Obamacare News Blog

Is ObamaCare Affordable?

There are conflicting accounts of whether or not the new Affordable Care Act premiums are doable for most people. Some media outlets are claiming that the prices are outrageous for Americans, while other outlets are saying due to the added ACA essential health benefits and subsidies these plans are a much better deal than plans available currently. So which is true? We’ll let you decide for yourself about the new ObamaCare metal plans: Bronze, Silver, Gold, and Platinum.

Monthly ObamaCare Premiums

The following monthly premiums are individuals in the 48 contiguous states, as Alaska and Hawaii both have a higher federal poverty line.

How ObamaCare Subsidies Work

It depends which state you live in -not just Hawaii and Alaska. Why is that? Well in the states that expanded Medicaid, premium subsidies are for individuals and families who earn 133% to 400% of the Federal Poverty Line (FPL). You may have heard conflicting accounts of 133% and 138% Medicaid eligibility. The answer is both. How can that be?  The first 5% of your income is automatically deducted for Medicaid qualification. In states that have blocked the expansion, subsidies kick in at 100% of the federal poverty line.

Now that that’s out of the way, for those who don’t qualify for Medicaid here’s how it works for you. For those earning up to 400% of the poverty line and do not qualify for a job-based health plan these persons are   eligible for a subsidy. Percentages can be overwhelming, so let’s take a look at the actual figures: 400% FPL = $45,960 for an individual and $94,200 for a family of four.

The less you make, the larger the federal premium subsidy. This is a little controversial, because people are saying it is rewarding those that don’t work hard. But let’s put this into perspective, if a person makes minimum wage at a non-salaried position, works 40 hours a week, doesn’t take a sick day, personal day, or leave town for a few days, that person makes $15,080 over the course of a year. That’s very little money for the same hours most Americans work. Therefore, the ACA has entitled those making $17,235 will pay no more than 4%, or $57 a month. Those who make about $34,000 to $45,960 would pay up to 9.5% of their income. And remember no matter how much more you make over $45,960 you don’t pay a tiered premium, even if you make $10 Mil a year.

Other ACA Subsidies Available

The other subsidy available is the cost-sharing subsidy to help with coinsurance, deductibles, and copays on Silver Plans only. This is available to those that make less than 250% of the poverty line or $28,725 for an individual. For example in California, if a person made just under $17,235 he/she would pay only $3 for primary care visits and a $0 deductible. While a person making just under that 250% mark would have a $40 primary care visit and $1,500 deductible, compared to the usual $2,000 deductible.

How Subsidies Are Paid Out

According to Covered California, you have two choices. You can either have your subsidies paid directly to your insurance provider or you can collect it at the end of the year as a refund.

For any further questions about how much your new metal plan will cost or to enroll in a plan now call 800-930-7956 or contact Medicoverage.