothing to lose by doing so. If you are enrolled in an Obamacare plan by January 31st, you will be grandfathered into a plan at that point. You will not be able to lose coverage for all of 2017, but it is imperative that you enroll before the deadline. If you try to enroll on 1/31, which is always the busiest and most difficult day to enroll of the year, you may not be able to do so. That’s a risk that you really should not take if you need health insurance.

Updated 1/12/2017

Obamacare Repeal Is Becoming More And More Likely

Senate Republicans aren’t listening to what the American people want, according to a recent poll by NPR and IPSOS. Just 14% of Americans polled want a repeal of Obamacare without a true replacement for it ready to go into effect at the same time. It’s easy to understand why. There’s millions of Americans who rely on prescriptions, like insulin for diabetics, including children with type 1 diabetes. These are essential benefits many now rely on in order to survive. If there is a true full repeal, and that repeal goes into effect immediately, it is unknown how long anyone with an existing plan will have coverage. This is entirely new territory for the health insurance industry within the United States. Health insurance executives are currently advising the government to not hastily enforce a repeal because it will most likely throw the entire healthcare system into total chaos, and the death spiral that’s been predicted could become a reality very quickly.

Apparently no one that has an R next to their name within the Senate, excluding uber contrarian and original thinker Rand Paul is willing to listen. He voted against the repeal yesterday, as the only Republican holdout.

Here’s our advice, enroll today, because you’ve got nothing to lose in doing so at this point. If you wait until the end of open-enrollment 1/31/2017 , you might not be able to get enrolled at all. On 1/30 and 1/31 it is going to be a chaotic scramble for millions and you are best to avoid that headache. We’re throwing our hands up in frustration because this rush to repeal and hopefully replace, it’s going to be a symbolic gesture on the part of the Republican Senate that literally serves to benefit no one. That is of course unless you’re a Republican Senator, because then you get to finally follow through on doing that thing you’ve claimed to have wanted to do for years, repeal Obamacare.

Updated 1/5/2017

Obamacare’s Confusing Possible Repeal Is Causing Major Concern For Americans

We’re going to take a break from being completely neutral with our perspective on the current status of Obamacare, because right now there’s just too much at stake and no one within either political party is giving the American people answers.

Right now the senate is angling to find ways through the reconciliation process to repeal Obamacare, and what it intends to do with said repeal is currently up for debate. No one entirely knows at this point how a repeal would work, nor if it could actually be pulled off without taking coverage away from tens of millions of Americans. Even Republicans are in disagreement with one another on how long a repeal and replace plan would take to implement.

Our take on the matter is that the political infighting and grandstanding is going to continue without question beyond 1/20/2017 when Donald Trump is sworn into office, and certainly beyond the Obamacare Enrollment Deadline of 1/31/2017. Part of it simply has to do with elected officials trying give the perception that they’re trying to serve their political party, without regard to the collateral damage it may cause American families. Mostly though it is simply because that’s what politicians do in turbulent times, disagree with one another and ask for your support to help keep them in office in order to “fight on your behalf”.

We’re not entirely sure what is going to happen with respect to your healthcare options after 1/20/2017. That makes us nervous and that should make you even more nervous. It is entirely possible that health insurance carriers participating in the exchanges currently, announce a withdrawal from the marketplace within the next thirty days. While that won’t go into effect until 2018, here’s a scenario in which it could harm you if you do not have coverage by the deadline to enroll.

If insurance carriers announce a planned exit from the exchanges starting in 2018, it could make obtaining coverage after 1/31/2017 impossible if you want a major medical plan. Once the deadline for enrollment is up on 1/31/2017 you can only obtain coverage if you have a qualifying life event or for special circumstances. It is unlikely that if insurance carriers are exiting the exchanges, and if Obamacare is repealed, and or “repealed and delayed”, that they would be required to enroll consumers in a plan outside of open-enrollment. If you or a family member is planning on having a baby, currently pregnant and or if you have complicated medical issues, obtaining coverage that will actually cover those expenses could be impossible after 1/31/2017.

So What Does This Mean?

It means that this year it is even more important that you enroll for coverage well before the deadline. Not having coverage is a far more risky proposition simply because of the uncertainty surrounding Obamacare and or a repeal. Making matters worse, is that CMS is now requiring all enrollments to be handled in some part with the assistance of the government exchange. This is bringing the enrollment process which in previous years could be a speedy task to accomplish, to an absolute crawl on big enrollment days. On 12/15/2016, there were more than one million consumers waiting on hold to enroll because of issues with the government exchange. This is precisely why CMS extended the December 15th deadline for coverage starting on 1/1/2017, for five days. Major bottlenecks in how everything is processed this year, resulted in more than 1 million people not being able to enroll on 12/15/2016.

If you wait until 1/31 to enroll, you should anticipate waiting on hold for six hours or more, and or not being able to complete enrollment. This has happened in past years with high traffic enrollment days, and there is a very strong probability it will happen this year in particular. Additionally we should note that historically more people try to enroll on 1/31 and or the final day of enrollment, than on any other. There are millions of people who are “waiting to see what happens” and have delayed enrolling in a plan or renewing their current plan. We highly advise because of everything mentioned above, that you not take that risk.

With respect to risk vs reward, there’s no risk in signing up now. If there’s some magical replacement plan that materializes on 2/1/2017 that’s better than the plan you signed up for, then simply cancel the plan you purchased and go with that. That said, we can assure you that there will be no replacement plans for Obamacare, and or “Trumpcare” plans available for at least one year.

Please don’t procrastinate, don’t delay enrolling while the politics play out. Get coverage now and that way you have options for the future. Obtaining a full coverage major medical plan now, getting a grandfathered Obamacare plan now and then waiting to see what happens is a much less risky proposition.

Updated 12/29/2016

CMS Seems Intent On Keeping Current Flawed System For Consumers To Enroll Online In 2017 and 2018

First we should absolutely note that the last two updates are getting a little into the weeds with respect to how everything works within the health insurance industry. You may or may not care too much about how exactly the “sausage gets made”. That said, we’re taking this opportunity to let you know, and the incoming administration, that if changes are not made that place the consumer experience first and foremost, any government based health insurance system is bound to fail. Specifically we’re referring to the dreaded “double-redirect” that occurs when a consumer goes from shopping for a health insurance plan on any other website than Healthcare.gov. Essentially if you want to enroll in a subsidized health insurance plan, the government requires that the individual be handed off to Healthcare.gov to complete part of the enrollment process. In past years, this was done behind the scenes and consumers didn’t have to try to make their way through the clunky experience that is Healthcare.gov. Now, not only do they have to be handed off to Healthcare.gov to verify data, they have to create a profile and then check their email for a link from Healthcare.gov.

