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What Is Health Care Reform?

Learn about The Affordable Care Act (ACA), officially known as the Patient Protection and Affordable Care Act (PPACA).


Optima Health – Video Script

Topic: What is Health Reform?

Confused about Health Reform? You're not alone. Almost half of uninsured Americans were unaware of the Affordable Care Act's requirement to purchase health insurance in 2014.  (http://www.gallup.com/poll/163280/uninsured-unaware-coverage.aspx 6/28/13)The Affordable Care Act, also called Health Reform or Obamacare, is on the way. In fact, the first open enrollment period begins October 1, 2013 and continues through March 31, 2014.

Even though it might sound confusing now, Health Reform is actually designed to give people more choice and control over their health coverage. (https://www.healthcare.gov/how-does-the-health-care-law-protect-me/ )

This means:

  • You'll receive essential health benefits no matter what plan you choose which includes things like cancer screenings, mammograms, vaccinations, birth control, mental health services, urgent care coverage, preventive care, like tobacco use counseling and more.
  • You cannot be denied coverage for preexisting health conditions.
  • Young adults may remain on their parent’s plan until age 26.
  • You will not be subject to a lifetime cap on coverage of essential health benefits
  • You may even qualify for a subsidy or tax credit to help pay for your health insurance – depending on your household income level.

Sounds pretty good so far, right? So, what do you need to do about it?

Let's say you work for a large company with more than 100 employees…

Most likely, you will not notice any changes in how you purchase health insurance.

What if you work for a small company – with less than 50 employees? Will your employer offer health insurance? Well, that depends.

Small business owners with less than 50 full-time equivalent employees (or FTEs) are not required by law to offer health insurance for their workers in 2014.  But, there may be incentives, like premium tax credits, if they get coverage through the Small Business Health Options Program (or SHOP). (https://www.healthcare.gov/what-do-small-businesses-need-to-know/) So you will want to ask your employer if they plan to offer health insurance.

But, if you're not covered by your employer and you’re not eligible for a government health insurance plan such as Medicaid or Medicare, then you’ll find yourself shopping for health insurance on your own beginning October 1, 2013.

Many individuals will be able to purchase their insurance plans directly from an insurance company, like Optima Health, or through the new online exchanges or Health Insurance Marketplace. (http://www.kaiserhealthnews.org/stories/2011/march/30/exchange-faq.aspx 1/10/13)

These websites allow you to compare plan prices and features, as well as determine your eligibility for a subsidy or tax credit and purchase the plan that fits your needs. Think of it as a shopping experience similar to "Expedia," but for health insurance.

What happens if you don't buy health insurance? Well, you may face a tax penalty when you file your annual income taxes.

With so much to consider and so many options, making the right choice will be important.

Visit us online at www.optimahealth.com/healthreform

Or call 1-855-556-8893 to speak with a personal plan advisor who can help you understand your options and choose a plan that’s right for you.