Obamacare, officially known as the Affordable Care Act (ACA), was signed into effect nationwide in 2010 and enforcement began in 2014. The intent of Obamacare was to increase access to healthcare through expanding Medicaid programs, protecting consumers from being discriminated against due to pre-existing health conditions, opening a regulated Marketplace to shop for cost-efficient health insurance options, and requiring all U.S. citizens to have minimum health insurance coverage.
Obamacare’s Effect on Minnesota Health Insurance
In Minnesota, Obamacare has resulted in a decrease of uninsured residents. Before the Affordable Care Act, the state already had a low uninsured rate because of their progressive Medicaid program. In 2014, Minnesota celebrated their highest number of individuals with health insurance to date. Last year, the state was recognized as being one of nine that had an uninsured rate decline from 7% to an unprecedented 5.8%. This is much lower than the national average, which is 9.1%, according to the National Health Interview Survey. These successes are directly linked to Medicaid expansion and the availability of a state exchange.
What Minnesota Residents Should Know About Obamacare in Minnesota
The Pros and Cons of Minnesota Obamacare
Minnesota Obamacare has made health insurance coverage available to thousands that could not previously afford care. They are an example state in adopting reform from the Affordable Care Act by expanding Medicaid and creating a state exchange. As such, the uninsured population has continued to decrease year after year. It has also been successful in stressing the importance of individuals owning their own care by taking advantage of wellness programs and early screenings. Finally, Obamacare in Minnesota has successfully eliminated denial of care based on pre-existing conditions and has disabled Minnesota companies from charging a higher premium based on race or gender.
One criticism of Minnesota Obamacare is that some insurance options, such as PPO coverage, are no longer available on the public exchange. In reality, this is a move to continue to eliminate options that are not financially sustainable. In addition, rate increases have been significant (in the double digits) and 2017 will be no different. For those that do not qualify for subsidies, this could make coverage a larger financial burden. This will mostly impact the middle class who may decide that they can no longer afford coverage and drop it when they cannot pay their premiums. Finally, the state has experienced technical issues with their state exchange, which has impacted the ability for residents to enroll. The state believes, however, that it has addressed these issues and they are not expected to happen in 2017.
Obamacare Health Plan Categories and How Much You Will Pay
When shopping in the Minnesota Obamacare Marketplace, there are four primary health plan categories you can choose from: bronze, silver, gold, and platinum. The categories determine the percentage of healthcare costs that the plan will pay for over a course of a year. The remaining percentage is what you will be expected to pay.
These percentage differences greatly impact how much you may expect to pay on care. Think about it this way: If the bronze plan pays for 60% of a benefit, then as the patient, you can expect to pay the remaining 40%. While this plan will cost you less monthly, it leaves you financially responsible for a larger dollar amount than a platinum plan, which pays for 90% of a benefit.
Here are the different kinds of Obamacare plans as well as the average amount of healthcare services each plan pays for:
- Bronze plan - 60%
- Silver plan - 70%
- Gold plan - 80%
- Platinum plan - 90%
How do I sign up for Obamacare in Minnesota?
The Minnesota Obamacare Marketplace and exchange can be accessed through MN Sure or by calling (855) 366-7873.
What are the Obamacare Marketplace and exchange?
The Marketplace is a central location to shop for insurance options and enroll for selected coverage. In the case of Obamacare, Minnesota utilizes a State-Facilitated Marketplace, which means that the state of Minnesota operates and manages the Marketplace where public health insurance plans are offered.
Do I need to use an exchange?
To access public health insurance, you will need to go through the government exchange. The only exception to personally using the exchange to sign up for Obamacare in Minnesota is if you are able to seek help from a Minnesota certified counselor or a private insurance agent who can discuss your options and select a plan, on your behalf, through the exchange.
How do I use an exchange?
You can use the exchange one of four ways:
- Visit MN Sure
- Use the telephone support assistance available by calling (855) 366-7873
- Find a local certified counselor
- Seek help from a private insurance agent
What does it mean to be on-exchange or off-exchange?
On-exchange generally refers to purchasing health insurance coverage from the Obamacare Minnesota Marketplace while off-exchange normally refers to purchasing private health insurance coverage from a private company.
When is the Obamacare enrollment deadline and what do I do if I missed it?
The Obamacare open enrollment period for 2017 in Minnesota is from November 1, 2016 until January 31, 2017. If you miss enrollment, you would need to qualify for a special enrollment period due to a qualifying life event or purchase short-term individual private insurance to avoid a penalty.
What is the Obamacare penalty if I don’t buy health insurance?
If you do not buy Obamacare or other qualifying health coverage (also referred to as “minimum essential coverage”) you will be subject to a tax penalty for each month you go without coverage. This fee should be paid when you file your federal tax return. In some special cases, there are exemptions to this penalty.
The Obamacare penalty for 2016 is either 1) 2.5% of your household income, with a maximum of the price of a Bronze plan sold through the Marketplace, or 2) $695 per adult and $347.50 per child under 18 yrs of age with maximum of $2,085. You will pay whichever of the two options is higher.
The Obamacare penalty for 2017 is fairly similar to 2016 with the percentage fee of 2.5% remaining the same, however, the flat fee will be adjusted for inflation.
What if I cannot afford Obamacare?
If you cannot afford to pay for Obamacare coverage, you may be able to qualify for a government subsidy. For more information on government subsidies visit the MN Sure website.
What are the alternatives to Obamacare?
Any health insurance coverage that meets the minimum essential coverage, as set forth in the Affordable Care Act, can be used, whether this coverage is received through an employer, private insurance company, or purchased through a private exchange.
There are several alternatives available when selecting coverage. You can select one of the available alternatives on the Marketplace, purchase one of the many options available on the private exchange, or see if you are eligible for subsidized programs through Minnesota’s Medicaid program.
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