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What if I can’t afford health insurance?

The lowdown...
  • Obamacare requires insurance coverage for every eligible US resident
  • Insurers must accept every applicant and charge similar prices to plan policyholders
  • Obamacare sets standards for qualified health plans but not the prices
  • Insurance companies set prices subject to state and federal approval of the content of the plans

Residents that cannot afford health insurance can qualify for no-cost coverage through Medicaid, Medicaid Expansion, and the Children’s Health Insurance Program. They may also qualify for exemptions from the individual mandate, but that does not add coverage that everyone needs.

Some persons may be exempt because no available health insurance policy costs less than eight percent of the annual family income.  This exemption also applies when employer-sponsored insurance exceeds nine and six-tenths percent of the annual family income.

Comparison shopping is the best way to find low prices and high value in health insurance. Explore your health insurance options today by entering your zip code above!

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Health insurance is costly and many people struggle to pay the premiums and out-of-pocket costs. The Affordable Care Act set up a structure to reduce the costs and monthly payout from the time before the law was passed. That did not change the basic fact that healthcare costs in the US are high, and they are higher than most comparable or advanced nations.

Many parts of the law that would have had the biggest impact on affordability were removed or disabled by political action. This included Medicaid Expansion and the COOP.

Four Types of Obamacare Policies

By applying subsidies to the monthly premium, the price of the monthly heath insurance premium drops to manageable levels.

The four types of Obamacare policies each offer features that help consumers pay for the coverage.

Platinum plans covers most of the costs of benefits and has the lowest deductibles. It offers high value because it has low costs outside of the premium. The high premium is a regular payment and, unlike cost sharing and copays, it is predictable for budgeting purposes.

Gold plans is similar to Platinum in that it has high premiums and lower rates for cost sharing and copays than the lower tiers. Since most of the costs are likely to be in the premiums, it too offers predictability for personal or family budgeting.

Silver plans have moderate premiums and deductibles Silver plans can pair with Health Savings Accounts, and this can make insurance more affordable.

The Heath Savings Account feature permits policyholders to use pre-tax dollars to pay for medical expenses. This feature softens the blow of high medical costs by allowing tax-free use of funds, a bigger tax deduction each year, and the ability to roll over any unused savings to subsequent years.

Reccomended reading: “What is a Health Savings Account (HSA)?”

Bronze is the lowest level for premiums and the highest for deductibles. Many young healthy people use these plans and take advantage of the low premiums and free prevention services.

If one has few medical needs, this is an ideal way to cut the costs of health insurance. In the event of a serious illness or injury, one can have insurance coverage after one pays the deductible.

Catastrophic coverage is not a tier but a special category for young people that need some form of emergency coverage. It does not satisfy the mandate, and it works best for those with an exemption. Catastrophic policies have low premiums and high deductibles. They provide prevention services, essential benefits, and annual examinations.

The Individual Mandate

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The mandate in Affordable Care Act does not exempt those that can’t afford health insurance. The law added provisions to help low-income earners and children in need of medical care.

If one has income too low to require filing a tax return, then one can avoid the penalty and will not need to buy insurance to meet the terms of the law. The federal Marketplace and state exchanges automatically refer applicants for Medicaid and CHIP when they cannot qualify for Obamacare policies.

Help for Those in Need

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The federal safety net provides some relief for those that cannot afford health insurance. Some applicants qualify for Medicaid and the CHIP. The Congress has moved consistently over several decades to protect the vulnerable by providing access to medical care.

Obamacare reformed health insurance and added provisions to promote insurance coverage among low-income families.

Medicaid provides qualified health coverage at low or no costs to the insured. States set upper limits on income to qualify. The Congress enacted the CHIP to protect children and adolescents in need of regular medical care.

Medicaid Expansion was the part of the ACA that absorbed the uninsured that could not afford Marketplace policies. The expansion raised the income limit above 138 percent of the poverty guideline.

This excellent program assisted states financially and organizationally to enable protection for their most vulnerable uninsured residents. If one were fortunate enough to reside in a state that adopted the expansion, there is a source of no-cost coverage.

Hardship Exemptions help avoid the tax penalty but do not help protect against medical expenses.

Marketplace Financial Assistance

Applicants with incomes within 250 percent of the federal poverty guideline may qualify for silver plan costs sharing reduction subsidies. These actions reduce the amounts that consumers must pay when getting benefits and reduces the amount they must pay before getting benefits.

This program can help applicants that struggle to pay premiums and expenses; it reduces the amounts consumers must pay.

Can’t Afford Living without Health Insurance

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Residents that must spend carefully when purchasing heath insurance can use Obamacare subsidies and select the best match among the policies with lowest costs. Those that cannot afford health insurance can get coverage of they qualify for no-cost programs like Medicaid, Medicaid Expansion, and the CHIP.

The option of living without health insurance is the more risky course; one can encounter unforeseen illness or accident and face large medical bills and expenses.

Comparison shopping is a growing practice among consumers that value assets and control spending. Put your priorities first and enter your zip code below to get free online health insurance quotes!

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