What Is Obamacare?

Obamacare, formally referred to as the Affordable Care Act (ACA), was conceived and enacted by President Barack Obama in 2010. The ACA aims to provide all Americans with the opportunity to access affordable health care. While in power, President Donald Trump repeatedly threatened to dismantle it. This has led many to ask, “Has Obamacare been repealed?” Numerous attempts in Congress failed to fully repeal and replace the bill, meaning the Affordable Care Act shall continue to endure, but its future is definitely in jeopardy.

Obamacare At a Glance

• Obamacare was signed into law by President Barack Obama in 2010.
• The law included significant terms dedicated to making health coverage on the individual market affordable – including subsidies and expanded Medicaid eligibility.
• Obamacare included alternatives to improve how Americans chose their coverage with the online health insurance marketplace, CO-OPs, and the Basic Health Program.
• The Affordable Care Act established coverage measures to prevent insurers from being selective with accepting applicants based on a person’s pre-existing medical condition or gender.
• ACA-compliant plans come with improved plan benefits, which are included in Obamacare’s essential health benefits (EHB).
• Health reform advocates praised Obamacare for its numerous stipulations intended to extend coverage and prevent discrimination regarding policyholders.
• Obamacare introduces various terms meant to decrease Medicare spending, lower costs, and better coverage for Medicare recipients.
• You can only enroll in ACA-compliant plants within an annual open enrollment period or special enrollment periods. 
• As of 2020, Republicans still oppose and attempt to repeal the law’s terms.

Updates to the Affordable Care Act / Obamacare for 2025

The Affordable Care Act continues to provide consumers with access to the health insurance they need. For coverage to start by January 1, 2025, you had to have enrolled by December 15, 2024. For coverage to start February 1, 2025, you had to enroll prior to January 15, 2025. 

What does Obama Care do? Consider its reach in 2025, according to the U.S. Department of Health and Human Services. According to data released by the organization, 24.2 million consumers selected a 2025 plan through the Marketplace during the 2025 Marketplace Open Enrollment Period. That includes 3.9 million new consumers. That information shows that it is more than double the number of enrollments in the 2021 Open Enrollment Period. Since the start of the Marketplace, 50 million people, which is equal to 1 in 7 Americans, have enrolled in the plan. 

When we consider who is eligible for Obama care, it is also very important to consider the changes that could come. According to the same report, a tax credit that has helped consumers purchase the plans will expire at the end of 2025. When that happens, it could mean 5 million people will lose their coverage entirely. Millions of others could see premiums rise by as much as 50%. That could be stopped depending on how Congress changes these laws in 2025.

If you are like many others and have questions, including “What’s Obama care? Or will an Obama medical insurance plan help you?” we have some insights to help you.

What Is the Affordable Care Act?

The Affordable Health Care Act (ACA) is often referred to as the Obama plan because President Obama helped to put the plan in place. The Affordable Care Act has several goals. That is to:

• Make affordable health insurance available to more people.
• Expand Medicaid coverage to all people who have an income below 138% of the Federal Poverty Level.
• Support innovative medical care delivery methods that can lower the cost of health care. 

• Increase the amount of Americans with health insurance.
• Ease the control of health care services. 
• Reduce the overall costs of health care by restricting certain insurance company practices. 
• Provide tax credits and subsidies for individuals and businesses.

Who Qualifies for Obamacare?

Various factors play a role in determining who is eligible for Obamacare. However, you may be eligible to use the Marketplace to purchase insurance if:

• You must live in the United States.
• You must be a U.S. citizen or national or be lawfully present in the U.S. as a non-citizen.
• Not be incarcerated.

There are other factors that determine who qualifies for Obama Care when it comes to immigration status. One of the most important updates has to do with a court order issued on December 9, 2024, related to Deferred Action for Childhood Arrivals (DACA). If you are a recipient of DACA or a consumer with certain immigration statuses in the following states, you are no longer eligible to use the Marketplace.

