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How Will Obamacare Affect You?

Major changes to U.S. healthcare have rolled out in January 2014. But what is Obamacare really? What changes will be made? And, most importantly, how will they affect you and your family? House Call Doctor explains in Part 1 of her Affordable Care Act series. 

By
Sanaz Majd, MD,
February 27, 2014
Episode #146

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Whether we like it or not, there are major changes in American healthcare that began in January 2014. Millions of Americans are now able to obtain medical coverage through the new Obamacare plans. 

But what is Obamacare really?  What changes will be made to existing coverage? And how will they affect you personally? 

These are all questions I hear from my patients over and over, mostly because so far it seems to be a rather vague entity.  No one seems to know for sure, and to be honest, I don’t think many health care workers and physicians even know exactly what’s in store for the upcoming years.

However, there are some basic elements of Obamacare that everyone should be aware of, whether you are currently insured or not.  I will address the major points of the bill in today’s episode, and next week I will guide you on how to enroll in 4 easy steps.

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What Is Obamacare?

Obamacare refers to a historic 2,572-page healthcare bill that was passed on March 30, 2010 and signed by President Obama. Its official name is the Patient Protection and Affordable Care Act. Obamacare's goal is to change the way insurance companies cover consumers and the way consumers can obtain coverage.  If you have time (and patience), you can read an almost 1,000-page "synopsis" of this new law here.  Otherwise, listening to or reading  the rest of this episode will give you a brief overview.

What You Need to Know About Obamacare

Here are some of the major points of this bill that everyone should be aware of:

The Individual Mandate:  Beginning in 2014, most Americans will have to either purchase health insurance from their employer or the healthcare marketplace, or pay a tax penalty of $95 per adult or 1% of your gross income (up to a max of the annual cost of the least expensive plan option), whichever is higher.  For people with children, the penalty for not covering a child will be $47.50.  You’ll be paying this penalty on your 2015 taxes. This penalty will increase in the following years and by 2016, the penalty will be $695 or 2.5% of your gross income for an individual, whichever is greater.  

10 Essential Benefit Requirements of Health Plans:  You cannot just select any health insurance plan; it must meet certain minimum requirements.  This means that it must cover a minimum of these 10 essential health services:

  1. Doctor visits
  2. Hospital stays
  3. Emergency care
  4. Maternity care
  5. Children’s care, including dental and vision
  6. Prescriptions
  7. Medical tests
  8. Mental health and substance abuse disorder care
  9. Rehab services and devices
  10. Preventative services (such as pap smears, mammograms, colonoscopies, etc.)

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