It’s like shopping in a store, getting to check out, and then when you want to pay first you are asked to leave and go to the DMV and wait in line to prove who you are. Then once you do that, then you can then go back to the store and complete your purchase.

That is an oversimplification for sure, but it’s a fair description of government bureaucracy at work. Where things really fall apart because of this red tape, is when consumers have questions about a health plans specifics and there’s no one to turn to at Healthcare.gov that is a licensed agent. There is an important distinction between a call center rep answering calls in an outsourced call center, and a fully licensed health insurance agent with years of experience.

It is entirely understandable why the current team at CMS wants Healthcare.gov to be the focus, and enforce the double-redirect that  drives down enrollments and makes enrolling so much more difficult than it needs to be. Because if Healthcare.gov isn’t the focus, and or required, then why were literally billions of tax payer dollars spent on getting all of this into place? If the free market can really handle creating the best consumer experience on its own, that makes keeping the current system in place all that much more difficult.

What oftentimes happens, and we believe is the case within CMS, is that while intentions are always good, the devil is in the details. In this case, the details are highly complicated health plans that are often being shopped by Americans for the very first time. Even before insurance carriers started leaving the exchanges, the abandonment rates of consumers leaving plans after a short period of time were exceptionally high. This is thought in large part to be from consumer dissatisfaction in plan selection, because there was not enough fundamental understanding on the consumers behalf in the first place.

Hopefully whatever changes are coming to the healthcare ecosystem, the primary focus is people, not politics or process, and certainly not justification of massive government contracts. Below is an excerpt from the just released guidance from CMS along with a link to the full PDF.

b. Enhanced direct enrollment pathways In the final 2018 Payment Notice63 and previous rules, CMS has begun to establish the regulatory framework to implement an enhanced direct enrollment process that would allow a consumer to apply for coverage on a non-FFM website without being redirected to HealthCare.gov. Under an enhanced direct enrollment process, the Marketplace would need to ensure an accurate eligibility determination and protect the privacy and security of all consumers that interacted with it via the direct enrollment partner. CMS will not implement this process until we can ensure technical readiness and sufficient oversight of the eligibility application processes. As such, we are maintaining the current “double redirect” direct enrollment approach for the 2018 plan year as we continue to explore program implementation details of an enhanced direct enrollment process. CMS must consider any additional risks an enhanced enrollment process may pose to consumer privacy and the security of the consumer data. We intend to conduct a privacy impact assessment as required by OMB Memorandum M-10-23. This will help to identify and assess any privacy and security risks presented by the enhanced direct enrollment pathway and will help identify necessary safeguards that need to be in place to protect the personal data that consumers would entrust to enhanced direct enrollment partners. These requirements would only apply upon implementation of any expansions made to the direct enrollment pathway.

Final 2018 Letter Regarding FFM

Updated 12/15/2016

CMS Announces Obamacare Enrollment Deadline Extension Until 12/19/2016

Within the health insurance industry there are a lot of people who expected this. Reason being is that because of decisions made by CMS ahead of this open enrollment, the ability for brokers to efficiently enroll consumers online or over the phone has become incredibly more complicated than ever before. Average enrollment times for online or telephonic enrollment have increased by five times or more, particularly in peak times when a larger number of individuals are trying to get enrolled. CMS now (unnecessarily) requires consumers to be redirected to Healthcare.gov in order to complete an online enrollment with a web-based broker. This is almost the equivalent of asking someone trying to check out in a store, to leave the store and drive to verify their identity and payment information with their bank, and only then can they go back to the store to complete their purchase.

This has contributed to longer wait times for consumers over the phone who have questions about what plans are best for them, and subsequently made the process to connect with a licensed agent significantly more difficult. If CMS wants to reach their enrollment goals, and more importantly place priority on Americans, and not government red tape and politics, they should return to using the systems in place that worked in previous enrollment seasons. Consumers are the ones who are paying the price for the poorly timed decisions that CMS made ahead of this open-enrollment season. It is entirely possible that the decision to change course this year, was based on the strong assumption that Hillary Clinton would be elected as the next President of the United States, and there would not be a complete change over of management at CMS.

Updated 12/14/2016

2017 Obamacare Enrollment Estimates Are In – Americans Are Enrolling – Just Not Quickly Enough

While the enrollment statistics below may give the Administration and the healthcare industry hope that consumers are in fact enrolling at a significant pace, what HealthNetwork is finding is that there are millions of consumers in the United States who are very confused about how the election of Donald J. Trump is going to impact their requirement to have health insurance this year and next. We have spoken with tens of thousands of American health insurance shoppers and more than 65% were incorrectly under the impression that they aren’t going to be required to have health insurance starting next year, which means that many people believe that they don’t really have to sign up for health insurance if they don’t want to.

But nothing could be further from the truth – that is unless you don’t want healthcare coverage and you don’t mind paying, minimally, a $695 tax penalty, per person. Unfortunately while there are hundreds, if not thousands, of reporters covering the politics that are being played out right now about how to repeal and replace Obamacare, no one seems to be ending the news report with the most important detail for Americans to know. That little detail is this – in no way is the election going to have an impact on anyone’s healthcare coverage requirements for all of 2017. Most likely there isn’t going to be a scalable national rollout of whatever “Trumpcare” ends up offering for at least two years.

Additionally what we are also finding from conversations with consumers is that there are some unethical insurance agents advising consumers to simply enroll in a short term health plan. Apparently some of which are disingenuously calling short term health plans “Trumpcare Plans”.

So let’s recap the facts, not the fiction or the spin, for the American people.

