Obamacare markets may soon be back. The Associated Press reported on Wednesday that US President Joe Biden is expected to reopen the HealthCare.gov insurance markets soon for a special sign-up opportunity for people who need coverage in the pandemic.
With this, Biden will fulfill an election promise and perhaps provide respite to thousands of Americans looking for cheaper health insurance coverage as the US reels under the pandemic. But what is Obamacare aka the Affordable Care Act? News18 explains.
What it Does
Known as the Patient Protection and Affordable Care Act (ACA), the 2010 act began to be called ‘Obamacare’ by former President Barack Obama’s critics. Before it, insurance companies could exclude people with preexisting conditions, and due to this, people with the worse health expenses often either went without insurance or settled for a policy that did not cover a preexisting condition.
Unable to afford even regular doctor visits, they often landed in hospital emergency rooms while not being able to afford their treatments.
The act sought to slow the rising cost of health care by making health insurance more affordable and available. It overhauled the individual insurance market, offered consumers discounts (tax credits) on government-sponsored health insurance plans, and expanded the Medicaid assistance program to include more people who don’t have it in their budgets to pay for health care.
One can buy Obamacare plans on healthcare.gov if their state participates in the federal program or from their state’s healthcare website if it does not.
In short, these are the major things ACA did:
• It expanded Medicaid, a federal program that provides health coverage to low-income Americans.
• It created insurance exchanges, online portals including Healthcare.gov where Americans can shop for coverage, some with financial help from the federal government.
• It made health insurance mandatory.
Who is Eligible?
Those who receive insurance through their employer don’t have to worry about the ACA. But who all are eligible? One can only receive discounts to help offset health insurance costs if their household income is between one and four times the Federal Poverty Level, ABC news reports.
A person can choose to apply the credits to their premiums to lower the monthly insurance bill or wait until the end of the year and declare them on their tax return.
Trump’s ‘Attack’ on Obamacare
Although the number of uninsured Americans has grown because of job losses due to the economic hit of COVID-19, the Trump administration resisted calls to authorize a special enrollment period for people uninsured in the pandemic. Failure to repeal and replace Obamacare as he repeatedly vowed to do was one of former President Donald Trump’s most bitter disappointments. His administration continued trying to find ways to limit the program or unravel it entirely. A Supreme Court decision on Trump’s final legal challenge to the Affordable Care Act is expected this year.
The White House had no comment on Biden’s expected order, but two individuals familiar with the plan said the new enrollment period would not go into effect immediately. Instead, the White House wants to provide time for the Department of Health and Human Services to mount a marketing campaign, and for insurers to get ready for an influx of new customers.
Biden’s order would directly affect HealthCare.gov, the federal insurance marketplace currently serving 36 states. The marketplace concluded a successful annual sign-up season in December, with enrollment for 2021 growing by about 7%. Final numbers for this year that include insurance markets directly run by the states will be available soon.
Opening the insurance markets is also likely to result in higher Medicaid enrollment, since people who qualify for that program are automatically referred.
The special sign-up opportunity is only a down payment on health insurance for Biden, who has promised to build on former President Barack Obama’s health law to push the U.S. toward coverage for all. For that he’d need congressional approval, and opposition to the health law still runs deep among Republicans.
White House press secretary Jen Psaki signaled Tuesday that Biden is also looking at limiting or reversing Trump administration actions that allowed states to impose work requirements for able-bodied low-income adults as a condition of getting Medicaid. Such rules are seen as a way to cull the program rolls.
“President Biden does not believe, as a principle, it should be difficult … for people to gain access to health care. He’s not been supportive in the past, and is not today, of putting additional restrictions in place,” she said.
Of some 28 million uninsured Americans before the pandemic, the nonpartisan Kaiser Family Foundation estimates, more than 16 million were eligible for some form of subsidized coverage through the health law.
Experts agree that number of uninsured people has risen because of layoffs, perhaps by 5 million to 10 million, but authoritative estimates await government studies due later this year.
(With inputs from the Associated Press)