877.962.8332

Obamacare Pros & Cons

Obamacare Pros and Cons

Follow Us

Written by: Benavest

BenaVest is an Insurance Agency dedicated to providing knowledge, services of Insurances like Health, Life, and Retirement. We want dedicate our time to bringing you the best services possible.

ACA | Medicare

May 14, 2021

b
Table Of Contents
9
Americans Under 65
9
Americans Over 65
9
Businesses
9
Catastrophic Plans
9
Bronze Plans
9
Silver Plans
9
Gold Plans
9
Platinum Plans

Obamacare Pros And Cons for Americans Under 65

Here is a list of Obamacare pros and cons for most Americans under the age of 65. It primarily covers Americans that make less than 400% of the poverty level. The federal poverty level starts at $12,880 for individuals and goes up to $55,850 for families depending on how many members are in the family and the state they live in.

Pros

  • Millions of uninsured people have access to affordable health insurance that was previously not possible.
  • More than half of the American population can receive free or reduced-cost health insurance and get help for other out-of-pocket expenses.
  • All major medical insurance policies are required to cover an average of 60% of covered medical costs and are required to cover the 10 minimum essentials
  • Obamacare’s protections ensure that individuals can not be dropped from coverage even if they become sick or make honest mistakes on an application. 
  • Insurance companies must spend the majority of their earned income from premium on care and not on paying executives.
  • Medicaid has expanded to cover almost 16 million Americans who fall below the 138% poverty level.
  • CHIP has expanded to cover more children.
  • Businesses with more than 50 full-time employees must provide health insurance.
  • Small businesses with less than 25 full-time employees can get tax credits for up to 50% of their employees’ health coverage.
  • Young adults under the age of 25 may stay under their parents’ health plans.

Cons

  • In order to cover all of these Americans there are higher taxes in place (Mainly on higher pay earners).
  • If an American can afford health insurance, the Individual Mandate enforces that they get health insurance, get an exemption, or pay a fee. Recently however the fee has been reduced to $0 with the exception of a few states that have their own fee.
  • Insurance companies can not individuals with pre-existing conditions; however, this has increased the total cost of health insurance for everyone. 
  • To ensure that everyone is covered and that individuals do not get coverage only when they need it, the only time to buy health insurance is during the open enrollment period (OEP). OEP starts November 1st and ends December 15th.
  • The CHIP expansion uses state and federal funding.
  • Due to the employer mandate, many businesses cut their employees’ hours.
  • Employee coverage can be quite expensive and because employees may get coverage through their employer, they are not eligible for cost assistance.
  • Americans have higher healthcare costs than most countries because it is run by a for-profit healthcare system.

Get A FREE Quote Now!

Quote now to find out if you qualify for low or no-cost health insurance.

Millions of people have access to cheaper health insurance than ever before!

Obamacare Pros And Cons for Americans 65 And Over

Obamacare has made a huge impact on the health insurance industry including for seniors over the age of 65.

Pros

  • Medicare improvement that eliminated the medicare donut hole which was a portion of time that seniors had to pay more for their prescriptions.
  • Rates have been kept low and cuts have been made on wasteful spending, fraud, and free preventive services.
  • Home health care costs have been reduced along with hospital payments.
  • Medicare part B premiums have been reduced in price

Cons

  • Some Medicare payments to doctors and hospitals have been limited. 
  • Medicare pays doctors according to a fee schedule.
  • These complications have raised the cost of healthcare for many.

Obamacare Pros And Cons For Business

Employers and employees have been affected by Obamacare as well. Some employers must adjust to the new changes while the ones that have previously provided health insurance do not need to adjust as much.

Pros

  • Obamacare provides millions of dollars in tax credits to small businesses with less than 25 employees. 
  • These tax credits help small businesses to buy health insurance for their employees.
  • Most of America’s unemployed individuals are because they work for small businesses or are dependent. Obamacare helps reduce the numbers.
  • Employer-sponsored health insurance is cheap for the employee

Cons

  • Many employer-sponsored health insurance plans are not great for employees’ dependants.
  • Due to the fact employees have access to employer insurance, their dependents do not get cost assistance because of that access.
  • Regulations are costing employers thus lowering employees’ wages.
  • Due to increased healthcare costs, some employers are forced to cut costs, hours, and jobs.

Catastrophic Plans Pros And Cons

Catastrophic plans are inexpensive plans with an actuarial value of 60% that are only available to young adults under 30 and people who qualify for a hardship exemption. These plans cover the same things that regular plans cover however they have much higher out-of-pocket costs.

To qualify for a catastrophic plan an individual must be under 30 or be facing one of the following hardships:

  • Eviction
  • Homelessness
  • Facing eviction or foreclosure
  • Bankruptcy
  • Domestic violence
  • Damages to your home in a disaster
  • Death in the family causing an individual to care for a disabled or elderly family member

Visit your state’s health insurance exchange to see if you qualify for a catastrophic plan. Remember these plans are available to people over 30 if they are facing one of the qualifiers above.

