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Obamacare Myths

Obamacare Myths

Health care in America always had been a topic of great debate, debacle and also in some instances neglected upon in the past. Mainly because many are still not aware about health insurance and why is it important to purchase one. Studies show that thousands of Americans die every year from lack of proper medical treatment and many have to suffer because of lack of money to pay for costly treatment. Even people who earn a good living can find it difficult to fish out a large sum of money in a short time. Hence having a medical insurance is of paramount importance for everyone. Medical insurance ensures that people get adequate money during emergency situations so as to afford even costly treatment if need be with ease. In order to secure the health of all its citizens, the American government has been formulating plans since the last 50 years and encouraging individuals to enroll for them. In 2010 in order to streamline all the existing plans under one banner the Affordable Care Act was formulated. But since its start the Affordable Care Act has been under close scrutiny and met with heavy resistance. Lack of proper information and misrepresentation of its clauses has created wide spread anger and a sense of insecurity not only among many Americans but also on many small business holders. This caused a delay of about 3 years before the Act was formally introduced in the market. So before understanding the various faucets of Obamacare, one must clearly understand what the ACA actually means, what it stands for and the amount of potential it possesses.

Affordable Care Act – A brief Intro

  • Now that one has a clear understanding about what the Affordable Care Act is and what it stands for, let us go deep into some of its clauses that are widely misunderstood. Below are some of the myths that surround the ACA against what the truth actually is. It is an Insurance Scheme Myth: Many people have the idea that Obamacare represents some form of health insurance scheme which has to be purchased from the marketplace as like any other insurances. Even experienced health care officials tend to get confused sometimes even today. Truth:  The Affordable Care Act is not any government insurance scheme, neither a government funded relief program for the poor. The ACA is a set of rules, policies and guideline that governs all the healthcare insurance schemes that are currently offered by both the government or private insurers in US soil. It ensures that the wealthy are appropriately taxed and the needy are substantially subsidized by the government so as to enable them to avail basic medical treatment all through the year. It is Free of Cost Myth: Another common misconception that people have regarding Obamacare is that they think that it is offered free of cost. Fact: The term free health insurance does not exist anywhere. So this thinking should be done away with at the beginning. What Obamacare does is to offer the people with low income a wide range of subsidized health care plans to choose from. Only individuals who qualify for Children’s Health Insurance Plan or Medicaid receive free of cost medical treatment but the relief amount is generally charged as taxes from other citizens. Obamacare works on the principle of shared responsibility under which young and healthy citizens are generally charged extra to cover up the medical expenses of the elderly and the under privileged. Can enroll anytime Myth: The third misconception is that one can enroll for the Affordable Care Act at any time during a year. Fact: Enrollment for Obamacare can only be done once every year during the open enrollment period. In 2018 the period was from Feb to March and was open for 45 days. Only individuals who qualify for special enrollment period can choose to enroll at any other time, other than that everyone have to enroll within the stipulated time. Special provision for enrollment is provided for business owners who pay for the medical coverage of their employees. Citizens who qualify for Medicaid are also exempted from the open enrollment period and can enroll through various relief programs throughout the year. Can Enroll Only in Person Myth: Many people think that they have to be present in person at enrollment agencies in order to enroll for Obamacare. Fact: Obamacare offers a host of options for the customers to enroll. Some of them are:
  1. Online: Everyone can visit the government health care website, download a virtual application, fill out the form with their personal details and submit them online. All of this from the convenience of their homes.
  2. Mobile Phones: People can also call up a toll free marketplace number and directly talk with representatives to get their doubts clarified and fill out the enrollment application with expert help.


  1. Email: Customers can download the form from the internet and submit it to respective authorities over email.


  1. Via Owners: People who are working and are covered by their respective company owners can follow the owners schedule in enrolling.


  1. Via Private firms:  People can even opt for hired third party help like that of a private firm to fill out to submit their applications.


  1. Visiting enrollment centers: Lastly one can always go to any enrollment centers based on the most nearby one according to their geographical location and enroll themselves for Obamacare.

Can choose not to enroll Myth:  It is also a common belief that if an individual is not capable of paying the annual premiums then he can opt to not enroll for Obamacare Fact: Obamacare mandates that all citizens have to enroll for a basic health insurance. However, exemption from enrollment is provided only if someone meets below mentioned criteria’s:

  1. If an individual earns less than the Federal Poverty Level then he is exempted from paying any tax. In 2017 the level stood at $10400 for individuals who are under the age of 65 and $20800 for married couples. In 2018, the amount was raised to $12060 in 48 states, $13680 in the state of Hawaii and $15060 in the state of Alaska per individual.


