Affordable Care Act Eligibility

Toll Free ACA Number is 1-800-318-2596

(Update October 12, 2016: the new open Enrollment period for 2016 coverage starts on November 1, 2016 and ends on January 31, 2017., which should direct you to your state exchange, all the way through April. The government wants people who experience the penalty to be able to sign up for healthcare once they find out about it. The Obama Administration has pared the application down to 5 pages for an individual, or 12 pages for a family.) The application for Obamacare, officially known as the Affordable Care Act, is around 200 pages and consists of a total of 1000 questions. Most people will end up applying online, but there are some people who may need to do this by means of a paper copy or printed PDF. A streamlined 20+ page application can be found here. The Affordable Care Act may be a big part of the presidential campaign after a tough primary season, and even former President Bill Clinton said it was "Crazy" but in the end you could still end up paying penalties if you are not enrolled for the 2017 year!

Obamacare Application Some notable changes for the ACA in 2015 include eligibility for same-sex couples thanks to the recent Supreme Court ruling, and and the employer mandate that kicks in on January 1, 2016. Many state marketplaces are also folding in favor of the exchange, especially since another ruling clarified that subsidies will be available for people in states that do not have an exchange set up. Therefore, we may see multiple state exchanges disappearing in favor of a single source like Out of pocket maximum payments also change this year, so for individual coverage you are on the hook for $6850.00 and for family coverage you are paying $13700.00 which may stretch your definition of what is "affordable health care" when you get socked with a bill like that all at once. If there is any kind of silver lining in the out of pocket numbers, this generally means that your insurance exchange is paying a whole lot more on the claim, and the number could stretch into the hundreds of thousands of dollars. It appears that the Obamacare Application process is running a lot more smoothly than it did back in 2013, but there are some glitches reported on a state-by-state basis. The question of whether or not the US Supreme Court will allow subsidies for states with no exchanges of their own is a front-and-center question, but this does not mean that people should avoid getting insurance in the meantime. It takes a little preparation to sign up for an exchange, and according to Multiple Sources you can't do it all in one sitting, so you will want to have some of the following information available, some of which will be provided by your employer assuming you have one. You need to have an idea of how much money you will make next year, and you may not be able to use the exchange if you can get a qualifying plan through your employer or through other health insurance programs. They will want your social security number. The good news is that you can use a debit card to buy insurance. There are subsidies if you have a low income, but you will need to prove that your income is low, that your dependents are yours, and that you can't get coverage through a spouse, etc. A good deal of information is needed for people who want to show their eligibility for health insurance under the Affordable Care Act. Some of that information may be harder to come by, since some questions include the email address of your company's health care offical, and it is possible that you work for such a small firm that no person fits the bill. There are also a lot of questions designed to filter out people who may end up over the limit.

Failure To Get Healthcare Means You Pay A Fine.

As the Supreme Court Ruled in a controversial 5-4 case, you can be compelled to buy healthcare or pay a fine, which (under the law) is considered a tax and not an unconstitutional intrusion forcing you to pay for something you might not want. In a 2015 ruling, it was also judged that people can get susidies even if their state did not set up an exchange.

Background of the Affordable Care Act

Health Insurance Marketplace Glitch

(Note: We have been trying to sign up for insurance through the health insurance marketplace, or get into the process, but it appears that the site is too busy to let us in.) The Affordable Care Act is known as Obamacare becase it is associated directly with President Obama, who narrowly pushed it through a Democratic House and Senate by a slim margin in 2009. The highly controversial law survived a Supreme Court challenge and is due for implementation in 2014. Many of the law's provisions, including a tax on medical devices and requirement to accept people with pre-existing conditions, have resulted in healthcare premiums going up. Additional cost increases come from legislation mandating that costs for groups (like men vs. women) had to be the same, so now one group (like reckless, dangerous men) may see its costs go down while hte other sees its costs go up. Similarly, cost averaging between the young and the elderly means that younger people will see their prices rise even though they don't use much healthcare, while elderly people pay less, even though they use a much higher percentage of services. Also, Medicare has essentially been cut to shift costs to the Affordable Care Act. Simultaneously, businesses have been cutting hours for employees and firing people in order to reduce their requirements for providing coverage. As it turns out, many companies are also cutting healthcare and paying a fine in lieu of healhcare, because the fine may be several thousand dollars cheaper than the cost of providing health insurance.

The Obamacare Application Form is already getting noted in the media for its extensive questions that will make consumers do their homework. People will need to ask their workplace administrator which plan has the "lost cost self-only" designation and if that plan "meets the minimum value standard" to qualify. Aside from all this, your health habits (like being a smoker) are now part of the government's questionnaire, and your household members may be asked to provide proof of income, but there is a question as to whether you would need to use W-2 forms, 1099s, or other data.

Aside from health insurance companies, who benefits from this application process? Ostensibly, the plan is to help more Americans get health insurance coverage, but the nature of the paperwork means that many poor, unskilled, and ESL people may have problems getting through the entire document. It could take several hours to collect the necessary information, and prove that income meets requirements. For example, if members of your family are seasonal workers, get income from various sources, and could possibly qualify for coverage through their work, then you have to know this. There are multiple places where you have to essentially certify that you are telling the truth and that you aren't hiding any income. You also have to affirm that you can't get healthcare through a spouse, and this could be an issue for the many estranged couples who may not be speaking. On top of those questions, the form asks if anyone in your family was in foster care, was disabled, or may be eligible for state funded Access or Medicare programs in lieu of Obamacare. You need to report your current working hours, and if your hours have been cut, and even if you got any money unexpectedly. On top of all that, there are even more questions to answer if your income is considered "too low" just to prove you aren't lying.

2014 vs 2015 Signup ChartOne of the ways that the government envisions helping people wade through the Affordable Care Act is through "Navigators" who are essentially experts financed by state healthcare exchanges that will assist individuals in getting the right care.

For the 2015 deadline, which is February 15 and not expected to be extended to the extent that the 2014 deadline kept moving, people may be more motivated to get insurance when they find out how much they could be paying as a penalty under the rules of the act. There are special enrollment periods outside the limits set forth in the law, so if you have a qualifying life event, then you don't have to wait for the opening data of November 15 before getting coverage for yourself or your family. Examples of such life events include the birth of children, changes in income, divorce, marriage, or moving to a new state where you will have to sign up for a new plan. Exceptional circumstances may also play in your favor, so if you were in a natural disaster, experienced display errrors on the site, or experienced "misconduct by a non-marketplace assister" then you may have grounds to sign up today.

Graph for top signup states 2015There are also a couple of new tax forms that are coming into play for people who either got healthcare from an exchange, directly through an insurer, or by way of their employer. The 1095-A tax form goes out to people who got monthly subsidies from a healtcare exchange. 1095-B, which is not mandatory until the 2015 tax year, is related to private insurers, and 1095-C is issued to people who get their coverage from an employer. With any of these forms, you may need to fill out Form 8962 which is part of your 1040 return. People who got assistance with coverage will now find that they cannot use the 1040EZ.