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Is There a Health Insurance Penalty in 2021?

Is health insurance required in the United States? The short answer: yes and no.

When the Affordable Care Act (ACA), or “Obamacare”, was launched in 2010, one of the biggest debates surrounding the law was not the idea of “healthcare for all” or what types of health incidents the ACA covers or doesn’t cover, but the idea that the act made health insurance mandatory for all Americans. While the law did not say anything like “you must have health insurance or you’ll go to jail”, it did create a tax penalty- popularly known as “the health insurance penalty”- for anyone without health insurance. One side of the political aisle said that this idea-  which simply became known as “the mandate”-  infringed on the freedom of Americans, while the other side felt that it was everyone’s right to have affordable health insurance, and a mandated public option would help keep costs down for everyone.

The Affordable Care act was launched nearly 10 years ago, and still never fails to be a major lightning rod in Washington, D.C. and in state government offices, especially during election season. While the individual mandate was lifted on the federal level in 2019, portions of the mandate still remain in the actual Obamacare law and in some states; these portions still create plenty of discussion everywhere in the United States.

What Is The Penalty For Not Having Health Insurance?

The national health insurance mandate was not as one-sided as we may have implied. While the mandate established a tax penalty for those without insurance, it also created a special premium tax credit for people with insurance, which served to help lessen the cost of health insurance. It also created provisions to expand Medicare for lower-income families. Congress voted to remove the federally mandated penalty for not having health insurance in 2017 via a law that became effective on January 1, 2019.

Some states, however, have their own insurance marketplaces, and have created their own mandated insurance, using a state tax penalty/tax credit system that is similar to the original federal system. As of early 2021, these states are as follows:

  • Massachusetts
  • Rhode Island
  • Vermont
  • California
  • New Jersey

In addition, the District of Colombia also has its own mandate. New Mexico, Kentucky, Maine, and Virginia are all expected to open their own marketplaces within the next two years, and Maryland, Hawaii, Connecticut, and Pennsylvania have made progress on creating mandatory healthcare law for their residents as well.

Pros and Cons Upsides and Downsides To Revoking The Health Insurance Penalty

In the words of the great Sir Isaac Newton, “with every action, there is an equal and opposite reaction”. In the case of the removal of the health insurance mandate, people quit their health insurance when it was no longer required in order to save money. Experts estimate that as many as 4 million people quit their health insurance solely based upon the removal of the health insurance mandate.

The biggest benefit of removing the mandate, especially for healthy young people, is that without having to pay for health insurance, a little more money can stay in one’s pocket. Stories have appeared of people who have used the mandate removal to their advantage, and have gotten rid of their insurance, then actually negotiated major health costs on their own and come out ahead of the system.

The downside, of course, is what Obamacare was originally created to avoid- not having health insurance is a major risk. Due to the extreme costs of healthcare in the US, most people without insurance or major savings are only one major medical crisis away from financial ruin or bankruptcy. Consider this- the average cost of an emergency room visit in 2018 was roughly $2000, which is nothing to laugh at, considering that in the pandemic era, surveys show that 25% of Americans have no emergency savings at all.

How To Compare Health Insurance

While the healthcare marketplace is one way to shop for insurance, there are other ways to shop that include other types of health insurance, such as private insurance and short-term coverage. The team at healthplanoptionstoday.com can help walk you through your options and get coverage in 3 easy steps, just click the button below to get started.

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The Health Insurance Marketplace Is Now Open

Millions of Americans are able to take advantage of the current special enrollment period, which lasts through May 15, 2021. Here’s what to expect out of Obamacare in the near future.

With one stroke of his pen, President Biden changed our country’s access to healthcare. On Thursday, January 28, 2021, after less than two weeks in office, the Biden-Harris Administration issued two executive orders that spurred a series of initiatives that will strengthen the American health care marketplaces.

President Biden’s two executive orders directed the Department of Health and Human Services (HHS) to reopen Healthcare.gov, which is the health insurance marketplace enacted by the Affordable Care Act (ACA)- more popularly known as Obamacare. These executive actions established a special health insurance enrollment period from February 15, 2021 – May 15, 2021, which would allow tens of millions of uninsured Americans in 36 states to secure an affordable health insurance plan. HHS has pledged to spend $50 million on outreach campaigns that encourage uninsured individuals to visit Healthcare.gov to explore their coverage options, complete unfinished applications, and enroll in a health plan.

Access to quality healthcare is a prevalent issue in this country that affects millions of Americans across geographic, racial, and social boundaries. These healthcare-related executive orders represent the commitment that the Biden-Harris Administration made in the American Rescue Plan to expand and protect Obamacare coverage, meet the growing healthcare needs created by the pandemic and strengthen healthcare services offered by federal agencies.

