Obamacare, officially known as The Affordable Care Act (ACA), was signed into effect nationwide in 2010 and enforcement began in 2014. The intent of Obamacare was to increase access to healthcare through expanding Medicaid programs, protecting consumers from being discriminated against due to pre-existing health conditions, opening a regulated Marketplace to shop for cost-efficient health insurance options, and requiring all U.S. citizens to have minimum health insurance coverage.
Obamacare’s Effect on Michigan Health Insurance
In Michigan specifically, Obamacare has resulted in the decrease of uninsured residents, especially children. In 2010, when Obamacare was signed, the state of Michigan implemented parts of the Affordable Care Act and have experienced positive results. According to the U.S. Census Bureau, Michigan’s uninsured rate was 8.5% compared to the national average of 11.7%. This is in direct relation to the state’s efforts to ensure that the children population received coverage despite not expanding Medicaid to the entire state population. n addition, Michigan has successfully implemented a unique approach to Medicaid coverage through their Healthy Michigan program.
What Michigan Residents Should Know About Obamacare in Michigan
The Pros and Cons of Michigan Obamacare
Michigan Obamacare has made health insurance coverage available to thousands that could not previously afford care. It has also been successful in stressing the importance of individuals owning their own care by taking advantage of wellness programs and early screenings. They have also expanded Medicaid through a unique approach by creating a cost share program through Healthy Michigan. This program allows discounted access to coverage for those between 100 - 128% of the Federal Poverty Level but premiums will be reduced based on healthy behaviors. As a result, the individual plays a larger role in owning their care.
There are criticisms of Obamacare in Michigan that while access to health insurance coverage has increased, the Michigan middle class has actually suffered significantly due to the increase in high deductible plans, and rates will continue to increase in 2017. If you do not qualify for subsidies, this can cause a larger financial burden. In addition, there has been a notable struggle in getting re-enrollments, especially for the healthy young adult population who would rather pay the fine for not having coverage than be responsible for monthly health insurance premiums they cannot afford.
Obamacare Health Plan Categories and How Much You Will Pay
When shopping in the Michigan Obamacare Marketplace, there are four primary health plan categories you can choose from: bronze, silver, gold, and platinum. The categories determine the percentage of healthcare costs that the plan will pay for over a course of a year. The remaining percentage is what you will be expected to pay.
These percentage differences greatly impact how much you may expect to pay for care. Think about it this way: If the bronze plan pays for 60% of a benefit, then as the patient, you can expect to pay for the remaining 40%. While this plan will cost you less monthly, it leaves you financially responsible for a larger dollar amount than a platinum plan, which pays for 90% of a benefit.
Here are the different kinds of Obamacare plans as well as how much each plan pays for:
- Bronze plan - 60%
- Silver plan - 70%
- Gold plan - 80%
- Platinum plan - 90%
How do I sign up for Obamacare in Michigan?
The Michigan Obamacare Marketplace and exchange can be accessed through the federal government website or by calling (800) 318-2596.
What are the Obamacare Marketplace and exchange?
The Marketplace is a central location to shopping for insurance options and enroll for selected coverage. In the case of Obamacare, Michigan utilizes a State-Federal Partnership Marketplace, which means that the U.S. Department of Health and Human Services operates and manages the logistics of the Marketplace where public health insurance plans are offered and the state manages the plans.
Do I need to use an exchange?
To access public health insurance, you will need to go through the government exchange. The only exception to personally using the exchange to sign up for Obamacare in Michigan is if you are able to seek help from a Michigan certified counselor or a private insurance agent who can discuss your options and select a plan, on your behalf, through the exchange.
How do I use an exchange?
You can use the exchange one of four ways:
- Visit healthcare.gov
- Use the telephone support assistance available by calling (800) 318-2596
- Find a local certified counselor
- Seek help from a private insurance agent
What does it mean to be on-exchange or off-exchange?
On-exchange generally refers to purchasing health insurance coverage from the Obamacare Michigan Marketplace while off-exchange normally refers to purchasing private health insurance coverage from a private company.
