Chelsey Tucker graduated with a Bachelor of History degree from Metropolitan State University in 2019. She now writes about insurance with her specialty being life insurance and has been quoted on Help Smart Phone and MEL Magazine.

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Dan Walker graduated with a BS in Administrative Management in 2005 and has been working in his family’s insurance agency, FCI Agency, for 15 years. He is licensed as an agent to write property and casualty insurance, including home, auto, umbrella, and dwelling fire insurance. He’s also been featured on sites like Reviews.com.

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Reviewed by Daniel Walker
Licensed Auto Insurance Agent

UPDATED: Mar 19, 2020

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The lowdown...

  • Obamacare does not require employers to provide their part-time employees with health insurance.
  • Obamacare does require that most Americans have health insurance.
  • Part-time employees can search for an insurance plan directly through insurance companies or through the Marketplace.
  • Some part-time employees may qualify for Medicaid based on their income levels.

The Affordable Care Act (ACA), commonly known as Obamacare, requires that most Americans be covered by a qualifying health insurance plan; otherwise, those people are subject to a tax penalty. Many full-time employees are provided health insurance through their workplace, but this same option may not be available for part-time employees.

If people who work part-time are looking for health care, they can get insurance directly from a company or apply for insurance on the Marketplace. They can also get covered through Medicaid if they’re eligible. It can be important to compare options since the out-of-pocket costs can vary depending on the type of coverage obtained.

Enter your zip code above to compare free health insurance quotes for all budgets today!

The ACA and the Workplace

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The ACA requires that certain types of employers provide health insurance to their full-time employees and their dependents. Those employers are generally those with at least 50 full-time employees. If they do not provide health care coverage, they are subject to an additional tax payment, called the Employer Shared Responsibility Payment (ESRP).

The ACA does not require employers with less than 50 employees to provide health insurance for its employees, nor does it require employers to provide their part-time workers with health care benefits. Sometimes employers will choose to provide that coverage, but this is a decision they make independently.

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The ACA and the Health Care Mandate

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Since the passage of the ACA, you may have heard about the Individual Mandate. This term refers to the fact that anyone who can afford to buy health insurance but chooses not to is required to pay a penalty. This penalty is either:

  • 2.5 percent of your household income (up to a maximum of the average price of a Bronze plan through the Marketplace)
  • $695 per adult in a household and $347.50 per child (up to a maximum of $2,085)

You’ll pay whichever amount is higher. This fee is sometimes referred to as the Individual Shared Responsibility Payment. This is paid to the government when you file your tax returns.

Exemptions to the Mandate

There may be certain situations when you are exempt from the fee. Some exemptions may be granted for people who:

  • Do not make enough money to file tax returns
  • Were uninsured for two months or less
  • Are living abroad
  • The cost of a plan would cost more than 8.13 percent of your household income

How to Get Health Insurance on Your Own

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You should compare your options when shopping for a health insurance plan. There can be significant differences in terms of premiums, deductibles, and copayments, and all of these factors can affect your total yearly costs. They may also affect what type of health care you end up seeking.

You can contact companies to find out more about individual plans. You can also look for insurance by using the Marketplace, which was established to make health insurance more affordable.

There are four ways to apply for health care coverage through the Marketplace.

  1. You can apply online.
  2. You can apply over the phone by calling 1-800-318-2596.
  3. You can find someone in your community (either at a health care center or a government agency) who is trained in helping people get coverage.
  4. You can fill out a paper application and then mail it in.

People with income under a certain level may qualify for Medicaid. This can vary by state, so you should contact your state’s Medicaid program to find out more about eligibility. This coverage can start as soon as your application is approved.

If you do apply through the Marketplace but it looks like you can get coverage through Medicaid, your information will be sent directly to your state agency.

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When to Apply for Health Insurance

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Open enrollment for the Marketplace traditionally begins at the end of a calendar year and extends through January 31.

You may qualify for a special enrollment period if you have:

  • Lost job-based coverage
  • Lost COBRA coverage
  • Lost eligibility for Medicaid, CHIP, or Medicare
  • Lost coverage through a family member

Medicaid coverage can begin at any time.

Marketplace Choices

There are four general categories through the Marketplace.

  • The Bronze plan has lower premiums but higher costs when you get care.
  • The Silver plan has a moderately priced premium and moderate costs when you seek care.
  • The Gold plan has a higher premium, but other out-of-pocket costs may be lower.
  • The Platinum plan is offered for the highest premiums. In return, you have the lowest out-of-pocket costs when you get care.

Potential Savings on Your Insurance

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Depending on your income, you may qualify for a premium tax credit. One option is to have your tax credit go directly to your insurance company, effectively lowering your monthly out-of-pocket costs. This scenario is called an “advance payment of the premium tax credit.” It can be wise to do so if you’re worried about your budget.

If you buy a Silver plan through the Marketplace, you may be eligible to receive additional savings. These cost-sharing reductions could help you lower your deductible, copayments, and/or coinsurance.

Since the federal law does not require employers to provide their part-time employees with health insurance, those people must look for coverage elsewhere. They can choose to buy insurance directly from a company, they can find coverage through the Marketplace, or they can apply for Medicaid. Before deciding on the coverage that you choose to buy, you should think carefully about what your projected needs will be and choose the appropriate coverage that fits your budget.