Pros

  • Covers up to 3 doctor visits
  • Routine vaccinations are covered
  • Basic health screenings
  • Catastrophic plans also cover the ten minimum essential benefits mandated by the Affordable Care Act.
  • It is a very inexpensive plan if you are a healthy individual with very few monthly medical expenses
  • It can help if you find yourself in a large financial setback momentarily

Cons

  • Catastrophic plans have very high deductibles
  • Catastrophic plans cater to those that are under 30 or those that have a hardship exemption
  • It does not help if you have a pre-existing condition due to the high out-of-pocket expenses
  • Your plans are quite limited because of the few covered doctors visits and preventive care coverage
  • It is a big risk because if hospital bills were to pile up you will be paying much more than other plans
  • Catastrophic plans do not qualify for ACA subsidies

 

Other Options

Catastrophic plans are a choice for a select few people. It may be great for someone that is very healthy and leads a safe life. For others we recommend that you look at all available options to make sure you get the coverage you need:

  • Medicaid – Medicaid is a program that offers individuals that meet the low-income requirement, health insurance free of charge or at lower cost. If you are someone that would be left without health coverage if you did not have Medicaid then please make sure to reapply every year for Medicaid.

 

  • ACA Plans – The Affordable Care Act, is a health reform law that reimagines healthcare in the United States. Obamacare makes it easy for millions of Americans to have access to affordable health insurance.

 

  • Short-Term Health Insurance – Non-Obamacare health plans offered off of the health insurance Marketplace are known as short-term health insurance. Although short-term plans are available throughout the year it is still recommended you check out ACA-compliant plans. They may be available to you even outside the Open Enrollment Period.
  • COBRA –  These plans are offered to employees who lose their employment. They are offered the opportunity to continue coverage with the same health insurance they had when they were employed. This option is expensive because the cost of the insurance must be covered by the ex-employee.

Bronze Plans Pros And Cons

Bronze plans are low premium plans that offer an actuarial value of 60% and are available through the health insurance marketplace. These plans cover an average of 60% of covered medical costs. These plans are very affordable and are recommended for people who do not visit the doctor very much.

Pros

  • Bronze plans have an actuarial value of 60%. These plans cover an average of 60% of your covered medical costs.
  • These plans qualify for the highest premium tax credit.
  • These plans save the most on premiums than any other plan.
  • All bronze plans cover the minimum essential benefits
  • You receive the same great medical care that all other plans cover at a cheaper premium

Cons

  • These plans do not qualify for cost-sharing reductions.
  • These plans generally have the highest maximum out-of-pocket costs. They are the worst in emergencies and for individuals or families that need lots of medical attention. You must hit a much higher maximum before you are completely covered.
  • Not recommended for the elderly or individuals or families with pre-existing conditions.

Silver Plans Pros And Cons

Silver plans offer cost-sharing plans and an actuarial value of 70%. These plans are available through the health insurance marketplace. These plans cover an average of 70% of covered medical costs. These plans are very affordable and are recommended for the majority of the U.S. population.

Pros

  • These plans qualify for cost-saving tax credits and cost-sharing reductions.
  • Bronze plans have an actuarial value of 70%. These plans cover an average of 70% of your covered medical costs.
  • Often provide the best value amongst all metal levels
  • Covers the minimum essential benefits
  • Recommended to most people who make 100% – 250% of the federal poverty line
  • You do not need to pay back cost-sharing subsidies if your income increases

Cons

  • Some plans can have higher premiums than bronze plans
  • Not all silver plans are the same
  • Some might have narrow networks
  • Others might cover an average of 70% of your medical costs but will have the cost savings spread towards things you do not need

Gold Plans Pros And Cons

Gold plans offer an actuarial value of 80%. These plans are available through the health insurance marketplace. These plans cover an average of 80% of covered medical costs. These plans have plenty of coverage and are recommended for individuals or families that must visit the doctor’s office often.

Pros

  • Gold plans have an actuarial value of 80%. These plans cover an average of 80% of your covered medical costs.
  • These plans are great for individuals or families that must visit the doctor’s office often
  • Generally have low maximum out-of-pocket expenses meaning that, besides your premium, you will hit the maximum that you will pay out-of-pocket very fast.
  • Provides minimum essential coverage

Cons

  • Very high premium
  • Not recommended for healthy individuals and families

Platinum Plans Pros And Cons

Platinum plans offer an actuarial value of 90%. These plans are available through the health insurance marketplace. These plans cover an average of 90% of covered medical costs. These plans have the most coverage and are recommended for individuals or families that must visit the doctor’s office year-round.

Pros

  • Platinum plans have an actuarial value of 90%. These plans cover an average of 90% of your covered medical costs.
  • These plans have the absolute lowest out-of-pocket maximums making an excellent choice for individuals and families that visit the doctor’s office all the time
  • These plans are the lowest medical cost plans you can get. Offering the lowest copayments and coinsurance.
  • Covers the essential health benefits

Cons

  • This plan is the absolute highest premium that you can pay for health insurance.
  • This plan is not the most cost-effective plan for individuals or families that are healthy.

Making The Right Decision

Remember that all of these plans’ pricing should be considered over the span of a year. If you are not going to visit the doctor’s office very often you should lean towards lower premium plans like Catastrophic, Bronze, or Silver plans. If you are always at the doctor’s office you should definitely consider the higher premium gold and platinum plans.

Get A FREE Quote Now!

Quote now to find out if you qualify for low or no-cost health insurance.

Millions of people have access to cheaper health insurance than ever before!

0 Comments

Call Now ButtonCall Us Now