• Alabama
• Arkansas
• Florida
• Idaho
• Indiana
• Iowa
• Kansas
• Kentucky
• Missouri
• Montana
• Nebraska
• New Hampshire
• North Dakota
• Ohio
• South Carolina
• South Dakoda
• Tennessee
• Texas
• Virginia

When it comes to who qualifies for Affordable Care Act coverage, note that these rules can change over time. If you are unsure of what type of coverage you may qualify for, reach out to a licensed insurance agent for additional insights. Obama Care eligibility can change even if you currently have a plan. 

Breaking Down: What Is Obamacare in Simple Terms?

What is Obamacare called now? Today, when selecting health insurance, you may be able to purchase your coverage on the Healthcare Marketplace. What is Obama Care called now? Often, it’s referred to as just the Marketplace. 

So, is Obamacare the same as Marketplace? Yes, Obama Care is the term often used to reference the Affordable Care Act, which is also what created the Health Insurance Marketplace, what we refer to as the Marketplace.

Notable, the Affordable Care Act vs Obamacare has had some changes over time (you will learn more about those in just a bit). The Obamacare vs Affordable Care Act costs are different, and eligibility has changed over time.

When Did Obamacare Start?

While President Obama officially signed the Affordable Care Act into law in 2010, the first Open Enrollment Period wasn’t until October 1, 2013. The initial enrollment period ended on March 31, 2014. Many people are surprised that it took so long to get Obamacare off the ground, but various aspects of the law had to be ironed out before opening the Marketplace.

How Does Obamacare Work?

Under Obamacare, insurance companies are required to offer healthcare to all Americans. The act made it illegal for insurers to reject individuals based on pre-existing conditions or their current health status. The main reason Obamacare plans are affordable is that the federal government siphons money every month to major insurance companies. This money (which was formerly called cost-sharing-reduction payments) collectively reduced insurance premiums for millions of Americans, therefore making health care plans affordable.

How does Obama Care work now? The same process remains in place now as it did previously (Obamacare initials – ACA, or Affordable Care Act), but it will see changes over time. It is important for you to update information about the policy options, costs, and processes.

Affordability Provisions

The ACA introduced significant terms intended to deliver comprehensive health coverage that is affordable to those who find it difficult to pay for coverage. Significant changes to the American Healthcare system included:

1) Premium Subsidies

Millions of Americans received through some sort of ACA subsidy, which helped offset the pricey premiums. This helped ease the cost of any metal-level health plan that was compliant with the terms of Obamacare available through the ACA marketplace. In 2023, 7.8 million Affordable Care Act Marketplace enrollees received these subsidies. 

Premium subsidies are not available to:

• Those whose employer offers comprehensive “affordable” coverage
• Medicaid eligible 
• Those receiving Medicare or other government programs 
• The incarcerated 

Obamacare also provides cost-sharing reductions, also referred to as cost-sharing subsidies. This helped lower out-of-pocket spending for those who were eligible. 

2) Medicaid Expansion

Millions of Americans have enrolled in Medicaid thanks to Obamacare’s extension of Medicaid eligibility. While the Supreme Court made the expansion optional for states, 39 states have accepted this federal funding. 

3) An Escape From Crushing COBRA Premiums

The Affordable Care Act introduced a new alternative to COBRA, a policy that gives employees the chance to continue group coverage after leaving a job or losing access to coverage. This was especially beneficial for those who had pre-existing conditions and could not qualify for medically underwritten individual health coverage. 

Obamacare also guaranteed that its new, individual-market coverage would be as comprehensive as its group plan, including the inclusion of maternity coverage.

COBRA was expensive as the beneficiary had to pay the full price of the plan. For most enrollees, this coverage was now more affordable, thanks to premium subsidies. This law freed Americans from “job lock,” as it ensured comprehensive, affordable coverage on the individual market.

4) Effective Rate Review

Before the Affordable Care Act, various states tried to ensure that premiums were actuarially warranted, but many did not. Without any policing on these premiums, Americans were gouged by insurers. 

Obamacare implemented a policy that requires an actuarial review of any rate increase of 10% or more. As of 2020, the threshold has increased to 15%. 

