Obamacare, officially known as the Affordable Care Act (ACA), was signed into effect nationwide in 2010 and enforcement officially started in 2014. The intent of Obamacare was to increase access to healthcare through expanding Medicaid programs, protecting consumers from being discriminated against due to pre-existing health conditions, opening a regulated Marketplace to shop for cost-efficient health insurance options, and requiring all U.S. citizens to have minimum health insurance coverage.
Obamacare’s Effect on Kansas Health Insurance
Kansas is one of the states that have not implemented any of the recommended steps through the Affordable Care Act and has not accepted any federal funding. Because Medicaid expansion has not occurred nor has the state implemented a state exchange or supported the national exchange, there has been little to no change in the uninsured population. In fact, reports say the uninsured population has actually increased to 17.6%. According to the National Health Interview Survey, the uninsured national average is 9.1%.
What Kansas Residents Should Know About Obamacare in Kansas
The Pros and Cons of Kansas Obamacare
Kansas Obamacare has been successful in stressing the importance of individuals taking ownership of their care by actively participating in wellness programs and early screenings. Also, Obamacare in Kansas has successfully eliminated denial of care based on pre-existing conditions and has disabled Kansas companies from charging a higher premium based on race or gender. Unfortunately, since the majority of the items that have made other states successful have not been implemented in Kansas, there are not many successes to tout.
There have been political criticisms of Obamacare in Kansas that have resulted in a lack of support of the Affordable Care Act. The state does not have many options in the exchange. With UnitedHealthcare leaving, it would leave only one option available until the recent addition of Medica. Finally, there has been a notable struggle in getting re-enrollments, especially for the healthy young adult population who would rather pay the fine for not having coverage than be responsible for monthly health insurance premiums they cannot afford.
Obamacare Health Plan Categories and How Much You Will Pay
When shopping in the Kansas Obamacare Marketplace, there are four primary health plan categories you can choose from: bronze, silver, gold, and platinum. The categories determine the percentage of healthcare costs that the plan will pay for over a course of a year. The remaining percentage is what you will be expected to pay.
These percentage differences greatly impact how much you may expect to pay for care. For example, if the bronze plan pays for 60% of a benefit, then as the patient, you can expect to pay the remaining 40%. While this plan will cost you less monthly, it leaves you financially responsible for a larger dollar amount than a platinum plan, which pays for 90% of a benefit.
Here are the different kinds of Obamacare plans as well as the average amount of healthcare services each plan pays for:
- Bronze plan - 60%
- Silver plan - 70%
- Gold plan - 80%
- Platinum plan - 90%
How do I sign up for Obamacare in Kansas?
The Kansas Obamacare Marketplace and exchange can be accessed through the federal government website or by calling (800) 318-2596.
What are the Obamacare Marketplace and exchange?
The Marketplace is a central location to shop for insurance options and enroll for selected coverage. In the case of Obamacare, Kansas utilizes a Federally-Supported Marketplace (FSM), which means that the U.S. Department of Health and Human Services provides the infrastructure for the Marketplace where health insurance plans are offered but the state will still manage the plans.
Do I need to use an exchange?
To access public health insurance, you will need to go through the government exchange. The only exception to personally using the exchange to sign up for Obamacare in Kansas is if you are able to seek help from a Kansas certified counselor or a private insurance agent who can discuss your options and select a plan, on your behalf, through the exchange.
How do I use an exchange?
You can use the exchange one of four ways:
- Visit healthcare.gov
- Use the telephone support assistance available by calling (800) 318-2596
- Find a local certified counselor
- Seek help from a private insurance agent
What does it mean to be on-exchange or off-exchange?
On-exchange generally refers to purchasing health insurance coverage from the Obamacare Kansas Marketplace while off-exchange normally refers to purchasing private health insurance coverage from a private company.
When is the Obamacare enrollment deadline and what do I do if I missed it?
The Obamacare open enrollment period for 2017 in Kansas is from November 1, 2016 until January 31, 2017. If you miss enrollment, you would need to qualify for a special enrollment period due to a qualifying life event or purchase short-term individual private insurance to avoid a penalty.
What is the Obamacare penalty if I don’t buy health insurance?
If you do not buy Obamacare or other qualifying health coverage (also referred to as “minimum essential coverage”) you will be subject to a tax penalty for each month you go without coverage. This fee should be paid when you file your federal tax return. In some special cases, there are exemptions to this penalty.
The Obamacare penalty for 2016 is either 1) 2.5% of your household income, with a maximum of the price of a Bronze plan sold through the Marketplace, or 2) $695 per adult and $347.50 per child under 18 yrs of age with a maximum of $2,085. You will pay whichever of the two options is higher.
The Obamacare penalty for 2017 is fairly similar to 2016 with the percentage fee of 2.5% remaining the same, however, the flat fee will be adjusted for inflation.
What if I cannot afford Obamacare?
If you cannot afford to pay for Obamacare coverage, you may be able to qualify for a government subsidy. For more information on government subsidies, visit the HealthCare.gov website.
What are the alternatives to Obamacare?
Any health insurance coverage that meets the minimum essential coverage, as set forth in the Affordable Care Act, can be used, whether this coverage is received through an employer, private insurance company, or purchased through a private exchange.
There are several alternatives available when selecting coverage. You can select one of the available alternatives on the Marketplace, purchase one of the many options available on the private exchange, or see if you are eligible for subsidized programs through Kansas’s Medicaid program.