Some Important Features of Health Reform in US

The Affordable Care Act (official name of health reforms in United States) has some good and bad news, as with any other reform. It is important for every Americans to know important features of health reforms, which Obama administration has implemented, for proper planning of their health care needs.

Americans have to buy health insurance or pay penalty:

Currently approximately 60% Americans have health insurance. But from 2014 every American has to have health insurance or pay penalty, with exceptions of low income individuals who are eligible for “medicaids”, “medicare” and other public funded healthcare programs. Individuals may have to pay approximately $5,000 per year and families may have to pay $15,000 per year on health insurance premium.

Government will provide subsidized policies (to reduce premiums) to individuals with income range of $15,000 to $43,000 per year and families with income of up to $90,000, (e.g. for a family of four subsidized health insurance plans will cost between $1,300 per year up to $8,400 per year).

How much penalty an individual and family has to pay for not having health insurance?

The penalty for individuals not having health insurance is $95 dollars or 1% of income, whichever is greater. But from 2016 the penalty will be $695 dollars or 2.5 percent of income, whichever is greater. But as a family the penalty may be as high as $2,085 or 2.5 percent of family income by 2016.

What is the best part of the health reform?

The best part of health reforms (opinion of the writer) is that, insurers won’t be able to deny health insurance to applicants based on any ground, for example an earlier diagnosis of cancer (e.g. breast cancer), which insurers are doing frequently at the moment. Currently many insurers do not insure an individual if he/she is suffering from serious and chronic illness, which they will not be able to deny due to health reforms. At present insurers frequently rescrubbed policies (discontinue policy before it closes) due to diagnosis of serious disease such as cancer, which they will not be able to do so. Insurers will also not able to drop policy holders (health insurance), unless there is a clear case of fraud such as failure to disclose a preexisting cancer, or make false claims.


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