The Directive’s Changes to Obamacare and Medicaid

Although this special enrollment period is the only action specified by President Biden’s executive order, these directives place the spotlight on federal agencies. When it comes to Medicaid and the ACA, Biden called for federal agencies that interact with these programs to reexamine (1) the policies that limit healthcare protections of individuals with pre-existing medical conditions under the Affordable Care Act, (2) the practices that make Medicaid eligibility difficult, (3) the practices that create barriers to enrolling in Medicaid and ACA, (4) the policies and practices that increase insurance premiums for policyholders and dependents.

While the President’s order doesn’t go into detail and provide specific insight into what actions Medicaid, HHS and their corresponding federal agencies should take, this order is likely to reverse several policies established by the previous administration. It’s clear that the Biden-Harris administration is taking a powerful stance on Medicaid Policy and preparing to reestablish Medicaid as a foundational part of the Affordable Care Act, especially during the pandemic where millions of Americans have lost their jobs and can no longer afford health insurance.

Insuring and Ensuring Women’s Health

A significant part of Biden’s executive order was his nationwide presidential memorandum that sought to protect women’s health and reproductive rights. In this memorandum, Biden rescinded aggressive policies established by the previous Administration that modified women’s access to a variety of healthcare services, and also expanded other services that pertain to women’s reproductive health and sexual health.

How Does The Health Insurance Marketplace Reopen Affect Me?

Do you have health insurance? In the last year, millions of Americans were laid off due to the pandemic and subsequently lost their healthcare insurance, and due to hardship, unfortunately did not get Cobra insurance after losing their job. Fortunately, Biden’s executive orders give uninsured individuals additional time to enroll in Medicaid or find affordable comprehensive coverage under the Affordable Care Act.

Can I Buy Health Insurance That is Not Obamacare?

Many people wish to seek out other insurance options outside of Obamacare and aren’t sure where to start. Out team at Health Plan Options Today specializes in helping people explore their healthcare insurance options to get health coverage that is perfectly suited for their budget and their needs. Our experts are standing by to help you! Click the button below or call 1-888-375-8879 to start discussing your insurance options.

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Got Obamacare? Then You’re Automatically Covered For This.

Obamacare includes a “coverage bill of rights” that helps raise the standard for all American health coverage plans.

Over ten years in, the Affordable Care Act (also known as “ACA” or “Obamacare”) has become such a major part of American life that it’s almost hard to remember that it was a truly groundbreaking- and highly controversial- law upon passage in 2010. Aside from offering more accessible healthcare options for all Americans, the ACA most notably represented an overhaul to the way Americans and American companies approach healthcare. In many disadvantaged communities, healthcare coverage was the exception, not the rule, prior the passage of ACA. Although there is still a long way to go, now that has clearly shifted drastically.

Because Obamacare represents such a major change from earlier healthcare practices, some of the smaller advances it assures are often forgotten when people discuss the law, but are no less deserving of recognition.

A shining example of this is the idea of essential health benefits. This portion of the act states that there are 10 categories of service that every type of Obamacare-compliant health insurance plan must cover. In essence, the essential health benefits package is like a health coverage Bill of Rights, giving people a guaranteed minimum expectation for any Affordable Care Act-compliant health insurance plan they purchase.

What Are The Essential Health Benefits?
The 10 benefits are as follows:

  1. Ambulatory Patient Services: This is more commonly called “outpatient care” or “ambulatory care”. This is any medical care a patient receives without admission into a hospital, such as urgent care.
  1. Emergency Services 
  1. Hospitalization: This includes overnight stays as well as surgical care.
  1. Laboratory Services
  1. Mental Health Services: These services include behavioral health treatments such as therapy and counseling, as well as substance abuse disorder services.
  1. Maternity, Pregnancy, Neonatal and Postnatal Care
  1. Coverage for Prescription Drugs
  1. Habilitation and Rehabilitation Services and Devices: These are services and devices to help people obtain, maintain, or recover physical and mental skills. This covers a wide range of services, from physical therapy to speech therapy to services for differently-abled people.
  2. Preventative Care, Wellness Services, and Management for Chronic Diseases
  3. Paediatric services, including dental and eye care: This is an interesting part of the ACA essential benefits, list, as vision and oral care are not part of the adult essential health benefits.

Additional Essential Benefits

There are further benefits that should be mentioned that aren’t always included with the list of 10 “essential” benefits. Every Obamacare plan must additionally guarantee coverage for breastfeeding support and birth control. It’s also worth noting that there are 66 individual screening, assessment, and preventative care services that are fully covered by Affordable Care Act plans.

Am I Eligible For An ACA Plan With The “Essentials”?

The short answer for the majority of people is “yes!” Even if the yearly open enrollment (or perhaps, special enrollment) period has passed by, there are still other options you may pursue, such as short-term insurance or private insurance, which offer similar or better coverage options.

