Healthcare, Insurance, Smart Spending, Taxes

Affordable Health Care Act Myths- Part I

The Affordable Health Care Act is law. It will be fully implemented in 2014, yet there are still tons of people who believe many myths that were promulgated during the time Congress debated the bill, according to Ron Pollack of the Washington D.C. advocacy group FamilieUSA. The group has completed a study of these myths and the truth behind them. Following are a few; the rest will be in a future posting.

Myth 1: Beginning in 2014, everyone in the country must have health insurance or pay a penalty, there are no exceptions.

Actually, there are loads of exceptions such as:

  • Folks who are not required to file a tax return
  • Folks with a legitimate reason based on religion who do not believe in insurance
  • Member of tribes of Native Americans
  • People with a short-term (90 day) lack of coverage
  • People for whom the health insurance premium exceeds 8 percent of income
  • Special circumstance exemption; such as folks who suffered through a natural disaster such as a hurricane.

Myth 2: If your employer provides your health insurance, the Affordable Care Act will not help you.

In reality, the Affordable Care Act gives many new protections to people covered by employer provided health insurance. These include:

  • No limit, either in time or in dollars for your health care coverage.
  • Free preventive health care
  • Children up to age 26 are covered on their parent’s employer provided plan
  • No limitations on choice of primary health care provider. Also, you have the right to see pediatricians and ob/gyn specialists without the need for a referral
  • Appeal rights to an independent third party if your insurer denies a claim
  • Protection against unwarranted premium increases and rebates for you if the insurance carrier does not spend at least 80 percent of premium dollars on health care services to the insured
  • Simple language plan benefits and costs

Myth 3: Every business in the United States must provide their employees with health care insurance.

This is a lie. Businesses with over 50 employees must either pay for employee health insurance on a shared responsibility basis or pay a penalty. Most businesses in the United States have fewer than 50 employees. However, smaller employers will find new affordable insurance offerings if they choose to purchase health care insurance for their employees Businesses with under 25 employees can be eligible for tax credits that help pay for the cost of employee health insurance.

Why is This Important

For the law to succeed it is important that everyone, employee and employer, the self-employed and the unemployed, as well as parents understand their responsibilities and opportunities provided by the Affordable Care Act (ObamaCare).