5) More Affordable Coverage for Small Businesses

Under Obamacare, small businesses that provide employees health insurance may qualify for an ACA-created tax credit, allowing for coverage to be more obtainable.

Health Plan Shopping Options

One of the most notorious Obamacare changes to the American healthcare system was the introduction of Marketplaces. These sites provide easy-to-understand coverage descriptions written with consistent clarity of sometimes tricky health insurance terminology.

1) Health Insurance Marketplaces

Health insurance marketplaces were established to help Americans compare coverage details and costs across a wide range of qualified, ACA-compliant health plans. All plans are categorized under metal-level classes based on their actuarial value. 

While the Marketplace was enforced in each state, the implementation varied. As of 2025, there are:

• 20 State-based Marketplaces
• 3 State-based Marketplace using the Federal Platform
• 28 Federally-facilitated Marketplaces

(source)

2) CO-OPs and Basic Health Program

The Affordable Care Act also formed non-profit health insurance co-ops, made up of private, non-profit, and state-licensed insurance providers that offered ACA-compliant plans for individuals and small businesses. As of 2021, there are still three Co-ops available in five states:

• Community Health Options in Maine
• Mountain Health CO-OP (Montana Health CO-OP) in Montana, Idaho, and Wyoming
• Common Ground Healthcare Cooperative in Wisconsin

New York and Minnesota – offer Obamacare’s Basic Health Program option for Americans with incomes too high for Medicaid and legal immigrants not eligible for Medicaid because of the five-year waiting period.

Coverage Standards

The Affordable Care Act also put standards in place that prevent insurance companies from discriminating against those with pre-existing medical conditions or their gender. 

Before ACA, insurers were allowed to charge higher plan premiums, which proved impossible for some to buy health coverage on the individual market. This law also abolished waiting periods that employer-sponsored plans would require before starting coverage of pre-existing conditions.

Once Obamacare came into play, all policies were guaranteed issue. Before 2014, most coverage on the individual market in most states was not. This allowed for all health coverage to be issued to applicants regardless of their health status, age, or income.

ACA also mandated minimum value standards for employer-sponsored plans offered by large employers. This means that the health plan can’t be a “mini-med” or a policy with holes in coverage. Large employers who do not comply can face penalties under the employer mandate.

These standards also saved ACA-compliant plan buyers from lifetime benefit limits or annual benefit limits. The plan buyers who once required expensive care could deplete their health insurance benefits, even including student health insurance, as those plans generally had low lifetime limits pre-Obamacare.

Improved Plan Benefits

Those plans that comply with Obamacare come with a lengthy list of advantages embodied in the essential health benefits (EHB) mandate. 

What Are The Essential Health Benefits (EHB) 

Under the Affordable Care Act, all individual and small-group major medical plans must include: 

• Hospitalization
• Ambulatory services
• Emergency services
• Maternity and newborn care
• Assistance for those suffering from a mental health disorder
• Support for problems with substance abuse
• Prescription drugs (brand name and specialty)
• Lab tests
• Chronic disease management
• “Well” services 
• Preventive services (some preventive services covered at no cost)
• Pediatric services for children, which include dental and vision
• Rehabilitative services

1) Free Services

Under the Affordable Care Act, all individual and small-group major medical plans must also include the following free services: 

• Colonoscopies
• Route cholesterol and blood pressure checks
• Birth control

• Routine vaccinations
• Breastfeeding supplies
• Screening for gestational diabetes
• Pap smears and HPV tests
• Screenings for HIV, Gonorrhea, and Hepatitis
• Tobacco cessation
• Rh incompatibility screening for pregnant women

2) Coverage on Your Plan for Adult Children

Thanks to the Affordable Care Act, adult children can continue receiving the benefits of their parent’s health care plan until the age of 26. 

3) Improved Programs for College Students

Health plans for college students are just as extensive as the ACA-compliant plans offered to all other Americans.

Consumer Protections / Anti-Discrimination

Obamacare has been widely celebrated for its protections, and an anti-discrimination legislature has been set in place. 

