ObamaCare Simplified

Introduction: What is ObamaCare?

Introduction to the Chapter: ObamaCare, otherwise known as the Affordable Care Act (ACA), has become law in the United States and contains sets of rules that regulate health insurance coverage. Although the law has received wide media coverage, majority of our citizens still do not understand the basic tenets of the law. This chapter and the ones that follow attempt to simplify the main provisions of ObamaCare in a question and answer format using scenarios to reinforce understanding.

Objective of the Chapter: After going through the chapter, the reader is expected to understand the goals of ObamaCare consisting of universal coverage and affordability, qualification criteria for tax credits, and essential health benefits. The regulation regarding the mandate and pre-existing conditions is also explained in a way that disentangles the complexities of the issues using easy-to-understand scenarios.

1. A child leaving for college, named Sue, receives an application from the school for health insurance. She doesn’t know whether or not she has to fill it out, but she knows that until now she has been on her parents’ health plan. She is 19 years old. Can she continue to be on her parent’s health plan and ignore that of the school?
a. No, because ObamaCare stipulates that as soon as a child turns 18, he or she must be on a separate health plan
b. Yes, because ObamaCare stipulates that a child may be on his or her parents’ health plan until the age of 21
c. Yes, because ObamaCare allows a child to remain on his or her parents’ health plan until the age of 26
d. All of the above are irrelevant because she is now in college

2. In the year 2014, the owner of a small business, named Sam, still does not have healthcare insurance. He weighs the pros and cons of purchasing health insurance and decides that, since he is healthy, he is not going to worry about it. Which of the following scenarios is he subject to?
a. He will be fined 5% of his income monthly until he purchases a health insurance policy
b. He will be court-ordered to purchase health insurance
c. The federal government will provide him with Medicaid coverage until he makes a decision
d. He will be charged a penalty fee and have to pay for all of his health care.

3. Sam is now considering purchasinga health insurance policy after being diagnosed with Gastro-Esophageal Reflux Disease (GERD). Which of the following scenarios is he subject to?
a. He will be charged a higher premium for having a pre-existing health condition
b. The insurance may refuse him coverage
c. He will not be charged a higher premium, but he will receive lesscoverage than someone without a pre-existing health condition
d. He will be able to purchase a health plan without any of the complications listed above