Kimberly Amadeo - The Ultimate Obamacare Handbook (2015–2016 edition): A Definitive Guide to the Benefits, Rights, Responsibilities, and Potential Pitfalls of the Affordable Care Act

Copyright 2015 by Kimberly Amadeo

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Library of Congress Cataloging-in-Publication Data is available on file.

Cover design by Rain Saukas

ISBN: 978-1-63450-561-1

Ebook ISBN: 978-1-5107-0155-7

Printed in the United States of America

INTRODUCTION

You need facts, not opinions, and this handbook delivers just that. This book is based on extensive research done using credible sources and real-life interviews with people who have personally been helped by the Patient Protection and Affordable Care Act (more commonly called the Affordable Care Act or Obamacare).

The Ultimate Obamacare Handbook gives you resources you can use, like:

A guide to how health insurance works.

Step-by-step instructions to signing up for insurance.

Descriptions of various tax exemptions.

Definitions of the key terms used in the Affordable Care Act (ACA), health insurance, and health care.

Youll also find out how Obamacare has been quietly improving the lives of Americans since it was signed in 2010. For example, 100 million people received free preventive care. They got their chronic diseases treated before they needed to use expensive emergency room services. That has already lowered costs, not only for them but for everyone.

Youll learn things like why mandatory coverage is needed for the benefits of the ACA to work. Youll be introduced to real people who have already been helped. (Disclaimer: Although the stories are all true, most of the names and identifying information have been changed to protect their privacy.)

Most importantly, youll understand how the ACA affects you specifically and the steps you can take now to make sure youre getting all the benefits you deserve.

How to Use This Book

I strongly advise you to read the entire book from cover to cover. Thats the best way to understand Obamacare. This book clarifies it all. In chapter 1, you will learn how Obamacare was created and, more importantly, who really drove the reform. Youll uncover the real reason why Obamacare was needed in chapter 2. In chapters 3 and 5, youll learn about all the benefits that you already receive, even without doing anything. The ten essential benefits are in also in chapter 5.

To really understand health insurance, how it works, and why America relies on it, read chapter 4. If youre curious about why the mandate was needed, thats in chapter 8. Benefits for seniors, small businesses, and charities are explained in chapter 9. These chapters give you all the information about how the ACA affects you, your family members, and your community.

You can also start with the chapters that apply to your immediate situation. They are organized so you can refer to the ones you most need at the moment. If you are looking for basics, like how to get insurance, go right to chapter 6. Thats where youll also find whether youre exempt from Obamacares mandate. Read chapter 7 to find out whether you qualify for a subsidy. Taxes are in chapter 10. Definitions of the most important Obamacare terms are at the end of the book in How to Speak Obamacare.

This book is designed to be used as a handy reference. You can carry it with you when you go to the doctor, meet with an insurance broker, or even watch the news. You can quickly find the information you want anytime you need to get up to speed.

The Patient Protection and Affordable Care Act is the biggest law since Social Security. The publishers and I want this to be a positive, useful book for you. Weve seen how it has helped, and hurt, our families and friends. Now we want to empower you to make your own decisions based on how the law affects not just segments of society, but you and the people you care about the most.

Chapter 1

WHAT IS OBAMACARE?

Most people think of Obamacare as simply the health insurance offered on the Healthcare.gov website, but its a whole lot more. Obamacare is actually two federal laws. The Patient Protection and Affordable Care Act (Public Law 111-148) was signed into law on March 23, 2010, while the Health Care and Education Reconciliation Act (Public Law 111-152) was signed seven days later.

The Truth About Obamacare

There are a lot of misconceptions about what Obamacare does and doesnt do. Answer the following questions to test your knowledge.

True or False? The Affordable Care Act is much better than Obamacare.

False, since they are the same thing. However, 45 percent of Americans polled in a 2012 Gallup survey approved of the ACA, while only 38 percent approved of Obamacare.

True or False? A majority of Americans want Obamacare to be repealed.

Not exactly. It is true that more than half (54 percent) of Americans are opposed to Obamacare. However, they dont all agree it should be repealed.

35 percent are opposed because its too liberal. They are the ones who want it repealed.

16 percent think its too conservative. Theyre opposed because it doesnt go far enough in providing affordable health care, but they dont want it repealed.

12 percent are opposed only because they think the Act has already been repealed.

7 percent think it was overturned by the Supreme Court.

True or False? Health insurance costs are rising because of Obamacare.

True and false. The true part is that health insurance premiums have been rising. For example, average premiums for company-sponsored family plans rose 4.8 percent a year from 2005 to 2010. Since the ACA was passed, premiums increased at a slower rate3.8 percent a year.

Privately-bought plans were worse, averaging from 15 percent to 20 percent premium increases before Obamacare. Once the exchanges opened, the subsidy affected price increases in both directions. A 2014 Kaiser survey found that 46 percent of those who switched from a privately-bought plan to a subsidized plan saw their premium payments drop, while 39 percent were hit with an increase.

The false part is that health insurance costs were rising, but not because of Obamacare. For the truth behind health insurance costs, see chapter 4. In addition, the plans available now have more benefits thanks to the ACA, so obviously they would cost more. These benefits are described later in this chapter in the section Summary of the PPACA.

True or False? If you like your plan, you can keep your plan, period. President Obama said this right from the beginning. He meant that the ACA itself had no provisions that canceled anyones plan. In fact, it had a provision that helped many keep their plans. Many plans that were in place before the ACA was passed could be grandfathered in, if they met some minimum requirements.