  • You are still required to have health insurance for all of 2017.
  • There are no such things as “Trumpcare Plans”. Short term health plans can be a good fit for some people, but not all, and they don’t exempt you from the tax penalty. Trump has nothing to do with them. “Trumpcare” is a slang term for whatever it is President-Elect Donald J. Trump’s healthcare reform policy ends up being.
  • Health insurance plans will not decrease in price when President-Elect Trump is sworn into office on January 20th, 2017. Health insurance plan pricing is regulated and set and they will not change until the 2018 enrollment season.
  • If you want health insurance coverage starting on January 1st, 2017, you have to enroll by December 15th, 2016.
  • If you wait until the end of the open enrollment period to apply for a plan, particularly January 28th through January 31st, there is a very good possibility you may not be able to enroll. Or you should anticipate waiting on hold for at least a couple hours, possibly longer. Right now the federal data hub can have delays that backup enrollments for hours or even more than a day. On peak days the increased volume can bring the government exchange, as well as state exchanges to a crawl. We can not be more clear, this enrollment season will be much more challenging to enroll on the last few days.

If you would like a safe and secure way to determine what options are available to you, simply use the form below. You will not be harassed over the phone and HealthNetwork, a company which helps more than 17 million American households a year safely research their options, is not an insurance broker or a carrier.

Without Question The Election Has Impacted The Health Insurance Enrollment Season For This Year

Over 4 million people have signed up for health insurance since the 2017 open enrollment period started in November. The Centers for Medicare and Medicaid Services (CMS), which oversees the federal health care marketplace at HealthCare.gov, tracks enrollment numbers on a biweekly basis, calculated Sunday through Saturday of each week.

This year, open enrollment started on a Tuesday, which means two fewer days for reporting versus last year. Despite the deficit, more people have signed up for health insurance during this year’s enrollment period than at the same time in 2015. There have been 250,000 more signups during the first 40 days of this year’s enrollment period than last year’s.

Of the people who have signed up so far using the federal marketplace, 2.9 million are returning customers. The remaining 1.1 million enrollees are new to the marketplace this year. Enrollment has surged in the days leading up to the deadline to have coverage by January 1. Between Monday, December 12 and Tuesday, December 13, more than 700,000 people enrolled in a qualifying health care plan. Enrollment will continue through January 31, but December 15 marks the final day for people to sign up for a health insurance that starts on January 1.

This week’s snapshot includes enrollment tallies from designated market areas (DMAs) throughout the country. These DMAs represent local media markets and offer a better picture of enrollment nationwide. While some DMAs come from states that aren’t using the HealthCare.gov platform for enrollment, signup figures primarily are drawn from the federal marketplace and states that use it. The CMS will include enrollment numbers from state-based exchanges as the 2017 enrollment season progresses.

States with significant enrollment totals include Florida (over 878,670); Texas (449,094); North Carolina (238,414); Georgia (208,433); and Pennsylvania (190,719). Illinois, New Jersey, Tennessee, Michigan, Missouri, Wisconsin and Virginia have each had over 100,000 signups. In terms of DMAs, the Miami-Ft. Lauderdale market leads the pack with 343,473 signups. Atlanta, Dallas-Ft. Worth, Chicago, Orlando and Tampa also have high enrollment numbers.

CMS also tracks site usage in addition to enrollment figures. During weeks five and six, more than 6.5 million people visited HealthCare.gov while over 2.1 million people called in to the marketplace’s customer service center. It’s clear that people are looking for help when it comes to getting health insurance.

With the election of a new president for 2017, people have questions and concerns about the future of the American health care system. President-elect Trump and Republicans have promised to repeal Obamacare, but there’s been no consensus on a replacement plan to date. Uncertainty about getting covered for 2017 and beyond is no doubt driving enrollment numbers this year.

ACA-compliant plans cover pre-existing conditions, preventive care at no added cost and a host of other benefits. Most people on the marketplace – 85 percent according to the Department of Health and Human Services – also qualify for cost assistance, bringing average monthly premiums down to $75 a month or less. Consumers who need private health insurance have until January 31 to enroll in a qualifying health care plan on or off the marketplace.

Updated 11/9/2016

Post Election Update Regarding Obamacare Enrollment In 2017

This is the only time of the year that you can change or enroll in a new health insurance plan. If you want or need new health insurance for January 1st, 2017, you MUST enroll in a new plan by December 15th, 2016. If you want or need health insurance at all in 2017, you MUST enroll during the Open Enrollment Period, which ends on January 31st, 2017.

The 2016 Presidential Election season has finally come to a close and the new President-Elect is Donald Trump. Whether or not he changes the law or intends to repeal Obamacare with an alternative does not change your requirements for this year.

As of 9:00AM Eastern Standard Time on November 9th, all health insurance exchanges and insurance carriers are experiencing record-setting traffic. Millions of Americans clearly still have concerns as to whether they will still being able to obtain health insurance post-election. Let us assure you that you can, in fact, still enroll in a health insurance plan. Nothing has changed with this 2017 open enrollment period and any changes that President Elect Trump may wish to make, will not go into effect until the first half of 2017.

We highly advise anyone who is seeking to obtain health insurance to sign up immediately because call volume and online enrollment traffic is already reaching record numbers. As we get closer to December 15th, it will only get more difficult and time-consuming to enroll in a plan.

If you want health insurance coverage for you or your family, you must get that coverage during the Open Enrollment Period. Otherwise you will be personally responsible to pay for your medical bills out-of-pocket.

If you are seeking information about President-lect Donald J. Trump’s upcoming healthcare reform plan, which has been coined “Trumpcare” by the press, you can find some information at the following link. Trumpcare

The 2017 Open Enrollment Period is finally here. If you are currently without insurance, need to shop around for a more affordable plan or one with better medical coverage, or your insurance carrier is leaving the market, which is effecting approximately 2.5 million Americans this year, now is the time to shop for a new Obamacare health insurance plan.

If You Want To Quickly Compare What Your Options Are For 2017 Rates, Please Use The Following Link.

2.5 Million Individuals Will Need To Find New Obamacare Plans

Open enrollment starts on November 1, 2016 and will end on January 31, 2017. If you find a plan that works for you by December 15th, the coverage can begin on the first day of the new year, January 1, 2017.

If you are already enrolled in an Obamacare healthcare plan and relying on auto-renewal this year – think again. You should still review your options this year for several different reasons:

Carriers exiting the exchange, the individual or family market, or the entire state

  • New personal circumstances or events that impact your income
  • Changes in reported income
  • Pricing variations to the plan
  • Base plan changes that effect your benefits and pricing
  • Discontinuation of the plan

The first item on the list may be the most vital reason to manually review your coverage and re-enroll this year rather than accepting any changes made by automatic renewal. New developments in 2016 have created headlines about major insurance carriers pulling their plans from the Affordable Care Act exchanges for the 2017 enrollment, and yours may very likely be one of them.