When is the Obamacare enrollment deadline and what do I do if I missed it?
The Obamacare open enrollment period for 2017 in Michigan is from November 1, 2016 until January 31, 2017. If you miss enrollment, you would need to qualify for a special enrollment period due to a qualifying life event or purchase short-term individual private insurance to avoid a penalty.
What is the Obamacare penalty if I don’t buy health insurance?
If you do not buy Obamacare or other qualifying health coverage (also referred to as “minimum essential coverage”) you will be subject to a tax penalty for each month you go without coverage. This fee should be paid when you file your federal tax return. In some special cases, there are exemptions to this penalty.
The Obamacare penalty for 2016 is either 1) 2.5% of your household income, with a maximum of the price of a Bronze plan sold through the Marketplace, or 2) $695 per adult and $347.50 per child under 18 yrs of age with a maximum of $2,085. You will pay whichever of the two options is higher.
The Obamacare penalty for 2017 is fairly similar to 2016 with the percentage fee of 2.5% remaining the same, however, the flat fee will be adjusted for inflation.
What if I cannot afford Obamacare?
If you cannot afford to pay for Obamacare coverage, you may be able to qualify for a government subsidy. For more information on government subsidies visit the HealthCare.gov website.
What are the alternatives to Obamacare?
Any health insurance coverage that meets the minimum essential coverage, as set forth in the Affordable Care Act, can be used, whether this coverage is received through an employer, private insurance company, or purchased through a private exchange.
There are several alternatives available when selecting coverage. You can select one of the available alternatives on the Marketplace, purchase one of the many options available on the private exchange, or see if you are eligible for subsidized programs through Michigan’s Medicaid program.
Obamacare, The Affordable Care Act FAQs
- What is Obamacare or the Affordable Care Act?
The Affordable Care Act was signed into law by President Barack Obama on March 23, 2010. The Affordable Care Act, often referred to as Obamacare, was intended to broaden affordable healthcare access to a larger population base and includes regulations that require all U.S. citizens to have minimum qualifying health insurance coverage as of 2014.
- Do I have to have Obamacare if I live in Michigan?
Since the enforcement of Obamacare, the Affordable Care Act, all U.S. Citizens are required to have a qualified health plan (includes minimum viable coverage) to avoid a tax penalty. This health insurance coverage can be purchased through a variety of vendors in a private or federal Marketplace.
- Where do I find the Obamacare plan options for Michigan?
The Federal Health Insurance Marketplace will contain the options for Michigan.
- How much does Obamacare cost in Michigan?
The cost of your Obamacare health insurance plan will depend on the tier of coverage you select. You can choose between the Bronze Plan (plan pays 60% of healthcare costs, you pay 40%); Silver Plan (plan pays 70% of healthcare costs; you pay 30%); Gold Plan (plan pays 80% of healthcare costs; you pay 20%), and Platinum Plan (plan pays 90% of your healthcare costs; you pay 10%). See more on the various tiers of Obamacare coverage here.
- What are government insurance subsidies and how do I qualify for them?
People that fit into the middle- or low-income tax bracket are eligible for government subsidies. These subsidies come in the form of tax credits. The amount of subsidy you are eligible to receive will be based on your income, the amount of people in your household, and the cost of the benchmark Silver Obamacare Marketplace plan in your region.
- What is the penalty for not having health insurance in Michigan?
The Obamacare penalty for not having health insurance coverage in 2016 is $695 per adult ($347.50 per child) or 2.5% of annual income claimed on a tax return without health insurance (whichever is larger). The health insurance penalty for 2017 will be similar, however the $695 flat fee will be adjusted for inflation.
- What if I missed the Obamacare Enrollment Deadline?
If you miss the Obamacare Enrollment Deadline, you will need to wait until the next Open Enrollment period or you may qualify for a Special Enrollment Period if you experience or have experienced a qualifying life event.
- How do I get an Obamacare quote?
The Federal Health Insurance Marketplace will allow you the ability to input your personal information and receive an Obamacare quote. You can access the Marketplace through the healthcare.gov website.
