Because of the Affordable Care Act, Texans who have insurance are granted more choices and stronger coverage than ever before. Additionally, Texans who don’t have insurance or have, but are not satisfied with it, can now receive new rights, protections and benefits.
Things you should know:
- The bill brings an end to discrimination for pre-existing conditions.
- ObamaCare covers preventive services with no deductible or co-pay.
- The ACA removes lifetime limits on health benefits.
- ObamaCare brings new coverage options for young adults.
- The new law makes prescription drugs affordable for seniors.
The new online Health Insurance Marketplace provides individuals, families and small businesses who are looking for a better deal a new way to find health coverage that fits their needs and their budgets.
The official ObamaCare enrollment period ended on March 31, 2014. Important Notice: Its urgent, to avoid future fines and penalties, to sign up for health insurance under the Affordable Health Care Act.
Texas Individuals & Families: Find out the most cost efficient healthcare insurance for you
The 80/20 Rule
Health insurance companies now have to spend at least 80 cents of your premium dollar on health care or improvements to care, or provide you a refund.
The health care law promotes better health by increasing support for community health centers and investing in the primary care workforce.
The health care law increases the funding available to community health centers nationwide to:
- Support ongoing health center operations.
- Establish new health center sites.
- Expand services.
- Support major capital improvement projects.
- Help enroll uninsured Americans in the Health Insurance Marketplace.
- Hire more workers.
Investments are also used by The National Health Service Corps to repay educational loans and provide scholarships to primary care physicians, dentists, nurse practitioners, physician assistants, behavioral health providers, and other primary care providers who practice in areas of the country that have too few health care professionals.
As of September 30, 2012, there were 325 Corps clinicians providing primary care services in Texas, compared to 115 in 2008.
To check your options you can visit your state’s Marketplace. For Texas it is HealthCare.gov
- You can start by getting a quote or you can go right ahead to the registration process.
- Price quotes will reflect any lower costs you may be eligible for based on your income and household size.
- To get a premium estimate or quote for ObamaCare in Texas go here.
What if I can’t afford coverage?
The Affordable Care Act provides two programs to help individuals afford coverage through the Marketplace:
- Premium tax credits.
- Cost-sharing reductions.
Subsidies are aimed at people with incomes between 139% to 400% of the FPL (federal poverty level).
*Current 139% FPL is $23,050 for a family of four and the 400% is $92,200.
Families who make more than the current FPL will get considerably less cost assistance.
Subsidies are given as refundable tax credits.
The Tax Penalty
If someone can afford health insurance and decides not to have coverage in 2014, they may have to pay a fee also known as Tax Penalty. The penalty can be any of the options explained below (whichever is higher):
- 1% of your yearly household income.
- $95 per person for the year ($47.50 per child under 18).
*This fee increases every year.
*If you’re uninsured for less than 3 months, you don’t have a make a payment.
To avoid the fee you need insurance that qualifies as Minimum Essential Coverage.
You’re considered covered and don’t have to pay a penalty if you have any of the following:
- A Marketplace plan.
- An individual insurance plan.
- Any employer plan with or without “grandfathered” status.
- The Children’s Health Insurance Program (CHIP).
- Veteran health care programs.
- Peace Corps Volunteer plans.
Some people are exempted from the fee.
• Individuals whose health coverage may cost more than 8% of their household income.
• Individuals with incomes too low for filing taxes.
• Individuals with religious exemptions.
• Undocumented immigrants.
• Individuals who are incarcerated.
• Members of Native American tribes.
To explore health insurance options access the Marketplace by visiting HealthCare.org