It is predicted that enrollees will be affected by the withdrawal of major insurance carriers, Aetna, United Healthcare, Humana, and four government-run CO-OPs.

Many regional insurers also withdrew with a little less publicity. Among these local providers, many have a much smaller number of enrollees, but some cover thousands and they will have a substantial impact on their members.

Why are Insurance Companies Leaving the Obamacare Marketplace?

In 2013, health insurance companies were trying to estimate the financial influence of an untested risk pool in the new Affordable Care Act (ACA) marketplace. Without being able to discriminate based on health status, people who were less healthy and using more medical services were going to be covered and medical claims would dramatically increase. Insurers needed to accurately project the number of younger and healthier enrollees entering the market and use their premiums to offset the increased claims expenses. The projections fell short and premiums were set too low to create the necessary balance, and insurance companies began losing revenue.

As companies withdraw from the Obamacare market to recoup losses, the effect is reduced competition and mergers between companies that monopolize and limit coverage options in certain areas of the country. The ACA encourages marketplace transparency and competition, without it, premium rates will rise with the 2017 Open Enrollment. This problem should resolve itself when there are more accurate numbers collected over a few years of enrollment, premium, and claims history. The current consensus suggests this will happen by 2018.

Until then, consumers need to log into the marketplace and review their plan to see if they are one of the thousands in their state looking for a new company and an affordable plan. Qualifying for cost assistance can reduce the financial impact of premium increases, but you need to have plenty of time to review the medical needs for you and your family, as well as your household income, to know the actual premium cost for the plan you have chosen. Marketplace representatives are available online and by phone 24/7 to answer questions and explain your options at no cost. Health insurance agents are also able to assist you with enrollment.

Who is Most Affected By These Changes For Obamacare in 2017?

People living in the Pinal County area of Arizona currently have no carriers contracted to sell exchange plans and the residents of Alabama, Alaska, Oklahoma, and Wyoming, all have only one carrier in their exchanges in the upcoming year.

If you are insured by one of the major insurers, Aetna now only has plans available in Virginia, New York, and Nevada and backed out of previous ideas regarding expansion. United Healthcare exited 31 state exchanges and their coverage also only extends to those states. Humana left four more states including Alabama, Arizona, Colorado, and Utah.

Some companies are simultaneously exiting, partially withdrawing, and entering the market in different states. Cigna is leaving Georgia and Texas exchanges, but entering the North Carolina exchange in 2017. Blue Cross Blue Shield of Kansas is pulling out of the Kansas exchange while other BCBS entities continue with plans. Priority Health Insurance Company is pulling out of the exchange in Michigan while still offering HMO plans on the exchange through another carrier entity.

There is a detailed list of smaller regional carriersand entities that are also exiting the exchanges at the end of 2017, including ACA-created CO-OPs. They are impacting the residents of different states and areas or counties within them. Going to your marketplace will give you the details.

While the overall trend is towards a reduction in the number of carriers offering plans in the exchanges, there will be new carriers joining some exchanges in 2017.

What Should You Do Now?

You need to make sure you’re getting the best health insurance plan for your buck. Premium prices are increasing and although 85% of Americans qualified for an average subsidy savings of $290 per month, it’s important to make sure that you’re getting the best medical coverage for the cost for your family.

With nearly 2 million Americans forced to shop for health insurance in addition to the millions already uninsured, it’s important not to wait until the very end of open enrollment period or on big deadlines like December 15th to figure out your options.

If you’re ready to shop for health insurance plans in your region or speak to a licensed health insurance agent, let us help! Call our toll-free phone number or provide us some basic enrollment information and we’ll get you on your way!

Updated 9/19/2016 Many Americans have been reading the recent headlines regarding the number of insurance carriers who have or have threatened to exit the exchange. Many people have emailed in regarding receiving cancelation notices from a number of insurance carriers. Currently United Healthcare, HumanaAETNA and Oscar have announced a major withdrawal from the federal exchange in certain states. It is not yet entirely known how this will effect what coverage options are available starting on 11/1/2016 when open-enrollment begins. We will continue to update this website as more information becomes available. Right now it is still possible for both AETNA and Humana to continue to offer coverage in most of the states they are currently providing plans in. Recently the administration and HHS has been making some significant effort to help keep insurance carriers within the marketplace. The next thirty days will prove to be a critical time for the health insurance industry and for more than 15 million families who have coverage under Obamacare.

Updated 4/21/2016 We have been receiving a lot of email from individuals requesting more detailed information about short term health insurance. Short term health policies and their surge in popularity as an alternative option to on-exchange or “Obamacare” health insurance plans, has received extensive media coverage. Despite this increase in coverage from various news sources, consumers have still had a difficult time determining if short term health insurance is a viable option for them. More specifically, many people have requested that we provide some real life examples of what ones cost would be for a short term health plan, vs an Obamacare plan. So, we have now updated our site to include a detailed Obamacare VS Short Term Health Insurance analysis. Within that page is a link to an unbiased site where you can compare different short term plans.

Comparing Short Term Health Insurance And Obamacare

Updated 2/24/2016 If you missed the Obamacare, or health insurance, enrollment deadline on January 31, 2016, you may have to wait until the next open enrollment period to get an on exchange health insurance plan with subsidies to help you pay your monthly premium. However, if you experienced a “qualifying life event” (QLE) you may still be eligible to enroll in a plan for 60 days following the date that the QLE occurred. You should take note that CMS just announced new qualifying life event eligibility requirements that are being put in place to prohibit individuals from signing up for health insurance outside of the open enrollment period when they are not actually eligible. Detailed Information on the New CMS Eligibility Requirements for Enrolling in Health Insurance Outside of Open Enrollment.

Updated on 2/10/2016 We have received information detailing that there may be an extension for Obamacare plans through Healthcare.gov that runs until March 31, 2016. This extension pertains only to individuals who were unable to enroll because of taxation and tax return filing issue that may have prevented a consumer from completing enrollment. Please see the following link for more information. 2016 Obamacare Extension

If you have a Qualifying Life Event, you will still be able to enroll in health insurance through Obamacare.

We have had a large number of people email us asking for help regarding the new 1095 form requirements. There are three different forms that you have to be aware of. We have a very detailed article outline everything pertaining to the 1095-A, 1095-B and 1095-C forms. Information can be found at this link. 2015 1095 Forms

While a few state exchanges have extended their deadline by a couple days to allow those who started enrolling before midnight local time, to complete enrollment, for the vast majority of Americans, if you are uninsured on February 1st, you may face the tax penalty. The good news is that if you have a Qualifying Life Event at any point this year, you may still enroll in a health insurance plan and get subsidies to help you pay your monthly premium.

