ObamaCare in 2020

For the most part, ObamaCare still offers the same benefits, rights, and protections it always has. For example it offers protections for pre-existing conditions and benefits like cost assistance. However, there have been some changes in recent years. For example, for 2019 forward the fee for not having health coverage was reduced to $0 in most states.[1][2]

 

Here are some key facts for Obamacare in 2020:

  1. There is no fee for not having coverage in 2020 in most states, but some states have their own state based mandate. See a list of states with their own mandate for 2020.

  2. Obamacare alternatives are expanded, so individuals and families who want limited benefit coverage have more options (like short term coverage).

  3. For those who want it, the ACA’s benefits and protections apply to major medical plans (they don’t apply to short term coverage). So if you have a marketplace plan, you still can get assistance, and are still protected.

  4. Medicaid and CHIP are still expanded in many states, and more states continue to expand.

  5. Open enrollment is still in place, so you’ll have to enroll in a plan from Nov 1 2019 – Dec 15 2019 for 2020 coverage. For 2020 coverage you already need to have it in place or you have to qualify via special enrollment unless you qualify for another insurance type like employer coverage, Medicare, or Medicaid/CHIP.

  6. There are some healthcare tax requirements to deal with each year, if you get assistance for example you’ll need to file form 8962 if you got tax credits.

  7. Unfortunately for those who rely on the ACA’s protections and assistance, there is a court case in the works that declared the ACA illegal. For now the judge issued a stay, but this one is still unresolved. See details below

STATE BASED MANDATES FOR 2020: States that have their own mandate for 2020 include: the District of Columbia, Massachusetts, New Jersey, and Vermont. States considering a mandate for the future: California, Connecticut, Hawaii, Maryland, Minnesota Rhode Island, and Washington. Please note this list is not official and is subject to change.

IMPORTANT DETAILS ON THE COURT CASE: Currently the fate of the ACA is somewhat uncertain as a Texas federal judge ruled the Affordable Care Act (Obamacare) unconstitutional on Dec 14 2018. In late March the DOJ then affirmed their support for the ruling. For now nothing changes as the appeals process plays out. However, there could be real consequences down the road if the ACA is struck down in courts. We will let you know if anything changes. For now, despite the changes, ObamaCare is still “the law of the land.” Learn more about the 2018 ObamaCare ruling.

Open Enrollment 2020

Open enrollment is still in place for 2020 plans. To get covered for 2020, enroll in coverage offered on the marketplace between November 1st and December 15th 2019. The only other way to get covered is to qualify for another coverage type like employer-based coverage, Medicare, or Medicaid/CHIP. Outside of open enrollment options are limited to short term plans and special enrollment. Remember, there is no penalty for not signing up in most states this year. However, unless you have access to another coverage type like employer coverage, only plans sold on the health insurance marketplace comply with the ACA’s benefits, rights, and protections. Meaning, unless you qualify for another coverage type you have to sign up during open enrollment to get the protections and cost assistance. Short term plans sold year round don’t have to offer the same benefits, rights, and protections.

TIP: Go to HealthCare.Gov during open enrollment or find a qualifying broker who can help you sign up for a marketplace plan and show you your other options.

FACT: Plans sold during open enrollment start as early as January 1st, 2020.

Getting Cost Assistance in 2020

There are three types of cost assistance based on income, family size, and access to other coverage:

  1. Medicaid/CHIP: Offers free or low cost coverage to single adults in many states and families in all states; Offered 365 days a year.

  2. Premium Tax Credits: Lowers premiums; only offered during open enrollment / special enrollment on marketplace plans.

  3. Cost Sharing Reduction Subsidies: Lowers out-of-pocket assistance; only offered during open enrollment / special enrollment on marketplace silver plans.

Aside from these you can lower costs using an HSA. NOTE: Employer’s subsidize a portion of coverage and Medicare has assistance options for low income seniors. Also, some charities provide assistance.

What is ObamaCare?

ObamaCare is a nickname for The Patient Protection and Affordable Care Act (sometimes called the Affordable Care Act, ACA, or PPACA for short), a health reform law signed on March 23, 2010, by President Barack Obama.

What is TrumpCare?