Our experts can help you get an affordable healthcare plan that is perfectly suited for your budget and needs. We are proud to serve the United States and have helped thousands of people obtain peace of mind through affordable health insurance plans. Click the button below or call 888-375-8879 to find the coverage options that are right for you.

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Experts Discuss Biden’s Health Insurance Marketplace Enrollment Extension

Health Insurance Experts share what they think President Biden’s new executive order means for uninsured Americans.

Last week, President Biden signed an executive order designed to address the impact COVID-19 has had upon Americans’ ability to access healthcare. President Biden’s order reopened the health insurance marketplace for a special enrollment period, and also encouraged all government agencies to review their health insurance policies. 

According to reports from the Commonwealth Fund research group, nearly 7.7 million Americans lost their job-sponsored health insurance in June 2020 alone, and many others have lost their coverage since then. In contrast, a relatively small number of those people have signed up for COBRA or new health insurance, meaning that millions of Americans are newly uninsured during the greatest health crisis our country has ever seen. Public health analysts believe that disparities like these could combine to create an even worse healthcare crisis than we’re already facing, and agree this is likely at least part of the reasoning beyond Biden’s executive order.

“…nearly 7.7 Americans lost their job-sponsored health insurance in June 2020 alone.”

– Commonwealth Fund Report: “How Many Americans Have Lost Jobs with Employer Health Coverage During the Pandemic?”

Health insurance experts at Health Plan Options Today who work directly with the uninsured have given their take on Biden’s executive order and whether they think it can help the uninsured masses. 

“The biggest concern folks seem to have is that they can’t afford health insurance- especially considering today’s financial condition- so they often see no way out”, said William G, a representative at Health Plan Options Today. “Of course, this isn’t the case, and we’ve been doing our best to educate people to the contrary. Hopefully the President’s executive order causes people to take another look at health insurance so they can get covered”.

“The biggest concern folks seem to have is that they can’t afford health insurance… Of course, this isn’t the case”

William G. HealthPlanOptionsToday Healthcare Expert

Stephanie A., another representative at Health Plan Options Today, says there are other major issues that have shaped people’s ideas of access to health insurance, especially given the United States’ unemployment rate: “Many people have no idea how COBRA health insurance works, and a lot don’t even know it exists in the first place. They just think that if they lose their job due to COVID, there are no other insurance options available.” Stephanie echoes William’s optimism for Biden’s Plan: “I really hope that the people who lost their jobs and didn’t take advantage of COBRA use the special enrollment period to their advantage.”

Overall, there is generally support for Biden’s executive order, especially considering 2020’s historically short marketplace insurance enrollment period and low enrollment numbers. Many people who missed the original enrollment period will now have a second chance at enrolling for ACA-based plans in 2021. Perhaps William G. summed it up perfectly: “I think we can all agree that no matter what, a second chance is always nice.”

Are you insured? To get your own second chance at affordable health insurance, fill out the form below and one of our agents will contact you, or call us at 1-888-375-8879.

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Biden Reopens Obamacare Enrollment

Don’t Have Insurance? Here’s How Biden’s Executive Order Helps You

On January 28, with just a few quick strokes of his pen, President Joe Biden signed an executive order that changed the way many Americans access their health insurance temporarily, and may permanently change the way federal agencies- and by extension, healthcare companies everywhere- approach insurance.

President Biden’s executive order will reopen Affordable Care Act (ACA) healthcare enrollment for a special enrollment period between February 15th and May 15th- and not just for those who are eligible for COBRA or other special coverages. The order also demands that federal agencies review their policies to make sure that healthcare truly is affordable, and to ensure their policies do not block insurance access for those with preexisting conditions, including COVID-19. Biden’s order also urged these same agencies to make other changes that will “protect and strengthen” access to healthcare in the future.

Biden made a statement after the order’s signing, saying “As we continue to battle Covid-19, it’s even more critical that Americans have meaningful access to health care”.

This executive order follows former president Trump’s changes to the Affordable Care Act. In 2018, Trump shortened the ACA’s enrollment period from 92 days to 15, which caused new healthcare enrollment to drop drastically. Also notably, the Trump administration and several states attempted to kill the ACA in a case that’s still pending before the Supreme Court.

What Does Biden’s Executive Order Mean For You?

If you’re worried because you or your family don’t have health insurance during the Coronavirus pandemic, you have another chance to secure insurance through the ACA marketplace- even if you have lost your job, stopped paying your private health insurance, or both. This will come as especially good news to those who missed because last year’s enrollment period was so short.

What If I Want Other Healthcare Options or Miss the Healthcare Enrollment Period?

If you miss the new Health Care Enrollment period or if you would like other healthcare options beside the ACA marketplace, there are still other options available for you, such as private insurance. The team at Health Plan Options Today can help you examine options such as these.

