Play or pay: Obamacare 101

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Christina Crawford

Reporter

The Patient Protection and Affordable Care Act, also known as Obamacare, is being buzzed about countrywide. As it is a complex issue, becoming savvy about what this policy entails and how it can affect citizens is something any student can afford to learn.

While this report doesn’t cover every detail, it provides a generic outline.

The PPACA is a policy designed to reduce affordable health care costs. Open enrollment began in October 2013 and coverage under the new policy began Jan. 1, 2014.

Americans are mandated to obtain health insurance by March 31 or pay a tax penalty.

Health insurance is available in four comprehensive packages increasing in level of coverage- bronze, silver, gold and platinum.

Insurance is available for comparison and purchase through online marketplaces designed specifically for health care; Washington Healthplanfinder is the Washington state online exchange where Washington residents can compare and enroll in insurance plans.

For those that don’t have health insurance, individuals can purchase insurance through their employers through online exchanges or through private insurance.

Individuals may also decline and pay a tax. Those that choose to pay the tax can expect to pay one percent of their adjusted gross income. The minimum an individual will pay in 2014 is a flat rate of $95 per adult plus $47.50 per child. Next year, it will be $325, and in 2016 it will be $695.

The most they will pay is the minimum Bronze insurance package price. The estimated minimum for a healthy 25-year-old is $167 per month.

If an individual already has insurance, they can generally expect to keep it if they maintained coverage from before March 23, 2010. These plans are grandfathered in. Vision, discount dental, workers comp and discount plans do not count as insurance. Rates may go up if your company shifts some of the added expenses to their consumers. Also, insured individuals can potentially be dropped from their existing insurance plans. People may find themselves dropped if:

Their insurance company doesn’t meet all of the criteria for the new policy or discontinues the insured’s plan.

Their workplace changes how they provide insurance or discontinues providing health care plans altogether.

Under the new reform, health insurance must provide the 10 essential health benefits.

Many insurance plans that did not previously cover everything in the list may have been cheaper than the insurance now available. Among the essential benefits, preventive care is included.

Preventive care is free and doesn’t require a copay. Preventive care offers many services such as immunizations, birth control and yearly checkups. Maternity care counts as preventive care, and chronic disease management is also free.

Young, healthy people will pay higher premiums. Individuals can remain on their parents plans until age 26 even if they are married, financially stable or don’t live at home. If someone has children, their children can’t be denied insurance for pre-existing conditions, and once a person has insurance, they can’t be dropped if they get sick.

If health insurance is not affordable, tax credits or Medicare may be available. Overusing tax credit can lead to owing money during tax time, so caution should be exercised when applying for them.

Conversely, incomes more than $200,000 or $250,000 married and filing jointly are to pay higher percentages in Medicare taxes.

Pharmaceutical companies and healthcare providers will be given fees to help absorb some of the costs involved in the reform. Changing the focus of healthcare from service-related to care-related will also reduce incentives for prescriptions and diagnoses to generate profit.

When it comes to getting care, patients will find their healthcare providers, locations, and choices more limited based on what’s available in their network.

The Puyallup Post is the award-winning student news of Pierce College Puyallup in Puyallup, Washington. Copyright The Puyallup Post 2017. Twitter/Instagram @puyalluppost

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Play or pay: Obamacare 101

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