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What is the Affordable Care Act?

The Affordable Care Act, also known as Obamacare, passed more than five years ago, but because the provisions of the act have taken effect on a rolling basis, many Americans are still confused as to how the new laws actually affect them. To help clear up the question “What is the Affordable Care Act?” here are a few things that Floridians need to know about the ACA.

What is the Affordable Care Act? In a nutshell, the Affordable Care Act was designed to increase access to health care for all Americans by lowering costs, keeping health insurers accountable, and expanding insurance coverage to all Americans. Under the provisions of the law, all Americans are required to carry health insurance coverage that meets certain standards, or face tax penalties.

What Qualifies as Health Insurance Coverage Under the ACA?

The ACA maintains strict standards for what qualifies as insurance coverage. Under the rules, the following are considered appropriate coverage:

  • An employer-sponsored health plan
  • A plan purchased by the individual, either through the Florida Exchange or on their own
  • Coverage through the Peace Corps or veteran’s service
  • Government-sponsored health insurance through Tricare, Medicare, or Medicaid

Policies that only provide a discount on medical services, cover certain conditions, or that only cover dental, hearing, or workers’ compensation injuries do not qualify under the ACA.

How Do I Buy Health Insurance?

If you do not have health insurance from another source, you can purchase insurance on your own directly from an insurance company, or apply for coverage on the healthcare.gov, the national health insurance exchange. When you apply, you’ll be asked to enter specific information about your income in order to determine whether you qualify for a subsidy that reduces the cost of the coverage. If you qualify, you can take the subsidy either as a tax credit at the end of the year, or a discount on your monthly premium.

However, you cannot apply for coverage at any time. The open enrollment period generally takes place in the fall each year. If you get married, divorced, have a baby, or lose your coverage at any point during the year, you qualify for a Special Enrollment Period, but there are time limits on the SEP.

What If I Don’t Purchase Coverage?

If you don’t purchase coverage, you’ll have to pay a penalty on your taxes; for most people, the amount of the fine is equivalent to the amount one would pay for the least expensive insurance policy for their family. However, you may be exempt from purchasing insurance. If you can prove that an insurance policy costs more than 8 percent of your annual income, for example, you’re exempt from purchasing a policy.

Of particular interest to Florida residents are the provisions relating to Medicaid. While the ACA called for the expansion of Medicaid, Florida legislators opted not to expand eligibility for the program. As a result, Floridians who qualify for Medicaid under expanded federal guidelines, but not state guidelines, are exempt from purchasing insurance.

If you don’t have insurance and need help, your best bet is to work with an approved insurance agent who can help you navigate your options and find coverage you can afford. Avoiding the issue altogether could prove costly in the long run. We are dedicated to making sure you have the answers to the question, “What is the Affordable Care Act?”

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