The Affordable Care Act And Its Misconceptions

For the first time in US history most Americans are faced with the concept of open enrollment.  Open enrollment used to be a phrase associated with group insurance when you worked for a medium to larger size company, or participated in a Medicare program.  Today the phrase “open enrollment” pertains to everyone and anyone who is insurable in these United States.  It is one of the provisions of the Affordable Care Act (Obamacare), also called by its acronym, ACA.

Now you ask, why did I title this blog the way that I did?  The answer is very simple, most of the people that I come in contact with, including insurance agents, still do not understand what the Affordable Care Act is all about.

Most still believe that it has to do with going on your Federal Government or State website, called an Exchange, to apply for your health insurance because you can afford anything else.  The exchanges available to individuals as well as medium sized businesses, is part of the Affordable Care Act, but not the crux of its existence.  Actually, the crux of ACA has to do with offering every American affordable health care; it is how it’s done that was legislated.  In the following blogs I would like to offer you, my client, and possible client, a clearer picture of what ACA is all about.

In the meantime, l would like to leave you with some “is” and “does-nots” of the program just to keep you interested and coming back to the next blog.  Also, this is a blog, not a book.

The Affordable Care Act is…

1.  A law that, supposedly, makes “affordable” insurance readily available to US citizens and legal residents.

2.  A law that allows some Americans, and legal residents of the US, to obtain credits that will help them and their families pay for their monthly insurance premiums; if you apply through one of the available Exchanges.  The State of Florida does not have its own exchange, so Floridians wanting to obtain their Health Insurance through an exchange in order to receive credits have to resort to the Federal government’s website.  Healthcare.gov.

3.  A law that requires that there be an open enrollment period, this year beginning November 15th, in order to obtain new coverage or change your present coverage.  There are exceptions to the law which we will be covering in future blogs; loss of a job, change in marital status, moving to a different state, etc.

4.  A law that will penalize any individual, who can afford to pay for their health insurance, but decides not to participate in any of the plans offered.  This is done through IRS monitoring.

5.  A law that requires guaranteed issued policies.  Basically, Guaranteed Issue means that an insurance company which claims to follow the ACA guidelines cannot deny coverage to any indiviudal because of a preexisting condition.

The Affordable Care Act does not…

1.  Obligate you to go to one of the Exchanges.  You will only go to the Exchange if you feel that you are eligible for any credits, otherwise your insurance agent can quote you or you can go directly into any of the insurance company’s website to obtain your own quote.

2.  Afford you the possibility of obtaining insurance if you are outside the Open Enrollment period.  This year Open Enrollment begins November 15.  There are some exceptions, of course.

3.  Allow you to change from one insurance carrier to another until the open enrollment period.

4.  Allow you to be without some sort of health policy that includes the 10 essential benefits.  Details to follow.

5.  Allow you to be covered if you are not a US citizen or have legal status in the US.

One more caveat; in many cases there is nothing Affordable about the Affordable Care Act.  In many cases insurance rates have sky rocketed for many individuals and their families, as much as 60% to 70%.

Stay tuned, more great information on ACA to follow.