  1. Secondly based on the geographic location of an individual, if the insurance plan of least value available either through marketplace or through work costs more than 8.16 percent of the total family income then one can choose not to opt for any plan.


  1. If an individual suffers from some form of permanent disability, final stage of kidney failure or aged 65 or above and is covered under the Medicaid Relief Scheme then he is also provided exemption from mandatory inclusion. Even if the residing state chosen to refrain from incorporating the new Medicaid guidelines but an individual meets all the requirement criteria then also mandatory inclusion is not applicable for him.

  For individuals who do not meet the third criteria or also falters from matching any one of the first two are mandated for compulsory enrollment. Even if I don’t enroll I will not be fined Myth:  People who fail the above mentioned criteria’s believe that they will not be fined for not enrolling. Fact: In order to grow awareness about health care insurance the mandatory inclusion clause was penned down under the Obamacare Act. If someone fails to meet the exemption criteria’s and still does not enroll for Obamacare during the open enrollment period then a good amount of money is charged as fine. The individual has to pay the fine as part of their income tax during the year or during filing for income tax return. The fine is charged as a shared responsibility fee, wherein a capable individual who can but choose to keep away from purchasing a health insurance would have to pay for the medical costs of others who cannot afford one.

It is less costly to pay penalty than to purchase insurance

  • Myth:  The rates of Obamacare sky rocketed since the years of its introduction causing some individuals or even families to feel that it is much cost effective to rather pay the fine for not enrolling than to actually enroll for a health insurance scheme and pay monthly premiums. Fact: As regard to the myth the fact can be quite opposite. Many families have to end up paying more fine than they would have paid for purchasing an insurance coverage. This is because studies show that people who fall in the higher income group always enroll themselves for health insurance as they can afford to pay for the premiums even if they are costly. Non enrollment strategy is generally practiced by families that generally don’t earn much. As any amount they can save at the end of the day are put to good use for availing the bare necessities of life. However, what many tend to forget is that the government provides subsidies to all families whose yearly income is less. Hence after taking these subsidies into account, the out of pocket premium amount comes to a bare minimum. Thus at the end the fine amount can turn out to be greater than the total premium amounts. In 2017, defaulters were fined an average of 2.5 percent of their yearly income or $695 per uninsured adult and $347.5 per child in a family whichever is higher. The rates are predicted to rise further in 2019. Let us take an example. A person whose current yearly salary stands at $45000 would be fined approximately $859 in a year if he is found to be a defaulter from Obamacare whereas the same person will have to pay $5 per month which totals to around $60 per year after deducting the subsidy amount he will receive in case he is not covered by his employer. Hence all options should be carefully assessed before choosing to pay a penalty rather than choosing a healthcare insurance. Even if in worst case scenario someone has to pay a bit more in premiums than the yearly fine, bright side is that the cost is worth it because it can save a lot of money for him in case of any serious medical emergency during short term or long term scenario.

The economy will be harmed by ACA

  • Myth: Many people believe, thanks to widespread lies by haters, that Obamacare will result in many job losses as well as financial loses. The increased premium rates coupled with the compulsion to pay full medical coverage of their employees, will eventually drive many companies to release many old timers. Thus, harming the economy as a whole in the long term. Fact: Although it is true that in the initial days of its launch, the mandatory inclusion clause of the ACA did create some confusion in the minds the employers and small businesses and this resulted in some job losses and others had their work hours reduced from being full time employees to part time employees as companies had to pay extra money to cover up for the extra premium amount of its employees. However, the condition didn’t last long and changed soon enough within a couple of years. Once companies were able to fully assess the impact hiring rate increased again. Comparing the results now than to 6 years earlier, employment rate has increased by almost 4.1 percent in the US. Moreover the ACA is still in its childhood as it has been only 6 years since it has been launched and a little bit too early to ponder on the long term effects. On the positive side in 2016 the Commonwealth Fund reported that American society has greatly benefitted from the Obamacare act. Some economist also say that the Obamacare Act was introduced at a time of great recession in the US economy. Hence majority of the job losses occurred because of recession than because of Obamacare.

