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The Patient Protection and Affordable Care Act (PPACA) or more commonly known as Obamacareis a Health Insurance Reform which was enacted into a law by President Barack Obama on March 23, 2010.

If you need a FREE consultation about Obamacare in Florida, please call us at 407-344-1228, or email us at [email protected]

The main objective of Obamacarewas to provide more affordable healthcare to the citizens of United States of America. It formally commenced and came into effect in the year 2014 and within a span of two years, the reform succeeded in reducing the insured population to half.

However, ever since its introduction, it faces massive political resistance. The general opinion is that the reform has several limits, both legally and economically.

Healthcare costs and services had been a great concern since a very long time.  Researchsuggests that healthcare costs and bills are two of the leading causes of bankruptcies in the US. Furthermore, the healthcare system of the United States was censured for quality, cost and coverage.

Things became better after the Obamacare came into effect. With its introduction, the medical bankruptcies reduced to 50%. The Patient Protection and Affordable Care Act is the most remarkable reform in the US healthcare policy since the Medicare and Medicaid were passed in 1965.

Some who favor the PPACA often go on to regard it as a political miracle.

President Obama in one of his Presidential campaigns said, “I will judge my first term as president based on … whether we have delivered the kind of health care that every American deserves and that our system can afford.”

During the debate, House Speaker Nancy Pelosi famously said, “We have to pass the bill so that you can find out what is in it.”

The PPACA does not favor the working and middle class much.  40% of the population that earns more than 400% of the federal poverty level does not get much benefit out of Obamacare. There have also been claims that not all medical cost reductions and healthcare improvements are a consequence of passage of PPACA.

One of the reasons why Obamacare in Floridaor in any other state of USA did not gain its due popularity is because it is a hundred paged well-detailed law. It is difficult for the general public to read a 100-paged law, let alone understanding it entirely. Hence, soon after it came into force, it was met by criticisms and misconceptions.

To clear some of those misconceptions, following are the things you need to know about Obamacare in Florida:

The Main Objectives of Obamacare

The presumed objective of PPACA is to provide accessible and affordable healthcare services to all the citizens of the United States of America.

However, initially, Obamacare was introduced with three main objectives.

The first objective was to increase the number of insured. The second objective was to improve the quality of healthcare services. While the third objective was to control the costs incurred by healthcare services in order to control medical bankruptcies.

Although, increasing the number of insured and making it affordable for people got more than its share of discussions but the accessibility of healthcare services to everyone found little attention to be a part of political and media debates.

Coverage by Obamacare

Obamacare basically covers almost all the healthcare expenses that incur on you when you get sick. It covers all the healthcare benefits defined by the administration as essentials. It covers your hospital visits for consultation, diagnosis, observation or treatment.

It further covers emergency services, maternity services, child healthcare or pediatrics, drug abuse treatments, mental health, prescriptions, hospitalization, laboratory tests expenses, dental, vision, rehabilitation services, etc. Obamacare has four types of coverage; bronze, silver, gold and platinum.

All four types cover all of these mentioned healthcare services but they are not limited to them. These four categories differ in the monthly payments of premium costs and the share of cost people pay for the healthcare services.

For example, the premium cost paid by the people having bronze policy will be lower than the cost paid by the people having gold policy while the share of cost of health services will be higher for the ones with bronze policy and quite low for the people with gold policy.

Coverage for Pre-Existing Health Conditions

Before the passage of Obamacare, Insurance companies dropped the customers or otherwise increase cost for the customers with a pre-existing health condition. Therefore, if someone was diagnosed with a critical health condition like a cancer or a tumor, the insurance companies would cancel their insurance or refuse their claim for coverage stating that it was a pre-existing condition. It would become very difficult for the people to bear medical expenses in such a case. In fact, Obamacare also covers preventive healthcare.

It covers all check-ups that include preventive health measures such as cancer screenings, vaccinations, flu shots etc.

State Health Insurance Exchanges

When Obamacare came into effect it mandated the people to buy a health insurance plan. The people were also offered to buy a plan from state health insurance exchanges. The state exchanges are run by the individual states and the states that fail to run it, the federal government runs the exchange for that state.

The state run exchanges are a market place to make comparisons of different insurance plans offered by various companies. There are still different plans for different levels of coverage that can be offered by the insurance companies as suitable to the customer.

Health Insurance Subsidies

The Obamacare program offers subsidies to reduce the amount paid for monthly premiums and out of pocket costs so that more people especially low income bracket of the population can have access to affordable health insurance.

This program also wishes to give relief to the people who do not have access to health insurance from their employer, Medicare or Medicaid. There are two categories of subsidies offered to people buying insurance from a marketplace.

The first kind is of the premium tax credit that offers to reduce the amount of monthly premium payments.

The second kind is the cost sharing subsidy that offers to reduce the share paid by the people for health services. In order to get either type of the subsidies, eligible people are required to enroll themselves in an insurance program through a health insurance marketplace.

Easy Explanation of the Coverage

Everyone has a legal right to completely understand what they are going to buy. Obamacare offers to ease the problem of understanding long explanations of the costs and benefits offered by an insurance plan. With the passage of Obamacare, all insurance companies are obligated to provide the customer with an SBC which is the summary of benefits and coverage so that the customer completely understands what he/she is opting for. SBC is as easy to understand as any summary chart. A customer would not need a solicitor or an insurance expert to translate the confusing details of an insurance plan.

Penalty for not having Health Insurance

According to the new changes made by the Trump administration, the federal penalty for not having a health insurance will be withdrawn in 2019. However, those who got a penalty in 2018 for not having a health insurance will have to pay their penalty with 2019 taxes.

The idea of putting a penalty on people for not having a health insurance plan was to prevent the people from not having a health insurance plan and also to prevent them from being unable to afford the expenses of an accident, injury or other health problems.

States that have their own mandate and do not follow the federal mandate of zero penalties from 2019 onwards are: the District of Columbia, Massachusetts, New Jersey, and Vermont.

Coverage Limitations of Obamacare

Under the Obamacare, the subsidized plans are mandated to cover 10 essential benefits including doctor’s prescriptions, hospitalization and emergency healthcare, etc. However, there are still some of the healthcare services that Obamacare does not cover.

Some more common healthcare services not covered by Obamacare are infertility treatments, cosmetics and weight-loss surgeries, unconventional medical treatments like homeopathic treatments and low-term healthcare.

However, not all can be covered by any healthcare plan because if a healthcare plan goes on to cover too many services, it might become unaffordable for the general public or for the federal government.

The Patients Protection and Affordable Care Act was the most effective and significant health reform after the passage of Medicare.

However, after it was enacted, it faced a lot of public and political backlash. 54% of the population apparently disapproved of this new healthcare reform and somehow showed some undue opposition as well. While Obamacare did bring a substantial increase in the number of insured citizens, it was not able to bring an improvement in the coverage or the quality of healthcare services

Moreover, it’s also estimated that majority of the increased enrollment in insurance plans are due to Medicaid expansion.

Nevertheless, Obamacare did make healthcare services and insurance more accessible and affordable for the citizens of United States of America.

If you need a FREE consultation about Obamacare in Florida, please call us at 407-344-1228, or email us at [email protected]


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