A few examples of Qualifying Life Events are:

  • You got married or divorced
  • You had or adopted a baby
  • You lost your employer-sponsored health insurance
  • You had a change in income that now allows you to get a subsidy or does not allow you to get a subsidy or you are no longer eligible for Medicaid or CHIP due to an income change
  • You moved to a different location and your insurance is no longer available
  • You left incarceration
  • You became a legal resident or citizen of the United States

If you have one of these or another type of Qualified Life Event that allows you to enroll in health insurance outside of the regular, annual enrollment period, you will have sixty-days from the date of the event to shop and enroll in new insurance. If you do not enroll during those sixty-days, you may face the tax penalty for being uninsured.

If you find yourself without or between health insurance for only a short period of time and need to find coverage in case of an emergency, you can always look at a short term health insurance plan. Please be aware that if you have a pre-existing condition, carriers that offer short term health insurance plans may deny your coverage from the beginning or may deny to cover certain claims. Short term health insurance plans do not comply with the Affordable Care Act either and you may still face the tax penalty for being uninsured even though you have a short term health insurance plan.

Some people find short term health insurance plans valuable because having it is cheaper and safer that having no insurance at all while they are between major medical plans. You can shop and enroll in short term health insurance plans here as well.

Updated 1/28/2016

The Federal Government has already announced that there will be no Open Enrollment Period deadline extension that will go through the tax season like last year and there’s no indication or guarantee that they will extend the deadline at all past the scheduled January 31st deadline, so do not delay enrolling in a new health insurance plan.

2016 Open Enrollment Period started on November 1, 2015 and ends on January 31, 2016. During this time, Americans are being encouraged to shop around for new rates and new health insurance plans. Even if you are happy with your health plan from last year, there may be a plan out there that is a better match for you or your family’s financial and medical needs. Updated rates are now online and available so you can quickly determine what the average 2016 Obamacare cost is right now.

Think you need a little extra help and guidance picking the right plan for your family? That is not a problem; it’s an opportunity to learn from a licensed health insurance professional. Simply call the phone number below and we’ll connect you with a knowledgeable and helpful health insurance agent that can provide you specialized advice, free of charge.

If you are seeking information about the federal poverty level for 2015, please use that link.

Speak with an Agent now. 1-800-920-4994

Prefer to shop and enroll online? Well, we’ve got you covered there too! Just fill out the enrollment form below and we’ll get you right on your way.

Update 12/15/2015: The Centers for Medicare & Medicaid announced on December 15th that any American who lives in a state that relies on the Federal Marketplace (FFM) will have until December 17th to enroll in a health insurance plan that will start on January 1st. Read more about the 2016 Obamacare Deadline

If you want health insurance coverage that begins on January 1st, make sure you enroll by December 15th, 2015; otherwise your plan will not begin until February 1st at the earliest. If you don’t enroll in a plan until the end of the 2016 Open Enrollment Period, your coverage will not begin until March 1st, 2016.

There’s no guarantee and we do not anticipate that there will be an extension for enrollment beyond January 31st, 2016 so don’t delay your enrollment. You can avoid long wait times by enrolling today.

Obamacare Deadline Information Updated

The 2015 open enrollment period finally closed on April 30th, after a brief extension was given to Americans who got their income taxes done and realized that they were assessed a penalty for being uninsured in 2014 and would certainly face the increased penalty in 2015. The Department of Health and Human Services revealed that nearly 12 million Americans enrolled in health insurance either through the Federal Marketplace or the state exchange during the enrollment period. This number exceeded the government’s projections by almost 3 million people.

If you recently lost your health coverage or are just wishing you could shop for a different plan, you either need to wait for the 2016 open enrollment period to begin November 1, 2015 or you need to wait until you experience an event that would be considered a Qualifying Life Event. Qualifying Life Events are described as circumstances that happen in people’s lives that would allow them to enroll in a new health insurance plan either on the Marketplace or through a carrier direct and to even get a subsidy if they were eligible, without having to wait for the next enrollment period. Some examples of these events are:

  • You get married or divorced
  • You have a child
  • You lose your previous health coverage for some reason like your COBRA benefits end or you lose your employer-based health insurance
  • You move to a different state or location and your previous plan is not offered in your new area

There are several other examples of Qualified Life Events that exist and whether or not you have experienced one of these events is tricky to understand. It is often best and easiest to discuss your life circumstances with a local health insurance agent as they are the best suited to listen to your situation and determine whether you meet the requirements of a Qualifying Life Event. Remember, if you do experience a Qualified Life Event, you have 60 days from the date of the event to enroll in a new health insurance plan. If you do not do it during that period of time, you may be penalized with a tax when you file your federal income taxes.

Another option for people currently without health insurance coverage is to take on a short-term health plan. Unfortunately, short-term health plans are not regulated the same way as regular, major medical plans under the Affordable Care Act and carriers that offer short-term plans can do things like consider whether you have a pre-existing condition, limit your annual payout for medical claims, and offer higher deductibles and coinsurance payments before the plan with kick in its part. The benefit of a short-term health plan is that you can have the peace-of-mind that you are covered in the event that something unexpected occurs. These types of plans also offer more flexibility in that you can sign up at any time of the year and can choose to keep the policy for as little as one month or for only six months.

The 2016 Open Enrollment Period will start on November 1, 2015. If you want your health insurance coverage to start by January 1, 2016, you must enroll by December 15, 2015. The last day to get insurance is January 31, 2016 unless the government or your individual state issues another extension.

Speak with an Agent now. 1-800-920-4994
(Updated March 11, 2015)

The regular 2015 Open Enrollment Period closed out on February 15th and the results were staggering. More than 11 million Americans are able to call themselves insured individuals after enrolling in a health insurance policy on the state or federal marketplaces.

After the 2015 OEP closed out, many states and even the federal government extended deadlines to enroll because many individuals faced technical problems completing their application before the midnight deadline. The requirement for a person to enroll during this special extension in many, but not all circumstances (some states had exceptions to this rule), was that the individual must have started their application on the exchange’s website for with a representative at the federal or state exchange call center before the February 15th deadline passed.