High rates will make Health care insurance out of reach

  • Myth: Majority of the enrollees believe that the huge increase in premium rates every year will eventually make it impossible to purchase health care insurance for the average income holders. Fact: The rates of premiums were kept very low initially but gradually they increased many folds over the years. Currently the rates are almost double than what they are in 2013 and it is expected to rise even more in the upcoming years. Furthermore, the new governmental regime is aggressively pursuing in launching new short term insurance schemes in order to de mean the ACA even further. Short term plans with low premiums are being launched to attract more individuals and the shared responsibility fee is also being wavered of in some cases. But fact is that for all this price hype, the customers won’t be taxed with too much hefty prices as almost 84 percent of the enrollees get some form of government subsidy to help pay for the premiums. On one hand where the premium rates have increased, on the other hand the subsidies have also been substantially increased. Medicaid coverage and other relief plans have been expanded in many states and new clauses have been introduced to safeguard the common man’s rights. People earning below the Federal Poverty Level are provided with a lot of options to go for low cost plans and are even provided full exemption from enrollment if they are financially unable to do. Obamacare is not needed Myth: Many Americans hold the belief that Obamacare is unwarranted for and not needed as the existing health care infrastructure was good enough. Fact: It is true that before Obamacare was introduced into the marketplace, many Americans already had access to health care insurances through various sources. But a vast majority were bereft of it. During 2010, when the Obamacare Act was formed almost 45 million Americans didn’t possess any form of health insurance. Many who did often were cheated by private insurers or had to go through lot of harassment to obtain the money and even then could avail only limited options. Patients with disabilities or pre-existing diseases were completely shunned and mal practices were rampant. Basically the people had no right and the insurance companies blossomed day by day. It was only after the initiation of the Affordable Care Act that the health care standards in America turned for the better. The common man was provided more power and authority and their rights were guarded zealously. Medicaid program was expanded in many states everyone started possessing health insurance. Subsidies were increased and many new reforms were inducted which changed the face of the health care industry forever. Enrollees were provided with easy options to enroll for a plan even from the convenience of their homes. Opportunities are provided to rectify any mistakes made during filling up the application which in earlier times could have led to the cancellation of the insurance policy.

Government forces the rich to pay for the poor

  • Myth:  Another common belief is that through the Affordable Care Act the government is in fact pressurizing the rich to pay for the insurances of the poor. Fact: This myth does have some semblance with the real scenario. The Obamacare Act has resulted in higher taxes for the privileged and more grants for the poor. It is not unknown that Health care involves a lot of money and to provide it on a nationwide basis eventually increases the magnanimity of the amount. The cost for maintaining Obamacare comes around $1.1 trillion annually and hence in order to sustain it the government has to increase the tax amount. But if we look at it from a broader perspective this shared responsibility is the key to the progress of the American society. Moreover, by availing a health insurance, one can save much money when any medical emergency comes. So if everyone play their part dutifully then ultimately any unexpected crisis can be averted. Although the rich may have to pay more for their insurance but eventually they will only end up obtaining more benefits for themselves. Obamacare will take the place of current insurance Myth: One popular misconception is that Obamacare is going to replace the current insurance plan that a person has already enrolled. Fact:  The first and foremost thing to k now in this regard is that the Obamacare Act doesn’t seek to replace any insurance plan that a person has already enrolled for. If anything, it only strengthens it. That is to say that one can now enjoy more coverage and facilities on the same plan that one has purchased. By ensuring that everyone who has a valid health insurance should enjoy 10 essential medical benefits, Obamacare has expanded the medical benefits manifolds. If the current insurance plan of any person doesn’t cover all the essential benefits that are mentioned in the Obamacare before, it does so now. Apart from this many new much affordable plans have been launched so as to make it easier for the common people to enroll. But if anyone is happy with their current plan then one can always choose to follow it in future. Coverage will decrease under Obamacare Myth: It is often believed that the coverage and benefits that one used to receive previously will be degraded. Fact: It was never the intention of Obamacare to reduce the benefits that are currently provided under any insurance scheme. The law in fact mandates that anyone who has purchased a plan from the Marketplace should be entitled to following medical benefits:

1. Hospitalization and surgery
2. Rehabilitative treatment
3. Lab testing services
4. Pediatric care
5. Maternity care prior to, during and after labor
6. Mental health services
7. Preventative services like annual checkups
8. Prescription medication
9. Emergency services
10. Outpatient care or ambulatory services