Protection from Discrimination

For example, Section 1557 outlaws bias in health plans – including prejudice based on gender identity or sexual orientation. 

1) A Level Playing Field for Women

Before the Affordable Care Act reforms were implemented, it was normal for women to be forced to pay a higher premium or be denied coverage due to pregnancy. This was huge for women, as it gave them access to the same health care coverage available to men. Birth control access also became easier to obtain as all ACA-compliant plans are required to cover at least one FDA-approved method of birth control. 

2) Ease of Claim Appeals

Obamacare also implemented an internal appeal process for claims and gave consumers the right to enforce an external review by an independent organization if they believe their claim was falsely denied. 

3) Protection From Rescission

Retroactive cancellation of your coverage by a health insurance company became prohibited under the ACA. This excludes fraudulent or intentional misrepresentations within an application. 

What are the Pros & Cons of Obamacare?

With everything in life, there are pros and cons to Obamacare. However, as you can see, the benefits outweigh the adverse effects. 

Pros

• More Americans have health insurance
• Health insurance is more affordable 
• Coverage for pre-existing conditions
• No time limits on care
• More screenings are covered at little to no cost
• Prescription drugs cost less
• Less bias against women and minorities
• Children can stay on their parent’s health plans 
• Slows the rise of healthcare costs

Cons

• Many Americans have to pay higher premiums
• If you don’t have insurance, you can be fined
• Raised income tax rate
• Businesses cut employee hours, so they don’t need to provide coverage

How and When to Enroll in Obamacare:

Signing up for Obamacare depends entirely on your state, as some have created a state-based marketplace, while the majority rely on the federally facilitated Marketplace. In regards to the latter, most states use HealthCare.gov. If you are unsure of how to sign up for Obamacare, HealthCare.gov is a great place to start. The site will direct you to the appropriate spot to sign up for insurance. An insurance agent can also tell you how to sign up for Obamacare in your state. This is the easiest way to find coverage.

During Open Enrollment

In most states, the Open Enrollment Period for 2025 health plans begins November 1, 2024, and ends December 15, 2024. Policies bought through Open Enrollment can start as early as January 1, 2025.

Remember, open enrollment is the only time of year you can enroll, switch plans, or re-enroll in your current policy in the individual and family market. 

Outside of Open Enrollment

If you miss open enrollment, your options are narrowed, but you still can enroll through:

• special enrollment
• short term health insurance
• employer-based coverage
• Medicare
• Medicaid 
• CHIP

Affordable Care Act Subsidies for Individuals and Companies

The Affordable Care Act provides subsidies for individuals and families, which means more Americans can afford to purchase health insurance. Through the Marketplace, you can evaluate a variety of insurance plans and see if you qualify for a subsidy, which will come in the form of a tax break or refund. Premiums are based on a sliding scale, depending upon your income. Companies can also receive subsidies or tax breaks. For small companies that have 25 or fewer full-time employees who make an average of under $56,000 a year, the SHOP or Small Business Health Options Program was started. This gives small businesses the opportunity to purchase a group health plan and see if they qualify for tax credits to help them absorb some of the costs of health insurance. 

Obamacare Insurance Varieties

Health insurance is not a one-size-fits-all type of business. Due to this, the Marketplace offers insurance coverage from several different companies. To find the plan that is right for you and your family, you must evaluate your own healthcare needs, medications, conditions, etc., as well as consider the premium amounts to see if they fit into your budget. Look at the quality of customer service as far as customer service is concerned. Search for reviews and then put in the name(s) of the companies that you are considering, seeing how they stack up against each other. All of these considerations should be taken to allow you to find the proper coverage for you and your family.

Obamacare Penalties

When Obamacare was first enacted, it included an individual mandate. If you did not purchase insurance, whether from your employer, on your own, or through the Affordable Care Act website, you were penalized. The individual mandate was in effect through 2018. People who had to pay the penalty did so when filing their federal taxes.

The mandate was removed from the law, starting with the 2019 plan year. That means that people without insurance will not have to pay the penalty to the federal government when they file their taxes in 2020.