TrumpCare is just a nickname for changes to healthcare under Trump, especially changes to the Affordable Care Act (ObamaCare).

What Does ObamaCare Do?

The ACA was signed into law to reform the healthcare industry by President Barack Obama on March 23, 2010, the and upheld by the Supreme Court on June 28, 2012. The aim of the ACA was to address the “healthcare crisis” the nation was experiencing before the law was enacted. In other words, the ACA was meant to address the fact that premiums were rising faster than inflation, that healthcare spending was raising as a percentage of GDP, and that the uninsured rate was increasing because of this.[3][4][5][6] An overview of the Affordable Care Act’s purpose can be stated as:

More specifically, the Affordable Care Act aims to accomplish the above goals by:

Meanwhile, key benefits, rights, and protections under the Affordable Care Act include:

OBAMACARE FACT: Roughly 1 in 2 Americans technically have a “preexisting” condition according to a a 2011 estimate done by HHS.

 

That means half of us have a condition that we technically could have been charged more for or even denied coverage for in some states before the Affordable Care Act. The ACA chipped away at preexisting conditions until 2014 when discrimination against them by insurers was banned. Today preexisting conditions are no longer a barrier to insurance coverage for anyone, including high-risk customers. This means you can no longer be denied coverage or treatment or be charged more due to your health status. This is just one of many things the Affordable Care Act did and still doing today.

Essential ObamaCare Facts for 2020

For 2019 – 2020 there are three main things to consider. 1. Getting covered during open enrollment (as covered above), 2. making sure you are ready to file your taxes as they relate to healthcare at tax time, and 3. keeping an eye on the latest healthcare reform news (such as repeal and replace efforts). With that in mind, here are some essential facts related to the above points (some of these points were already noted above, but they are reinforced here with some extra helpful links).

What Has Changed For

2019 – 2020?

A lot has changed with ObamaCare for 2019 – 2020. Changes include the mandate being repealed, short term coverage being expanded, budget cuts, and premium rate drops. Please note that most changes that impacted 2019 – 2020 also impacted 2018 – 2019. Here is that information in more detail:

  • Starting January 1st, 2019, the federal ACA tax penalty for not having health insurance coverage officially goes away. Consumer warning, some states may take measures on a state level to reverse this. Make sure to check if your state will have a mandate in 2019 or beyond.

  • Operational budget cuts, as well as funding for marketing and outreach, along with some HC.gov contractors not having their contracts renewed for call center service support, means it could be more difficult to enroll through the HC.gov over the phone.

  • There is however now going to be seamless support for WBE (web based brokers) to directly enroll consumers into Obamacare compliant on-exchange plans in a very seamless manner. This is one positive that will help ensure that an extension for open-enrollment will not be required.

  • Short-term health insurance regulations have been stripped back. Depending on where you get your news from, this could be perceived as both good and bad for consumers long term.

  • One bit of good news however, is that rates are actually expected to decline in some states for the first time in years. Below, we detail how much rates are expected to change on a state by state basis.

Everything You Need to Know about Obamacare Cost Assistance 2019 – 2020

Below is a break down of everything you need to know about cost assistance for health plans under the Affordable Care Act (ObamaCare) in 2019 and 2020. In other words, here is everything you need to know about Premium Tax Credits, Cost Sharing Reduction Subsidies, Medicaid and CHIP, HSAs, and Medical Deductions for 2019 and 2020 all in one place.

Types of Assistance

First off, the types of assistance offered under the Affordable Care Act are:

TIP: Want to find out what you can save quickly, check out our Subsidy Calculator.

Understanding Which Guidelines to Use

Below we have provided two sets of guidelines, which one you’ll use depends on specifically what you are looking for. If you are looking at Medicaid eligibility, use the 2019 guidelines. If you are looking for cost assistance for 2020, use the 2019 guidelines. If you are looking for cost assistance for 2019 (for special enrollment for example, then use the 2018 guidelines).

The 2019 Federal Poverty Guidelines (for 2020 Cost assistance and 2019 Medicaid/CHIP)

Below are the 2019 Federal Poverty Guidelines that went into effect in early 2019 (the ones you use for Medicaid/CHIP in 2019 and for 2020 marketplace cost assistance).