Before Obamacare was introduced, no plans however promising they might have been covered all 10 critical medical benefits. This ensures that people become more healthy and recover quickly both physically and financially even after a major emergency. Even adults who are aged less than 26 years can enjoy health care insurance bought by their parents. Insurance companies have been more streamlined and now need definitive reasons to cancel payments or to increase premiums mid-way through the year. A maximum limit has been introduced beyond which all medical expenses shall be borne by the insurers and enrollees don’t have to pay a dime. Additionally subsidies are also provided to meet the premium amount. Keeping all this is in mind one can easily deduce that coverage has only increased under Obamacare and that too many fold than any of their current or previous health plans. Businesses will incur significant losses Myth: Many business owners feel that they are going to lose out on a lot of money now that Obamacare has been introduced. Fact: The premiums for Obamacare are not particularly cheap and when it comes to business owners who have to pay the full coverage of their employees it can be a bit of a nuisance. Hence in the initial years there were few job losses and reduction of work hours but those days are well past now. The initial panic which was caused by mayhem in the congress forced many businesses to go on the back foot. But with recurring years they have fully turned around. In fact many new jobs both in the public sector and private sector have been created and that too with full medical coverage. Obamacare cohered employers to pay for the medical coverage of their workers based on the size of their businesses. By 2016, it was mandated that companies that are quite successful must have in their employment 50 employees who are offered full time coverage. The smaller companies were not burdened with the mandatory inclusion but receive handsome tax reliefs if they should choose to provide coverage to their employees. If any company does not provide medical coverage to its employees then they are taxed accordingly. Keeping in mind that in the worst of cases if added premiums do lead to job losses, the ACA even provides hardship exemptions to individuals who end up being fired for this reason. The exemptions are provided in the form of subsidies so that even temporarily unwaged employees and their families don’t miss out on their health care premiums or can even find a new less costly one. Obamacare also provided a host of added benefits for businesses. Normally an individual can enroll only during the open enrollment period but businesses are not hassled to do so. They can enroll during SHOP programs as well. SHOP stands for Small Business Health Options Programs. Employers can file for tax relief before paying the taxes or can also use the credit to pay for future year. If a state doesn’t have Market place then the residents won’t be able to enroll for Obamacare Myth: In some states across the US, especially interior or small ones, Marketplace is not present. Since Obamacare applies for those plans which can be purchased from the marketplace many residents believe that the unavailability of a Marketplace in their residing state will prevent them from enrolling to Obamacare. Fact:  It is true that Obamacare only applies to plans which can be bought from the marketplace. The marketplace can be compared to a virtual shopping destination where customers can view different plans, easily compare them against one another, get all their doubts and queries resolved from experts either by chatting or talking to them over the phone and also calculate the amount of subsidy that they are liable to receive against any plan. So naturally many think that unavailability of a marketplace in the residing state will force them to lose out on the numerous benefits that are offered under Obamacare. But the good news is that one can still enroll for Obamacare even if their state doesn’t have a marketplace. The Obamacare does not mandate any state to host a marketplace if they shouldn’t wish to do so. Hence state authorities are well within the law if they so choose not to. Residents of such states who wish to enroll for Obamacare simply have to go on to the marketplace offered by the federal government. After logging on to the website, one can simply select his residing state, browse through all the available plans and choose the one best suited to his needs and income level. The Affordable Care Act strives to ensure that no one has to live without a proper health care insurance and thus crosses all limitations to offer it to the American citizens even if some of the states don’t comply. The marketplace website is not easy to navigate Myth: In the initial days the marketplace website had a few glitches and was prone to crash sometimes in the middle of a transaction which caused some nuisance for the people to enroll for an insurance scheme. This has led to a popular belief since then that the website is still very hard to navigate Fact:  When the Obamacare Act was introduced for the first time, the act makers didn’t have much time to oversee all the aspects of it. Like can one easily apply for it or not or how many people are going to enroll etc. The website that was launched was not properly tested and hence some glitches were left unattended. As a result of these glitches the website got hanged or even crashed sometime if the servers were overloaded with users. Moreover the short tenure of the open enrollment period also further added to the woes. This made online purchase almost impossible. But those issues were quickly countered and rectified within a course of mere two months and millions of Americans, as many as 8 million, were able to successfully enroll after that. The site has been regularly updated year by year and now boasts of a much user friendly interface. New features such as online chat have been introduced where one can get their queries resolved within moments by chatting with a virtual online assistant. All the links are properly named so that one can easily navigate through the options, easily compare them and also calculate the amount of subsidy conveniently. Even if after all the modifications one still finds it difficult to navigate the site, one can still choose to enroll through their mobile phones or via email or directly visiting any of the exchanges. Medicaid