However, some states do charge a penalty to those who do not have health insurance. It is expected that additional states will add an individual mandate in the near future as well. These mandates will be paid when filing state tax returns. States set their own penalties, so the amount you will have to pay depends on where you live.

If you live in California, the District of Columbia, or Maryland, you must follow each of these state’s exemption processes. You can learn more about those exemption processes at the respective websites.

• If you live in California, visit Covered California.
• If you live in the District of Columbia, visit the DC Health Link.
• If you live in Maryland, visit Maryland Health Connection for information on exemptions.

Obamacare Insurance Requirements

If you currently have an insurance plan via your employer, it has to meet specific insurance requirements that have been laid out in the Affordable Care Act. Here are the main requirements: 

Coverage cannot be denied due to pre-existing conditions, while premium variations can only be due to age, tobacco use, family size, and geography. This removes the changes due to pre-existing conditions, health status, claims history, etc. 

Guaranteed Renewability of Coverage means that an insurance company cannot refuse to renew coverage due to illness or pre-existing conditions. Catastrophic Plan changes include making sure they have lower premiums, protecting against high-pocket costs, and covering preventative services without cost-sharing. 

Obamacare and the Affordable Care Act have many benefits for those who do not currently have insurance, work at a company that does not offer it, or simply cannot afford it. When you go to the health insurance marketplace, you will find that there are many different options for you and your family. 

By evaluating each of the plans and the companies that issue them, you can ensure that you make the right choice for you and your family.

The Obama Administration

Leading up to the 2008 Presidential election, health insurance was widely debated by both Republican and Democratic candidates who spoke openly about reforming the current system through various means. For example, Presidential candidate John McCain proposed a series of tax cuts to those who purchased a plan through the individual market, which was hypothesized to reduce the number of uninsured individuals in the country.

Once Barack Obama won the election, he tasked his administration to come up with a solution that would make healthcare more affordable and accessible. This would ultimately lead to the creation of the Affordable Care Act, which was signed into effect in 2010. Often, you’ll hear the word Obamacare being thrown around, which is synonymous with the ACA.

Trump Administration

The Affordable Care Act has continuously faced a lot of opposition. The Republican Party voiced their discontent toward the bill and created various legal battles in an attempt to nullify the effects.

The main argument surrounding the ACA is that it would increase the country’s deficit and raise the price of new insurance standards, according to the Kaiser Family Foundation.

In 2013, a fierce Congressional debate raged over this bill, which resulted in a stalemate and forced a temporary government shutdown for 13 days. The reason the shutdown occurred was that the Republicans refused to raise the debt ceiling unless Obama made concessions to the bill.

President Donald Trump has campaigned heavily on the promise to “repeal and replace” the bill. However, since he assumed office in January 2017, he and the Republican Party have failed to do so. This is mainly because all the replacement proposals were deemed too harsh by politicians and are thought to be devastating for the American people. Many people ask, “Has Obamacare been repealed?” and so far, the answer is “no.”

Biden Administration

When President Biden took office, he worked to change and improve the Affordable Care Act in a variety of ways. That includes streamlining Medicaid, Children’s Health Insurance Program, Basic Health Program Application, Eligibility Determination, Enrollment, and Renewable Process rules. This was meant to make it easier with fewer administrative barriers to limit access to care.

The final rule includes:

• Elimination of annual and lifetime limits on children’s coverage in CHIP
• Ends the locking children out of CHIP coverage rule if the family is unable to pay premiums
• Eliminates waiting periods for CHIP coverage, providing children with coverage immediately
• Improves the transfer of children seamlessly through Medicaid to CHIP when income increases
• Requires states to provide at least 15 days to provide additional information when applying for the first time and 30 days to return documentation when renewing coverage
• Prohibits states from conducting renewals more frequently than every 12 months and requiring in-person interviews for older adults and those with disabilities

Note that, heading into 2025, the second administration of President Trump could make significant changes to these and other rules first put in place by Obamacare. 