If you have any other questions, need help picking the best health insurance plan for your needs or would like to enroll in health insurance, just fill out the short form below or give us a call at 1-888-375-8879 and we’ll help you get insurance at a rate you can afford.

Need Health Insurance?

Fill out this form and our experts will contact you to help you get the right insurance for your needs.

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President Trump Tries to Bypass Obamacare

Never in my life did I ever think I would hear the following words: “The president’s support for killing Obamacare during the coronavirus pandemic shows a callous disregard for communities in crisis” (Jonathan Metzl, 2020). To catch up, the Affordable Health Care Act has been around for about a decade under President Obama’s decision to make it mandatory for Americans to all have health insurance. Though half of uninsured Americans denied themselves of potential coverage, the other half embraced it! It was a breath of fresh air to many who were without affordable health insurance.

But things change, and politics rule.

Now, in the midst of crisis and a pandemic we cannot seem to stop, President Trump has decided to call Obamacare a “disaster,” and said he wished to “terminate it.” This is not completely in context. Many Americans were (and still are) upset about being forced to pay a fine given they did not have the right coverage (Kaiser, 2020). It is a dual-edged sword: Americans did not embrace the ACA, but now that we need it the most it makes the most sense to use it. You would think this would lead to better health coverage, but that is not the case. Obamacare enrollment skyrocketed since Trump became President. But Trump has decided that now, of all times, is a good place to end the system.

Backing up to May 2020, Trump began the process of getting rid of the necessity of Obamacare, but in a time when Americans can barely afford the premiums, it seems as if the Affordable Healthcare Act is, as of now, quite useless. But the time and place to cancel this ethereal part of our history, in my opinion, is where the “wrong” begins. Aside from personal opinions and political orientations, let us examine this factually.

First, some statistics. 33 percent of White Americans (as of 2010) were without proper health coverage; 33 percent of Hispanics; and 20 percent for Black Americans. This accounts for a tremendous 46.5 million people who currently do not have the proper health coverage. This is ironically 18 percent of the nonelderly population.

 Then, the ACA began.

By 2016, 90 percent of Black Americans had health care, as one example, and many people claimed to have paid much less for prescriptions, to have less medical debt, and in turn, more security when something goes wrong. However, despite this progress, the Trump administration has spent three long years trying to eliminate it. Speculations are amidst. Many claim that it is a way of ridding us of the Obama era; others feel it is simply Trump’s way of cutting funds to a crucial problem.

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However, despite political boundaries, the main issue is not “why” we are cutting it. Rather, it is a question of: “what happens when it is cut?” The main issue seemed to be the cutting of advertising the program. Since Trump’s induction, there has been a 79 percent drop in community outreach, according to the Kaiser Family Foundation. In other words, though the ACA still exists, and most likely will continue to exist (one can only amend so much), the fact is many Americans have forgotten – especially in the midst of a pandemic – that Obamacare is an option. So, what happened last week?

The Trump administration “urged the Supreme Court to overturn the Affordable Care Act.” Ironically, it was the same day that half a million Americans lost health insurance due to the economic shutdown, of which was meant to slow the COVID-19 spread. 20 million Americans can and have lost their health coverage, and according to House Speaker Nancy Pelosi: “If President Trump gets his way, 130 million Americans with pre-existing conditions will lose the ACA’s lifesaving protections and 23 million Americans will lose their health coverage entirely.”

Sound bad? Well, it really is.

When this case approached the Supreme Court, many conservative-led states did make their point that the ACA was “unconstitutional,” where fines are issued for not having proper health insurance. What many do not realize is, that was not meant to harm the American public. Rather, it was a way to incentivize the notion that without health insurance, one is subjected to potentially thousands of dollars during a routine visit. In turn, it was not meant to “punish” us, but rather to motivate us!

With due respect, Trump is not the monster they are making him out to be. However, he certainly is not making the health insurance game any easier. With so many Americans affected by the coronavirus, the loss of millions of jobs, and God knows what else, it seems the last thing we should be doing is cutting down on affordable care. Despite this, Trump has made sure we all know that those with preexisting conditions (i.e. an illness or a health issue that was made prior to the actual insurance policy) will still be protected, but how? That is the question many are currently asking, as though it was announced that Obamacare would be seeing changes, no mention of how to redeem its loss have come into earshot, leaving many stressed and without help.

Denied health coverage? Contact us for some assistance!

Now, the good news is since the loss of millions of jobs, around 487,000 people have been wise enough to sign up with HealthCare.gov, after the loss of workplace overage. It is a drastic increase of 46 percent since last year, and all we can do at this point is hope that an appeal is missed, or an executive order is ignored. Otherwise, the realm of health insurance will never quite be the same – if we allow it, that is. We can only hope…