facility is no longer available Myth: Of all the lies spread by the haters of Obamacare the most preposterous was that the Medicaid plan was eradicated with the initiation of Obamacare. Fact:  The Medicaid plan was put into place keeping in mind the plight of the aged people. According to this act anybody who is 65 years of age can enroll in it and enjoy free of cost health care benefits for the rest of his life. Provisions are also there to en cash in the benefits at an earlier age but in that case the benefit amount is reduced appropriately. Individuals who suffer from permanent disability or end stages of critical life threatening diseases are also covered under the Medicaid plan irrespective of their age. Hence the Medicaid plan serves as a beacon of hope for all the disabled and elderly. Before Obamacare was introduced people could still enroll for Medicaid but the benefits were severely low and also denied many times in case of even small mistakes. Obamacare made it its primary goal to make states expand their Medicaid program so as to reach out to majority of the elderly people who still were left without any insurance. Figures state that as of 2018, 27 states back the Medicaid expansion program and made them available to their residents. Residents of the rest 21 states can still enjoy the original benefits provided by the Medicaid plan but will miss out on the new benefits. People who miss to enroll themselves for Medicaid during the open enrollment period can no longer enroll via the marketplace but can still enroll via other options like any assistance program all throughout the year with ease. Even doctors who previously received less payment for accepting Medicaid covered patients will be receiving the same payment as those who don’t accept Medicaid patients. Hence their salaries have increased significantly than before. Judging by all the points it can be safely concluded that Obamacare has not only upheld Medicaid but also expanded it. One who couldn’t afford health insurance earlier can’t still do it now Myth:  Many of the underprivileged people feel that even with Obamacare nothing has changed for them. They were unable to purchase a health insurance before and neither can they do now. Fact: It is true that many underprivileged people were denied medical coverage in the past but Obamacare is changing that picture. People who fall under the 400% Federal Poverty Limit get good amount of subsidies so as to cover up for their premiums. The Medicaid program is also expanded in many states under Obamacare, which ensures free medical checkup. Families can now even select plans which cost only $100 per month. The shared responsibility motto of Obamacare rigorously guards the well-being of the underprivileged.  Additionally insurance companies who previously had the option to charge absurd rates for even meagre medical benefits were made more accountable and forced to revise their rates or provide formal justification for keeping them so high. Cost of prescribed medicines were also lowered and free of cost preventative services have been introduced. Moreover, the annual limits and lifetime limits were abolished so as to provide more breathing space for the enrollees. It is seen that in US the main reason for bankruptcy is caused by over charged medical bills. Obamacare set out to change this age old statistics and provide more stability. Families who still couldn’t pay for Obamacare were provided exemption or if someone already have a low cost insurance they were allowed to still follow it. Obamacare forces to enlist for unwanted services Myth: This myth is mainly propagated by religious fanatics who are opposed to the ACA act on account of certain items which are objectionable as per their religion. Like certain Christian beliefs condemn the use of contraceptives or other birth control pills. Fact:  Keeping these beliefs in mind, the Affordable Care Act has included some clauses to adhere to the religious guidelines as well. For example employers who have a deep faith in Christianity can choose to offer medical coverage to their workers excluding the birth control benefits. Under no circumstances Obamacare asks its enrollees to go astray from their beliefs in order to gain medical insurance. Even if some clause do not adhere to religious beliefs, they can be challenged in a court of law and examples of such cases have been seen multiple times in the past. In such cases the court rules in the favor of the believers and allow them to bypass such clauses. Number of uninsured people are rising daily Myth: Number of uninsured people have increased after the Obamacare was launched. Fact: Opposition and haters like to spread that contrary to popular belief and results published by survey houses that the number of uninsured individuals has been increasing steadily since the ACA was introduced. But if one looks at the statistics before the Trump administration came to power and compare it with today’s scenario, it can be easily seen that the ruses are far from truth and are spread only to belittle the achievement of Obamacare. The rates started increasing after the new insurance act (also called as Trump care) were introduced. By removing the mandatory inclusion clause even for those who can afford a decent coverage the Trump administration is alienating the American youth from signing up to a health insurance scheme. Synopsis The Affordable Care Act is no short of a miracle for the American Health Care system. This act protects the interests of all individuals and unless and until in case of frauds or serious violations on the part of the enrollees no one is denied insurance. Every aspect of health care has been closely taken care of to curb out any malpractices and to fill any gap that might have existed before. The smokers and addicts are charged more premiums so as to discourage them from continuing their bad habits. Wellness programs are conducted throughout the year in regular intervals to spread awareness among the common people about various health problems like obesity, cholesterol etc. so as to encourage them to lead a healthy life. Employers are also educated on the need to spread awareness among his employees so that they don’t fall sick unnecessarily. All in all the Affordable Care Act strives to make the American people live a healthy and long life by guiding them to take effective long term health decisions.

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