Affordable Care Act at the Start of 2025

You can read the full Affordable Care Act as it stands as of January 2025 on Healthcare.gov. It is critical to note that this law could be changing and may face significant changes in the years ahead. This resource on the HealthCare.gov website provides the most up-to-date information.

Critical Questions for 2025: Obama Health Plan and Affordable Care Act Insights

What was Obamacare’s impact in 2024?

In 2024, 23.6 million consumers selected a health insurance coverage plan from the Marketplace. That is an addition of 3.2 million new customers. 

Is Healthcare.gov Obamacare? 

Yes, Healthcare.gov is the website to access the Affordable Care Act Marketplace, previously called Obamacare.

What’s Obamacare anyway?

Many people recognize the Obama Care health care plan as the Marketplace or the Health Care Marketplace. The Obama Healthcare plan was the initial version of the Health Care Marketplace. As you consider Obama care initials used here (ACA), you will find that these terms are used interchangeably. 

Can anyone get Obamacare?

As you learn how Obamacare works, you’ll find that there are limitations, including on what Obamacare covers as well as who can obtain coverage. 

What is Obamacare, and how does it work?

Here’s Obamacare explained: The Obama health insurance plan is known as the Obama Affordable Care Act, a law put into place to establish a way for Americans to obtain health insurance when they could not obtain it through an employer. Obama health care plans provide access to lower costing health insurance than was available prior. 

What Is the Obama care plan now?

The Obama health plan today is called the Affordable Care Act, and you can obtain access to these policies through the Marketplace. 

What does Obama Care cover?

In this guide, we will cover what is included in these plans and how they work.

Different Types of Plans

There are four different types of health insurance plans under the Affordable Care Act. These are the Bronze, Silver, Gold, and Platinum plans, which all offer the core benefits that adhere to the ACA. 

The plans differ in price and coverage, with the Bronze plan being the most affordable and the Platinum plan being the most expensive but with the most coverage. No matter which metal category you prefer, you can save on your monthly premium based on your income.

What Does the Bronze Plan Cover?

The bronze plan is the right choice if you are looking for a low-cost way to protect yourself from severe sickness or injury. While your monthly premiums will be low, routine care will be covered by yourself. 

• Lowest monthly premium
• Highest expenses when care is needed
• Bronze plan deductibles can be thousands of dollars a year.

What Does Silver Plan Cover?

The silver plan is a good fit if you are eligible for additional savings or are willing to pay a somewhat higher monthly premium than Bronze to have more of your routine care covered.

• Reasonable monthly premium
• Moderate costs when care is needed
• Silver deductibles are typically lower than those of Bronze plans

If you qualify for cost-sharing reductions, you must pick a silver plan to get the extra savings. 

What Does Gold Cover?

The gold plan is a good fit for you if you’re able to pay much more each month to have costs covered for your medical treatments. If you tend to depend on health care services, a gold plan can be incredibly beneficial. 

• High monthly premium
• Low prices when you require care
• Deductibles are generally low.

What Does Platinum Cover?

The platinum plan is a good fit for those who need a lot of care and can pay a high monthly premium for nearly all medical costs covered.

• Most expensive monthly premium
• Lowest prices when you get care
• Deductibles are very low, meaning your plan starts paying its share quicker than other programs.

How Much Does Obamacare Cost?

You will need to get a quote to determine the cost of coverage. However, various factors go into the amount you will pay. Your quote will be based on your:

• Age
• Income
• Family size
• Location
• Plan type

Age

When asking how much Obamacare costs, you must first consider your age. The older you are, the more you will pay for health coverage. On the other hand, you can find cheap plans when you are young.

Income and Family Size

As of right now, cost-sharing subsidies are still in effect for silver-level plans. If your family has a household income of 400 percent or less of the federal poverty level, you will qualify for a subsidy. The subsidy ensures that individuals and families do not pay more than 9.6 percent of their annual income. The subsidy is subtracted from the price of the premium, making health insurance much more affordable for low-income families.

