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The Patient Protection and Affordable Care Act (ACA) was signed into law on March 23, 2010 The ACA is also known

as Health Care reform; it is a national health care plan aimed at reforming the American health care system.  Many think that the ACA creates a new government-run insurance plan; that is incorrect. The law does call for the creation of new insurance plans, but the government won't run them.

 Health care reform accomplishes many of the goals of so-called universal coverage through (1) its interwoven expansion of the existing Medicaid program, (2) increased federal regulation of the health insurance industry and (3) tax credits to make private insurance more affordable.

President Obama may have signed the Affordable Care Act into law, but according to Wikipedia “the truth is the concept of national health insurance began in the early 20th century. …Medicare and Medicaid became the United States' first public health insurance programs in 1965. The legislation was vigorously opposed by the American Medical Association until it had been enacted, following which the AMA cooperated in its implementation.”

The ACA or as it is commonly called Obama Care; is the result of decades of ideas from both sides of the political isle and the health care industry. The idea of an individual mandate was first presented by current opponents of the law the Heritage Foundation in 1989. Obama Care itself was in fact modeled after "Romney Care", which is the nickname for the health care reform law implemented in the State of Massachusetts by then Governor Mitt Romney.

The Patient Protection and Affordable Care Act significantly expanded both eligibility for and federal funding of Medicaid. Under the law as written, all U.S. citizens and legal residents with income up to 133% of the poverty line, including adults without dependent children, would qualify for coverage in any state that participated in the Medicaid program. However, the United States Supreme Court ruled in National Federation of Independent Business v. Sebelius that states do not have to agree to this expansion in order to continue to receive previously established levels of Medicaid funding, and many states have chosen to continue with pre-ACA funding levels and eligibility standards Obama care has expanded Medicaid  to cover 15 million uninsured low –income Americans.

A few facts about the ACA

The ACA was designed to cut health care costs and provide affordable health insurance, improve the quality of health care in America and make health care accessible to the millions of Americans who could not get health care.

The new health care law aims to reform the health care industry by cutting out waste, reallocating where government funding goes, fixing what doesn't work, and most of all ensuring health care for Americans.

 

 Before the law you could be denied coverage or treatment because you had a pre existing condition, be charged more because you were a woman, be dropped mid-treatment for making a simple mistake on your application, and had little or no way to fight insurance company rulings. Today all Americans have access to a large number of unprecedented new benefits, rights, and protections.

 Most Americans will have to have health insurance by March 31st, 2014 or pay a fee on their year-end taxes. Many Americans will be eligible for subsidized health insurance costing anywhere from 0% - 9.5% of their taxable income. Subsidized insurance can be purchased through your federally licensed agent or the Health Insurance Marketplace.

If you have Medicare, have health care insurance from your employer, are on Medicaid, or Tricare, or are receiving VA benefits or any government healthcare benefits then you are exempt from purchasing a health care plan.

If you are 64 and under and your total annual pre tax household income is less than 133% of the federal poverty line (and you live in one of the states that expanded Medicaid) then you will qualify for assistance to help you pay for your healthcare. For example an individual making up to $15, 282 per year will qualify for Medicaid health care cost sharing subsidies if they are available in their state.

Those making below $15,282 and who live in states that did not agree to the Medicaid expansion will be the hardest hit. Although they can still purchase health care through the marketplace they will not have any of the subsidies or tax credits available to them and will have to pay full price for insurance if they wish to purchase it. Those making below $15,282 do not have to buy health care insurance. If an individual makes below $15,282 and cannot afford to purchase health care they will not have to pay a penalty.

Amira Wazeer is a state licensed and federally certified agent with over 14 years experience in life and healthcare insurance. She specializes in Medicare Health care plans, Affordable healthcare plans and Janazza (final expense) insurance. Consultations are free. As an accomplished and highly sought after speaker she is available to speak at your upcoming events. This is a weekly column, it will be dedicated to the things you need to know about the Affordable Care Act and Medicare. Questions and comments are welcome. a.d.wazeer@ Comcast.net

 

 

 

Part two of two

Obama Care is the unofficial name for health care reform.  Health care reform did a number of important things including offering Americans a number of new benefits, rights, and protections in regards to their healthcare and setting up a Health Insurance Marketplace also called an exchange.