Even though this extended enrollment period for the federal marketplace passed on February 22nd and many of the extended state exchange deadlines also passed at the end of February, but despite this, the government realized that there would be many people who would not realize that they really  needed to enroll in health insurance until they got their 2014 taxes done and were told that they would face a tax penalty for being uninsured during the 2014 calendar year and would also face a penalty for not enrolling for 2015 either.

Due to this predicament, the government announced another special enrollment period, which is commonly being called the Tax Special Enrollment Period. This enrollment period started on March 15th and runs until April 30th and many of the state exchanged, the exception of only a few, have followed step and also created a Tax Special Enrollment Period for their residents.

Check out the list below to determine whether your state has a Tax Special Enrollment Period and the requirements to enroll in health insurance during this period of time.

Obamacare Deadline 2015

Keep in mind that even if the Tax Special Enrollment Period, you may enroll in a new health plan if you experience a Qualifying Life Event. If you do experience one of the events below, you must enroll within sixty-days in order to avoid a tax penalty.

Examples of a Qualifying Life Event are:

  • I recently had a baby (or adopted).
  • I recently got married (or divorced).
  • I lost my healthcare coverage.
  • I became a U.S. citizen, national, or have gained lawful status.
  • My income has changed so that I am now either eligible or ineligible for a subsidy.
  • I’ve moved to a new state.
  • You were unable to enroll due to a system outage or technical error with Healthcare.gov or there was an issue with your account on the Federal Marketplace that was not resolved.
  • You experienced a hardship in your life that prevented you from enrolling in health insurance during the regular Open Enrollment Period, such as you went through a bankruptcy, foreclosure or eviction, you were a victim of domestic violence, you experienced a death of a close family member recently, you were the victim of a natural disaster, you have medical bills you cannot pay for, you have to care for a family member that causes you a financial burden, you were recently hospitalized.

Speak with an Agent now. 1-800-920-4994

Obamacare- What You Need To Know For the Next Enrollment Period

(This article was updated on October 13, 2014)

Americans felt the effect of growing prices in the economy, a deflated job market and the recession in many different but personal ways. One such way was the fact that many Americans could no longer afford health care for themselves or their families either because they were without a job or simply without health insurance, or because they could not afford the increasing costs of seeing a doctor, going to the hospital or getting medicine.

Review & Compare Obamacare Plans Now

Speak with a Healthcare Professional 1-800-920-4994

On March 23, 2010, President Obama signed into legislation the Affordable Care Act (“ACA”), which is also commonly referred to as Obamacare. Obamacare.Net is an informational, unbiased and non-political resource to learn about Obamacare. Additionally, Obamacare.Net offers its visitors access to an exceptional network of Obamacare compliant healthcare policies and brokers that are very knowledgeable about healthcare and the new requirements under Obamacare.

Obamacare was not well received by many Americans, including their representatives in Congress, but the Obama Administration knew that a severe and swift regulatory overhaul of the U.S. healthcare system was necessary and overdue to protect the well-being of every American. Since its inception, Obamacare has faced many significant challenges from the opposition, including dozens of attempts to repeal the ACA in Congress, numerous lawsuits in federal courts across the country and an infamous Supreme Court ruling that paved the way for the penalty imposed on any American who fails to comply with the ACA’s mandate to get compliant health insurance by certain annual deadlines.

Speak with an Agent now. 1-800-920-4994

The first open enrollment period for individuals to shop and sign up for health insurance through Healthcare.gov or a state exchange commenced on October 1, 2013 and the numbers were steady. Many Americans experienced frustration and dissatisfaction with the Healthcare.gov website, which experienced a very public lashing after users were faced with numerous downtime. Within a short period of time the Administration was able to get the Healthcare.gov website back on track and Americans were able to sign up for insurance plans that would commence on January 1, 2014.

Despite the negative press and constant opposition to Obamacare, the U.S. Department of Health and Human Services (“HHS”) proudly reported on May 1, 2014 that after the extended deadline to finish an application closed on April 15, 2014 (the deadline to start an application was March 31, 2014), more than 8 million Americans were able to call themselves “insured” – 8,019,763 people to be exact. 2.2 million of those who signed up for Obamacare were between the ages of 18-34 years old, which equates to approximately 28% according to HHS. The reasons why this demographic is important is discussed in further detail below. Additionally, HHS reported that 4.8 million people enrolled under the newly expanded requirements for Medicaid and CHIP (Medicaid for children).

If you enrolled in a plan in 2014, you can rest assured that unless you want to change your plan, your currently healthcare plan will renew for 2015. If you missed the 2014 deadline to sign up for insurance and are anxiously awaiting the opportunity to get coverage for 2015, open enrollment starts on November 15, 2014. You may also be able to obtain an Obamacare compliant insurance policy if you have experienced a Qualifying Life Event that will allow you to sign up for insurance and avoid the tax for non-compliance or an exceptional circumstance that will excuse non-compliance by the deadline. These concepts will be discussed further below as well.

What is the individual mandate?

The main purpose of Obamacare is to make sure that all Americans are either insured by their employer or are self-insured and that the costs associated with being insured are affordable. Although to their benefit, not every American would willingly and voluntarily take the steps necessary to obtain an Obamacare compliant health insurance policy unless there was some sort of consequence, which is where the infamous Individual Mandate steps in.

The Obamacare Individual Mandate requires all American citizens to obtain health insurance by a certain deadline. For the 2015 calendar year, open enrollment will begin on November 15, 2014 and the deadline to sign up will be February 15, 2015. Of course the Administration could always extend that deadline as well.

The Obamacare Act states that should an American citizen who is not insured under a policy offered by their employer choose not to sign up for an ACA compliant plan by the deadline, they will be taxed $325.00 per adult and $162.50 per child or 2% of the adult’s income, whichever is greater. This particular tax amount only applies to non-compliant Americans during the 2015 calendar year. The tax amount will increase each subsequent year that a person is not in compliant with Obamacare. In 2016 the tax penalty will increase to $695.00 per adult or 2.5% of that person’s annual income whichever is greater. This tax will either be deducted from or imposed on the person when they file their federal tax return for that calendar year.

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As mentioned previously, the Individual Mandate was very controversial and the question of whether or not it was constitutional was heard and decided by the U.S. Supreme Court in June 2012. Our Justices returned a 5-4 vote in favor of the constitutionality of the Individual Mandate, including the tax provision for non-compliance, and reasoned that the Federal Government’s power to tax its citizens authorized the taxing provision of the Obamacare Act.

