Obamacare, officially known as The Affordable Care Act (ACA), was signed into effect nationwide in 2010 and enforcement began 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 Colorado Health Insurance
In Colorado specifically, Obamacare has resulted in a decrease of uninsured residents. In 2015, Colorado was one of the states with the lowest uninsured population at 6.7%. This is lower than the national average, which sits at 9.1%, according to the National Health Interview Survey. The decrease can most likely be tied to the expansion of Medicaid in the state. Currently, there are over 1.2 million Colorado citizens that are covered by Medicaid.
What Colorado Residents Should Know About Obamacare in Colorado
The Pros and Cons of Colorado Obamacare
Colorado Obamacare has made health insurance coverage available to millions that could not previously afford care. It has also been successful in stressing the importance of individuals owning their own care by taking advantage of wellness programs and early screenings. Obamacare in Colorado has also successfully eliminated denial of care based on pre-existing conditions and has disabled Colorado companies from charging a higher premium based on race or gender.
There have been criticisms of Obamacare in Colorado that while access to health insurance coverage has increased, the Colorado middle class has actually suffered significantly due to the increase in high deductible plans. In addition, 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 Colorado 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 percentages difference greatly impact how much you may expect to pay for care. Think about it this way, if the bronze plan pays for 60% of a benefit, then as the patient, you can expect to pay for the remainder 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 each plan pays for:
- Bronze plan - 60%.
- Silver plan - 70%.
- Gold plan - 80%,
- Platinum plan - 90%.
How do I sign up for Obamacare in Colorado?
The Colorado Obamacare Marketplace and exchange can be accessed through the state website Connect for Health Colorado or by calling (855) 752-6749.
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, Colorado utilizes a State-Facilitated Marketplace, which means that the state of Colorado operates and manages the Marketplace where health insurance plans are offered.
Do I need to use an exchange?
To access health insurance in which you may qualify for government subsidies, you will need to go through the public exchange. The only exception to personally using the exchange to sign up for Obamacare in Colorado is if you are able to seek help from a Colorado 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:
What does it mean to be on-exchange or off-exchange?
On-exchange generally refers to purchasing health insurance coverage from the Obamacare Colorado Marketplace while off-exchange typically refers to purchasing health insurance coverage through the insurance company or an outside party. If you purchase off the state exchange, you forfeit government subsidies that may be provided.
When is the Obamacare enrollment deadline and what do I do if I missed it?
The Obamacare open enrollment period for 2017 in Colorado starts November 1, 2016 and ends January 31, 2017. If you miss enrollment, you will 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 needs to be paid when filing your federal tax return. In some 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 years of age with a maximum of $2,085. You will pay whichever of the two options is higher.
The Obamacare penalty for 2017 is similar to 2016 with the percentage fee of 2.5% remaining the same, although, the flat fee will be adjusted for inflation.
What if I cannot afford Obamacare?
If you cannot afford to pay for Obamacare, you may be able to qualify for a government subsidy. For more information on government subsidies and to see if you qualify, visit the Connect for Health Colorado 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 Colorado’s Medicaid program.