Location

Your location can also impact how much you pay for Obamacare. The cost of living is different from one area to the next, and that factors into the cost of coverage. If you live in an area with a low cost of living, you can expect to pay less than if you live in a big city with a high cost of living.

Plan Type

The type of plan you choose also determines how much you will pay for coverage. Plans that sit at the bottom of the tier system cost less than plans at the top. However, plans at the top of the tier system have lower out-of-pocket costs. That means if you have a lot of health needs, you could end up spending more overall if you get a plan with a lower premium. Consider your health care needs when choosing a plan. Make sure you select one that offers the coverage you need.

Obamacare Glossary 

ACA Costs and Benefits

ACA is the acronym for The Affordable Care Act, which mandates everyone to buy insurance. Healthier young people paid premiums even though they didn’t use their policy, thus offsetting insurance companies’ cost of insuring even the sickest. The ACA also blocked insurance companies from excluding anyone. 

Expanded Subsidies for Middle-Income Families

The Affordable Care Act extended subsidies for middle-income families, allowing for better insurance. Before the ACA, families with corporate-sponsored insurance were the only ones who could afford comprehensive plans.

Health Insurance Exchange

Health insurance exchanges are online shopping sites that allow you to compare and buy health insurance plans. While some states run their own, most allow their citizens to use one run by the federal government. Those who do not purchase a policy by the end of open enrollment cannot get insurance through the exchange. Since Trump came into power, he shortened the open enrollment period from 90 to 45 days.

Federal Poverty Level

The federal property level is the annual income level that the federal government sets, which identifies those who are under the poverty line. The poverty level rises each year with inflation. Obamacare expanded Medicaid to cover Americans who make 138% or less of the poverty level. It grants tax credits for those who make 400% or less.

Grandfathered In

This term applies to all health insurance plans that were available before March 23, 2010. These plans do not have to implement the ten essential benefits or adhere to many of the other ACA ordinances. They could, however, offer lower coverage or premiums than the policies on the Obamacare exchanges.

Health Insurance Premiums

A premium refers to the monthly cost of your health insurance. For individuals with job-based coverage, their premium is typically deducted from their paychecks. Those enrolled in an Obamacare plan have to pay a monthly premium directly out of pocket. Premiums differ in price depending on your location and the type of plan you’ve selected.

Cost-Sharing Reduction (CSR) Payments

Recently, the White House announced it would halt cost-sharing reduction payments (also known as CSRs). This refers to federal funding that’s siphoned to insurance companies across the nation, which effectively reduces the cost of premiums for Americans who purchase an Obamacare plan.

This means insurance premiums are likely to increase, as insurers will no longer receive federal funding. Individual states like California have already incorporated price increases into their premiums to compensate for the fact that they’re going to be losing money in the long run.

Non-Obamacare Health Insurance Alternatives 

Short-Term Insurance

Short-term health insurance is an ACA alternative for those who need coverage for a short amount of time. It will not give you the same amount of coverage, such as the ten essential benefits, and can exclude pre-existing conditions. However, these types of plans are an excellent option to ensure you’re covered.

Medical Insurance Packages

Medical insurance packages are an alternative for Americans who cannot afford Obamacare or who need insurance outside of the open enrollment period. These plans are not qualified under the ACA. 

Catastrophic Coverage

Before the ACA required coverage, a lot of Americans utilized catastrophic policies as an affordable health insurance option. These plans are less expensive than full health coverage but only cover you in a specific ‘catastrophic’ event. Any regular check-ups or trips to the hospital are out of pocket. 

Healthcare Sharing Organizations

 A health sharing program is an association that aids in the sharing of healthcare expenses between a group of like-minded people. While many are non-profit, not all are. 

Members send in a combined monthly payment, and the program then pays out for any qualifying medical expenses that are incurred. Health Sharing programs are shared with people who have similar beliefs and values. It may be necessary to meet specific requirements, such as sharing the same religious beliefs. 

Ancillary Policies

If you are in good health, ancillary policies can be an affordable solution. Essentially, these policies are designed to cover specific services such as dental. You can choose the number of services you will need, though anything that is outside of your plan is out of pocket.