Obamacare, officially known as The Affordable Care Act (ACA), was signed into effect nationwide in 2010 and was officially enforced 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 Connecticut Health Insurance
Connecticut has been able to successfully ensure that 90% of its residents have healthcare coverage and has significantly decreased their uninsured population. The state-run exchange, Access Health CT, has also been a rousing success that has avoided many of the technical problems other state run exchanges have experienced.
Because they have been so successful, Connecticut is moving on to other initiatives such as educating their beneficiaries how to appropriately utilize the healthcare systems and price transparency.
What Connecticut Residents Should Know About Obamacare in Connecticut
The Pros and Cons of Connecticut Obamacare
Connecticut Obamacare has made health insurance coverage available to thousands 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. Finally, Obamacare in Connecticut has successfully eliminated denial of care based on pre-existing conditions and has disabled Connecticut companies from charging a higher premium based on race or gender.
There have been criticisms of Obamacare in Connecticut that while access to health insurance coverage has increased, the Connecticut middle class has actually suffered significantly due to the increase in high deductible plans. In addition, the state developed co-op (HealthyCT) recently closed after it was determined that it would not be a financially feasible initiative.
Obamacare Health Plan Categories and How Much You Will Pay
When shopping in the Connecticut 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 percentage differences greatly impact how much you may expect to pay on 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 remaining 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 Connecticut?
The Connecticut Obamacare Marketplace and exchange can be accessed through the state website Access Health CT or by calling (860) 757-5300.
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, Connecticut utilizes a state-owned marketplace, which means that the state of Connecticut manages the Marketplace where health insurance plans are offered.
Do I need to use an exchange?
To access public health insurance, you will need to go through the government exchange. The only exception to personally using the exchange to sign up for Obamacare in Connecticut is if you are able to seek help from a Connecticut 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:
- Visit Access Health CT
- Use the telephone support assistance available by calling (860) 757-5300
- Find a local certified counselor
- Seek help from a private insurance agent
What does it mean to be on-exchange or off-exchange?
On-exchange generally refers to purchasing health insurance coverage from the Obamacare Connecticut Marketplace while off-exchange normally refers to purchasing private health insurance coverage from a private company.
When is the Obamacare enrollment deadline and what do I do if I missed it?
The Obamacare open enrollment period for 2017 in Connecticut is from November 1, 2016 until January 31, 2017. If you miss enrollment, you would 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 should be paid when you file your federal tax return. In some special 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 yrs of age with maximum of $2,085. You will pay whichever of the two options is higher.
The Obamacare penalty for 2017 is fairly similar to 2016 with the percentage fee of 2.5% remaining the same, however, the flat fee will be adjusted for inflation.
What if I cannot afford Obamacare?
If you cannot afford to pay for Obamacare coverage, you may be able to qualify for a government subsidy. For more information on government subsidies visit the HealthCare.gov 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 Connecticut’s Medicaid program.