- What is an Obamacare exchange or marketplace, do I need to use it, and how do I use it?
The Michigan Obamacare Marketplace or Exchange is a service that allows you to compare and enroll for medical insurance in your state. It can be accessed through different websites (healthcare.gov), calling, or in person. You will need to use the Marketplace to apply for government subsidies.
- How do I know if I'm exempt from Obamacare in Michigan?
To be exempt from the Obamacare, or Affordable Care Act penalty in Michigan, you will need to fill out a hardship exemption form and file it with the Federal Health Insurance Marketplace. Some hardships that qualify for exemption include: homelessness, eviction or foreclosure, domestic violence, the death of a family member, a natural or human-caused disaster, or filing for bankruptcy. For other qualifying hardships, see the Federal Health Insurance Marketplace hardship exemption page.
- What information and documents should I have when I'm signing up for Obamacare?
To sign up for an Obamacare health insurance plan you will need documents that verify your annual income and United States citizenship.
- Where can I get help with my Obamacare application?
The Federal Health Insurance Marketplace can help you with your health insurance applications. You may also call the government's helpline for assistance at (800) 318-2596.
- What is a Navigator?
A navigator is an individual or organization that is required to be unbiased as they help consumers, small businesses, and their employees explore health insurance options in the Marketplace. Navigator services are free to the public. They are trained to offer guidance in many areas, including how to complete eligibility and enrollment forms.
- What does Obamacare cover in Michigan?
Obamacare, or the Affordable Care Act (ACA), states that health insurance companies must cover treatment associated with any and all medical conditions, these are called essential health benefits. Obamacare removes the ability of insurance companies to discriminate or deny coverage for any pre-existing medical condition. Additionally, once you are enrolled in an insurance plan, you cannot be denied coverage for any condition and your rates cannot be increased based upon your health. This coverage applies to pregnancy as well as pre-existing conditions. Learn more about what all Marketplace health insurance plans cover here.
- How can I decrease the cost of my health insurance in Michigan?
Your health insurance costs will be dependent on the type of health insurance plan that you select. Health insurance plan costs fluctuate based on monthly premium costs and deductibles. In most cases, if you have a higher monthly premium, your deductible will be lower. Alternatively, if you want a lower monthly premium cost, you can opt for a higher deductible. Learn more about how your deductible affects your monthly premium here.
- How do I find Obamacare plans?
You can find the qualified Affordable Care Act (Obamacare) health insurance options on the Federal Health Insurance Marketplace.
- Are Obamacare health insurance premiums tax deductible?
If you are self-employed, Obamacare health insurance premiums may be tax deductible.
- Do I need Obamcare if I already have other health insurance?
If your existing health insurance plan meets the minimum essential requirements of a qualified health plan, as determined by the Affordable Care Act, you can keep your existing plan and avoid the tax penalty.
- Where do I buy Obamacare if I live or work in two different states?
If you live of work in two different states, it is recommend that you look for multi-state federal health insurance coverage (Obamacare), which is available in the federally regulated Marketplace.
- Will short term insurance help me avoid the Obamacare penalty?
No, short term coverage does not meet the minimum viable coverage of a qualified health plan according to Obamacare, the Affordable Care Act (Obamacare). Without additional health insurance coverage you will be subject to an ACA tax penalty.
- How has Obamacare Affected Health Insurance in Michigan?
Obamacare has resulted in a decrease of uninsured residents in Michigan, especially children. In 2010, when Obamacare was signed, Michigan implemented parts of the Affordable Care Act. The state has experienced positive results. The state now has an uninsured rate of 9% (lower than the national average) because they have done a great job of covering the children population. In addition, Michigan has successfully implemented a unique approach to Medicaid coverage through their Healthy Michigan program.
- Who runs Obamacare marketplace in Michigan?
The state of Michigan has a joint partnership marketplace. The Marketplace is administered by the federal government, under the Department of Health and Human Services (HHS) but the state manages the plans within the exchange.