A recent survey from the Family Foundation (April 2013) reports four out of 10 Americans don’t know Obamacare is now law. Even fewer Americans and visitors to America know how Obamacare – otherwise known as The Patient Protection and Affordable Care Act – will affect visitors insurance and health insurance coverage for immigrants and temporary residents. Millions of Americans and visitors to the US still have questions about Obamacare and its potential effects on healthcare affordability and eligibility. What exactly is Obamacare? What is the impact of Obamacare on US citizens, immigrants, and visitors to the US?
What is Obamacare?
Hear the word Obamacare and what do you think? Free healthcare for everyone? Fines and penalties for non-compliance? A more complicated health system, or a streamlined alternative care solution? Healthcare Reform or the Affordable Care Act is popularly known as Obamacare because President Obama is the man responsible for signing the Act into law. While the name may be catchy, the legislation contained in the Act (which is over 11,000 pages long, or three feet high) is anything but simple. But don’t worry, you don’t have to wade through the paperwork to understand the act and its implications – a few of the details are more important than others for consumers.
Key Facts about the Obamacare Bill
Obamacare is a US plan aimed at reforming the healthcare industry in the United States. The main focus of Obamacare is to give more Americans access to affordable healthcare, regulate the healthcare industry to benefit consumers, reduce healthcare spending, and improve healthcare quality. Obamacare was signed into law on March 23, 2010 and will apply to US citizens from the beginning of 2014. Obamacare brings with it several key features including the development of a Health Insurance Marketplace where Americans can buy subsidized health insurance.
- Most citizens and legal residents of the United States must have health insurance coverage by January 1st 2014.
- Citizens without health insurance must pay a fee with their year-end taxes.
- You cannot be denied health insurance if you have a pre-existing medical condition.
- Health insurance plans must contain clear summaries of coverage and benefits.
- Health insurers can no longer charge higher rates depending on gender.
- Medicaid and Medicare are expanded to allow uncovered Americans to access health insurance.
- Many US citizens will be eligible to buy subsidized health insurance on the Health Insurance Marketplace.
March 23rd 2010: President Obama signs the Affordable Care Act into law.
October 1st 2013: Open enrollment begins in the Health Insurance Marketplace.
January 1st 2014: Coverage begins in the Health Insurance Marketplace for plans purchased before December 15th, 2013. Most Americans must now have health insurance or risk a fee for remaining uncovered. The fee is $95 per adult, $47.50 per child, or 1 percent of your income – whichever is higher. You are considered covered if you have any type of health insurance plan, a job-based plan, Medicare, Medicaid, CCOBRA, CHIP, VA health coverage, or retiree coverage, among others.
March 31st 2014: Open enrollment in the Health Insurance Marketplace ends.
The Health Insurance Marketplace
The Health Insurance Marketplace, or the health insurance exchange, helps uninsured, or poorly insured, Americans find coverage they can afford. Using the Health Insurance Marketplace you find out whether you qualify for lower-cost health insurance based on your income and the size of your household. If you qualify you can buy subsidized health insurance that gives you essential healthcare benefits, coverage for pre-existing conditions, and cover for preventive care. If you don’t qualify you can use the Marketplace to buy insurance at standard prices – you benefit from being able to choose from federally approved insurers that offer clearly explained and transparent insurance plans. Americans making less than 400 percent of the Federal Poverty Level will generally be able to claim discounts in the Marketplace. Four-hundred percent turns out to be roughly $46,000 for individuals and $93,500 for families. You can use the Marketplace wherever you live in the United States. In some states the Marketplace is operated by the government and in others it is administrated by the state itself.