The health insurance marketplace, www. healthcare.gov is an online price comparison website where Americans can view plans and purchase affordable quality insurance and receive cost assistance for lower premiums, reduced out-of-pocket costs, or even Medicaid. Each State has their own health insurance marketplace, some are run by the state, some are run by the state and the Federal government and some are run by the Federal government alone.

Although the Affordable Care Act (Obama Care) was signed into law in 2010, the health care reforms it enacts roll out year by year until 2022. President Obama explains that most of the 85% of Americans with health insurance are already experiencing the bulk of what the program has to offer and have been for the past 3 years.

 New essential health benefits and preventative services at no out-of-pocket costs, mandatory coverage for pre-existing conditions, and the elimination of annual limits, have already been implemented. Children 26 and under can remain on their parents health care plans. Seniors have saved millions of dollars in prescription costs in the last three years. More than 8.5 billion dollars was refunded to healthcare clients in 2012 as a result of the ACA. More benefits and rights kicked in January 1, 2014 on all plans without a grandfathered status.

Here are some of the most important aspects of the law:

  • Obama Care requires that all Americans have health insurance either through a private provider or through a state or federally assisted program. If you don't have insurance you must pay a tax equal to 1% of your income in 2014 and 2.5% in 2016.
  • Unless you make over $200k individual / $250k as a family or small business you are exempt from almost every tax Obama Care levies.
  • Those making less than 400% of the federal poverty level (FPL) may qualify for cost assistance through the marketplace. 400% of the federal poverty level is roughly $46,000 for individuals and $93,500 for families. Cost assistance is only available through your State's marketplace.
  • Obama Care improves the quality of care that Americans receive by providing free preventative and wellness services and raising the standards of basic health care coverage.
  • Obama Care increases consumer protections. These help to protect you from being charged more ( unless you smoke), dropped while sick or due to gender related reasons, denied care due to lifetime limits, denied care for pre-existing conditions, and offers Americans a better legal standing against health insurance companies.
  • Obama Care helps to ensure that health care coverage is available to any legal U.S. resident who cannot otherwise obtain "quality" healthcare through their employer.
  • Obama Care gives American employers with over 50 full-time equivalent employees the choice between providing insurance that meets the standards of Obama Care or paying a penalty. This penalty helps to offset the cost of employees who aren't covered through their employer to purchase insurance through the public health insurance exchanges instead of using emergency services.
  • Employers with less than the equivalent of 25 full-time equivalent employees may qualify for tax credits, tax breaks and other assistance for insuring employees through the Health Insurance Marketplace.
  • The health insurance marketplace www. healthcare.gov  is an online price comparison website where Americans can view plans and purchase affordable quality insurance and receive cost assistance for lower premiums, reduced out-of-pocket costs, or even Medicaid. Each State has their own health insurance marketplace, some are run by the state, some are run by the State and the Federal government and some are run by the federal government alone.

Tips: Make it easy on yourself consult with a federally licensed agent first; or view the plans first to see if you qualify before creating an account at http://www.healthcare.gov if you find an affordable plan then move on to create an account. Many times with an licensed agents help affordable plans can be located that may not be visible to the viewer

Next week’s column will focus on how to understand and purchase the healthcare plans available at healthcare.gov

Amira Wazeer is a state licensed and federally certified agent with over 14 years experience in life and healthcare insurance. She specializes in Medicare Health care plans, Affordable healthcare plans and Janazza (final expense) insurance. Consultations are free. As an accomplished and highly sought after speaker she is available to speak at your upcoming events. This is a weekly column, dedicated to the things you need to know about the Affordable Care Act and Medicare.

Questions and comments are welcome. a.d.wazeer@ Comcast.net

 

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Comment by Bilal Mahmud المكافح المخلص on March 25, 2014 at 5:06am

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