The Individual Mandate does not apply to everyone living in the United States however. The Obamacare Act outlined certain categories of people who will not be required to obtain an Obamacare compliant health insurance policy. Those people are: 1) Americans who are exempt from filing a Federal Income Tax Return; 2) Native Americans receiving healthcare from a different governmental program; 3) Americans who have only been without health insurance for three months or less; 4) Americans that are imprisoned; 5) Americans that qualify for a religious exemption; 6) Americans that are under the age of 26 and are still on their parent’s health insurance policy; or 7) illegal immigrants living within the United States.

Another important part of Obamacare and the burden it imposed on many Americans who chose not to have healthcare previously due to financial concerns is that the government is offering subsidies or tax credits on insurance plans for people who make under a certain amount of money each year. Effectively, the government will help you pay your insurance premiums each month unless and until you make enough money to pay for it on your own. An individual who makes between $11,670 and $45,680 and a family of four that makes between $23,850 and $95,400 may qualify for a subsidy on their healthcare premiums. Healthcare.gov has laid out the income requirements for different family sizes on its website. The dollar amount of the subsidy will be identified after you fill out the enrollment application.

There is a second type of subsidy available for families who earn less than 250% of the FPL and who enroll in a silver-level plan. This tax credit is issued to families on their tax return and is designed to reimburse people for their insurance-related out-of-pocket expenses for things such as the annual deductible, copays and coinsurance payments.

What Are  Qualifying Life Events?

When planning the execution and carrying out of the first Obamacare Open Enrollment period, the Administration anticipated certain circumstances whereby a person should be excused for not being able to enroll in an Obamacare compliant plan by the deadline. Under Obamacare, people that experience these exceptional circumstances or other complications are exempt from the tax penalty so long as they report the circumstance and then sign up for a compliant policy.

The list of contemplated, exceptional circumstances and complications is: you experienced an unexpected hospitalization or experienced temporary cognitive disability, you experienced a natural disaster, there was a system error, outage or display error on Healthcare.gov that prevented enrollment, you were not qualified for Medicaid and were transferred to the Marketplace with not enough time to enroll or you were a victim of domestic abuse that prevented timely enrollment.

More common than experiencing an exceptional circumstance or complication that prevented compliance is the fact that a person experienced a Qualifying Life Event that caused them to not be insured. If one the of the following Qualifying Life Events occurred in an American’s life, Obamacare provides that the person can sign up for a plan for themselves and/or their children, post-deadline, without fear of being taxed for non-compliance. A Qualifying Life Event under Obamacare is: having or adopting a baby, getting married or divorced, losing healthcare for some reason such as becoming unemployed, a change in income that now makes a person eligible or ineligible for a subsidy, a person moved to a new state or a person became a U.S. citizen, national or gained lawful status and can now apply for Obamacare.

What is an ACA compliant health insurance plan?

One important aspect of the Obamacare Act is that insurance companies are now required to provide a minimum amount of protection to their customers. This new minimum standard is undoubtedly a great improvement from the healthcare standards imposed before Obamacare. For instance, it is now illegal under Obamacare for an insurance company to deny you coverage based on a pre-existing health condition. Previously, an American currently living with a health condition that required attention would regularly be denied coverage and more than likely always denied affordable coverage due to their unfortunate health conditions. Today, that worry is no longer a factor in whether or not a person can be insured.

Additionally, Obamacare now allows for children under the age of 26 years old to be covered by their parent’s insurance policy. Obviously if the under 26-year-old is afforded healthcare through an employer they will have to accept that coverage in lieu of staying on their parent’s policy. Considering the fact that more young adults are opting to extend their education in lieu of entering the workplace where they could ordinarily obtain their own health insurance, this new provision of Obamacare is greatly appreciated by concerned parents and their cash-strapped students.

Another great provision of Obamacare, which is oftentimes a problem faced by Americans will an illness or injury that requires extensive or prolonged medical attention, is that insurance companies can no longer cap the amount of money available to a customer for coverage on a yearly or lifetime basis. This means that no matter how much money a person racks up in insurance claims in a year or in their lifetime, their insurance company must continue coverage. In addition, insurance companies cannot arbitrarily cancel any policy simply because a person gets sick under the new Obamacare requirements.

Finally, Obamacare provides that the insurance company must offer their customers free preventative care. Therefore, despite whether you’ve met your yearly deductible, an American adult can go to their doctor and receive the following care without paying a single cent. The free preventative care services under Obamacare are: Abdominal Aortic Aneurysm one-time screening for men who have ever smoked, alcohol misuse screening and counseling, access to Aspirin to prevent cardiovascular disease, blood pressure, obesity, HIV, tobacco use, cholesterol, colorectal cancer, depression and diabetes (Type 2) screening, diet counseling for those at a higher risk for chronic disease, immunization vaccines and finally sexually transmitted infection prevention counseling and screening for syphilis specifically.

There is also a long list of preventative care services available to woman and children that are similar in nature to the list described above, which is available for all adults. During the 2014 open enrollment period, many companies challenged one particular preventative care service offered to women under Obamacare, contraception, because they believed it violated their religious rights. The Supreme Court examined this issue after two lawsuits were brought up for review and held that companies with a specific religious opposition to paying for a healthcare plan for their employees that included contraception, can simply offer plans that do not include contraception coverage.

Medicaid expansion and CHIP (Children’s Health Insurance Program)

One of the many reasons that there were so many uninsured people in America was because insurance was not attainable by many lower income people. In 1965, the government created Medicaid to aid families earning an income that was insufficient to pay for healthcare. Prior to Obamacare, the qualifications for eligibility into the Medicaid program were more strict; however Obamacare expanded the income requirements for Medicaid from persons under the age of 65 that were under 100% of the federal poverty line, which amounts to approximately $11,670 a year as a single person or $23,850 for a family of four, to persons under 65 who make under 133% of the federal poverty line, which equates to $16,105 a year for a single person or $32,913 for a family of four. Because of the way that the income is calculated, people who make under 138% of the FPL are actually eligible for Medicaid in states that expanded the requirements. The above incomes reflect the correct percentage of FPL.