Obamacare and Business
Employers with over 50 employees must provide Obamacare-approved insurance to workers or pay a penalty fee. What about small businesses? The process of arranging health insurance for employees has always been complicated, but Obamacare sets out to simplify the system. Obamacare includes the Small Business Health Options Program (SHOP), a new procedure that claims to cut the hassle in buying health insurance for a small business. The SHOP marketplace is similar to the Health Insurance Marketplace and it is currently running for a 2014 start. The Marketplace is for businesses with fewer than 50 full time employees. Benefits of SHOP include the ability to control the cover you offer for your employees, and how much you have to pay towards employees’ health insurance premiums. In order to use the SHOP marketplace you must offer health insurance to every one of your full time employees (full time typically means people working 30 hours or more a week). The marketplace system allows business to compare plans online to make it easier to see which plan is best for their needs. Some businesses qualify for a healthcare tax credit through the SHOP system, which will begin in 2014. There is a SHOP Marketplace for every state.
Who is Eligible for Obamacare Benefits?
Obamacare is the President’s crusade because he claims it will improve the quality of healthcare for all Americans by offering better-quality services, providing preventive care services, and by raising standards in basic healthcare provision. The Act is seen by many people in the States as an improvement on existing healthcare systems for a number of reasons. Several sectors and types of people in the United Sates will benefit from Obamacare legislation. For example, people who were previously dropped from healthcare plans or refused coverage because of pre-existing medical conditions will be able to find affordable plans in order to continue or start quality treatment. Before, many people were charged higher premiums based on their gender but this will be outlawed with Obamacare. Consumers now have better legal standing against insurance companies should there be a dispute regarding coverage. Low-income Americans that couldn’t find affordable health insurance, and consequently were uninsured, will benefit by being able to buy discounted plans through the Health Insurance Marketplace. Middle-income families may also benefit from the Marketplace and its health insurance discounts. Americans that can’t access good quality health insurance through their employers will benefit from Obamacare, which aims to take the health insurance power out of the hands of the insurers and give consumers more choice. Businesses must offer healthcare insurance to workers if they have more than 50 employees, and if they don’t then the Marketplace will help uninsured workers buy their own plans. This will save many employees from having to access healthcare through the emergency services. In addition, the Medicaid system is expanded to cover more than 15 million uninsured Americans. However, Obamacare doesn’t benefit everyone in the United States.
Obamacare and Green Card Holders
If you live in America you qualify for the Obamacare benefits and can use the system if you are a permanent resident or citizen. Green Card holders, permanent residents, are eligible for Obamacare. Therefore, if you hold a Green Card and your income is low enough to meet the eligibility requirements, you can buy subsidized health insurance. If you are lawfully in the United States with the relevant documentation you can access the Health Insurance Marketplace. At the same time, all citizens and Green Card holders are subject to the requirement that says you must purchase health insurance or pay a fine. All legal residents and citizens of the United States can get insurance cover through their work, by purchasing a private plan, or through Medicaid and Medicare. In many states, however, you will not qualify for Obamacare or Medicaid until you have been a resident for five years. While Green Card holders and other permanent residents of the US will see changes through the Obamacare reform, those people that live and work in the US illegally won’t see any changes to their healthcare status.
Obamacare for Undocumented Immigrants?
Immigrants and workers in the United States that do not hold official documentation that allows them to stay in the country will not be eligible for Obamacare. In any case, undocumented immigrants are also ineligible for Medicare and Medicaid. Immigrants without a Green Card can receive medical treatment through services that give help without regard to immigration status, such as public health programs like the Federally Qualified Health Centers, or at certain community health centers. Immigrants may also be insured through the healthcare insurance of a legal resident such as a spouse or a parent. Immigrants may also purchase insurance from outside the Healthcare Exchange Marketplace.
What about Students and Temporary Workers?
Any person in the United States on short-term business, or as an international student at a US College or University, is considered to be a non-immigrant and is therefore not included in the Obamacare reforms. Students, temporary workers, exchange visitors, au pairs, and other temporary visa holders are not part of the Affordable Healthcare Act and must make sure they purchase their own visitors insurance before coming to the United States.
US Health Insurance for Visitors
Many people are under the misapprehension that the arrival of Obamacare means the dawn of free healthcare in the United States. Nothing could be further from the truth. Healthcare in the US is, and will continue to be, expensive for visitors and non-residents. If you are traveling to the United States and you are not a citizen or resident of the country you will not be able to take advantage of the subsidized healthcare plans offered by the Obamacare reform. If you travel without health insurance, you will need to pay for your own medical treatment out of your own pocket. Healthcare in the States is never likely to be free. In the US, a doctor’s visit for a minor condition like the flu costs a few hundred dollars. If you suffer a broken leg you may be surprised to receive a bill for up to $80,000. And when you think about a serious auto accident, or a skiing accident that requires an airlift off the mountain, you can see the huge risk in traveling to the United States uninsured.
For these reasons, a visitors insurance package is essential for visitors to the United States.
Visitors health insurance is a form of short-term health insurance for travelers and visitors to the United States. Relatives and parents visiting people in America, tourists, temporary workers, and exchange visitors all purchase visitors insurance to safeguard against the cost of accidental injury or unexpected sickness that may strike during their time in the United States. Visitors insurance is a form of travel insurance and it is a private plan for voluntary opt-in – for example, you don’t normally get visitors insurance through your work, or as a form of benefit. This insurance is valid only for the time period specified in the policy and for the countries listed in the plan.
Visitors insurance offers a number of benefits for people coming to the United States who are not eligible to buy insurance in the Health Insurance Marketplace. Cover is included for simple illnesses like the flu or an ear infection, to serious life-threatening conditions such as heart attack. You also get cover for prescription drugs, doctor’s visits, and often repatriation and emergency evacuation. Coverage is for visitors from outside the country to all states in America.
You may not be able to buy a subsidized health insurance plan through the Health Insurance Marketplace but by shopping around you can, as a visitor to the United States, find affordable short-term health coverage. It is important to compare benefits under different health insurance plans because some will be more expensive with the initiation of Obamacare, while others will offer increased benefits and cost savings.
Do Doctors Accept Visitors Insurance Plans Under Obamacare?
What happens if you are traveling to the US and you get into an accident. You have a visitors insurance policy but how can you be sure it will be accepted by doctors and hospitals now working under the Obamacare legislation? Do you need to purchase an Obama-approved visitors insurance plan? All plans are different although most will apply to the Affordable Care Act in the same way. Visitors insurance plans may provide benefits that match the levels expected of Obamacare policies, but they are exempt from the Affordable Care Act conditions by being limited duration policies designed for international travel or temporary living. Consequently, the doctors and hospitals you visit in the US will work with your visitors insurance in the same way as in pre-Obamacare days. A doctor will treat you under your insurance and will then bill you or bill the insurance company direct, depending on the arrangement they have with the insurer. Bear in mind that is it useful to buy visitors insurance from a US insurer. When you buy from an American company the hospital will generally bill the insurance company direct, meaning you don’t need to pay anything out of your own pocket. The process can be more complicated when working with international health insurers – in most cases you will need to pay for your treatment and then make a claim with the insurer to get the money back. For convenience and peace of mind, a US-underwritten plan makes life easier for you.
Not everyone is a fan of Obamacare. The Affordable Care Act has been the subject of intense debate ever since it was first instigated, and will continue to inspire columnists and commentators to voice their opinions on Obama’s healthcare policy for many months to come. Critics point to the fact that in order to insure the millions of Americans that are currently uninsured, the premiums of many people will have to go up. However, Obamacare’s Health Insurance Marketplace is designed to get around this problem by providing the opportunity for low-earners to access subsidized plans. High earners will be taxed more in order to meet shortfalls. Some employers, it is claimed, have cut workers’ hours in order to make sure they don’t have to comply with the Obamacare legislation. Other critics claim the Act concentrates more on getting everyone covered than it does on addressing the high cost of US health care in the first place. Obamacare stands to make a big difference to how the healthcare system operates in the United States. It remains to be seen whether all the changes will be beneficial for citizens and residents. However, one thing is for sure – if you are not a US citizen or are in the country for a short period of time, you must continue to purchase a travel insurance or visitor insurance plan before every visit, in order to safeguard against the high cost of healthcare in the country.