Initially the Obamacare Act attempted to require that all states expand the Medicaid guidelines to include a larger percentage of people. For any state that did not comply the Obamacare Act threatened to take away any federal funding allotted for that state, for the Medicaid program. Since Medicaid is partially funded by the Federal Government and partially by the states, this provision and the resulting penalty for non-compliance faced a lot of opposition. In addition to reviewing whether the Individual Mandate and the resulting tax for non-compliance by an individual was constitutional, the Supreme Court also reviewed the issue of whether the Obamacare Act can mandate a Medicaid expansion in every state or suffer the consequences. The Supreme Court ultimately ruled that the government did not have the authority and power to impose this requirement and resulting sanction for non-compliance upon states and struck the provision down as unconstitutional.

The result of this Supreme Court holding is that each state could individually decide whether or not it wanted to expand the guidelines for Medicaid. If a person under 65 lives in a state that expanded the requirements, they could be eligible if they were under 133% of the federal poverty line. If a person under 65 lives in a state that did not adopt the expanded guidelines, they could only qualify if they were under 100% of the federal poverty line. Presently, a little less than half of the states have opted not to expand the guidelines of Medicaid.

Before Obamacare, many people were under the belief that a Medicaid policy was a deficient or bare bones policy that would not cover very much. However, under Obamacare, every Medicaid policy will offer Essential Health Benefits. For states that are expanding Medicaid, Essential Health Benefits include: ambulatory services, emergency services, hospitalization, maternity and newborn care, mental health and substance use disorder services and treatment, prescriptions drugs, rehabilitative services and devices, lab services, preventative and wellness services along with chronic disease management and pediatric services that include oral and vision care.

Related to the Medicaid program is CHIP, which stands for the Children’s Health Insurance Program. This program is separate from the Marketplace and is used to provide healthcare to child whose parents earn too much to qualify for Medicaid. CHIP and Medicaid work hand-in-hand and is offered by every state in the United States. Each state has their own income requirements for CHIP eligibility and also requires that the child be under the age of 18 years old, be a U.S. citizen and be the citizen of that particular stat. Some states also offer CHIP to parents of children already covered by CHIP and to pregnant women.

Under Obamacare, every state must offer routine check-ups, immunizations, coverage of doctor visits, prescription drugs, dental and vision care, hospital care, laboratory and x-ray services and emergency services under CHIP. Some states also offer additional services. The cost of CHIP varies per state but under Obamacare, all routine wellness doctor visits and dental visits are free and no state can charge a parent more than 5% of their total annual family income for CHIP.

The official website for CHIP is insurekidsnow.gov. Although a family cannot sign up for CHIP through the Marketplace, after they fill out and submit a Marketplace application on Healthcare.gov, the website will advise the applicant if any of their children are eligible for coverage under CHIP in their state.

Other Provisions of Obamacare

Obamacare revised, overhauled, or had an effect on almost every aspect of healthcare and the health insurance industry. One such additional effect was on Medicare, which is healthcare coverage for Americans over the age of 65 years old, those who receive disability benefits under Social Security (SSI) or the Railroad Retirement Board (RRB) or people who have been diagnosed with End-Stage Renal Disease or Lou Gehrig’s Disease.

Under Obamacare, Medicare is now required to cover a long list of preventative and screening services. Additionally, hospitals that offer exceptional service to its Medicare patients, which are measured by the rate of re-admittance, will be rewarded with additional funding.

Obamacare also imposes a minimum coverage standard on Medicare customers. If a person has Medicare Part A, they have reached the minimum essential coverage required. Medicare Part A covers hospital stays, skilled nursing facilities, hospice care and some home health care facilities. If a person only has Medicare Part B and no other coverage, they have not met the essential health coverage required under Obamacare and will be taxed for non-compliance. Medicare Part B generally covers doctor’s services like lab tests and supplies that are medically required to treat a disease or condition and preventative services. The only way to then be in compliance with a Medicare Part B plan is to take on a Medicare Part A plan as well.

An American would not shop for a Medicare Part A or B plan on the Marketplace but must still be aware of the minimum standards and deadlines imposed under Obamacare. An American can shop for a Medicare Part C plan on the Marketplace however. Medicare Part C is a policy written by a private, corporate insurance company that offers substantially the same coverage as Medicare Part A and B and may also include additional perks such as a prescription drug coverage that is similar to Medicare Part D. The Open Enrollment period for Medicare commences on October 15 and will close on December 7.

In addition to Medicare, Obamacare also had a huge effect on small and larges businesses and the responsibilities they now take on and mandates they must follow under Obamacare. Obamacare cannot require all businesses to insure their employees but has implemented a provision of the Act whereby some larger companies will have to make an Employer Shared Responsibility Payment if they choose not to provide their employees with Obamacare compliant insurance coverage. Any business that has less than 50 full-time employees is exempt from making this payment for not providing healthcare at all or supplying insufficient healthcare to their employees. Whether or not a company is required to make an Employer Shared Responsibility Payment is dependent on circumstances that can be researched through the Treasury Department or the Internal Revenue Service.

Obamacare also created a separate Marketplace for business owners to shop for healthcare for their employees. This Marketplace is called the Small Business Health Options Program, or SHOP for short. Companies with less than 50 full-time employees can start using SHOP in 2014 to find insurance for their employees. SHOP will be available for companies that employ up to 100 full-time employees in 2016.

In an effort to help small business owners provide their full-time employees with coverage that the company can afford, the Obamacare Act provides a tax credit that amounts to 50% of the company’s premium costs for policies purchased through SHOP.

Why is the 18-34 Year-Old Demographic So Important to Healthcare?

As mentioned before, it was impressive for HHS to report that 28% of all new Obamacare enrollees were 18-34 years old. The reason that this is an important statistic is because without the typically healthy 18-34 year olds signing up, paying for and participating in Obamacare, the entire system would crumble. The reason that this demographic of Americans is so vital and desirable to insurance companies is because they will keep the money steadily flowing into the pool of premiums paid without taking much out to pay for medical claims. The 18-34 year old demographic of people is just simply healthier than their counterparts who are dealing with the medical requirements of aging and illness. Therefore, they cost less money to keep healthy unlike people of an older demographic who take more out of the pool of premiums paid in to pay insurance claims.

The very reason that President Obama discussed and promoted the Affordable Care Act on programs like “Between Two Ferns” with Zach Galifianakis and visited our favorite late night talk shows is because he was trying to speak to the 18-34 year old demographic on the programs they were already watching. Apparently his efforts were successful because 2.2 million Americans in that demographic signed up for a compliant healthcare plan in 2014.

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