Please help a newbie about understanding obama care

[Joel thakkar]

I am a new legal immigrant and i want to know more about obama care.


I am writing my doubts below. Please clear my doubts.

1) Why employers are not mandated to have health insurance for their part time workers (working less than 30 hours) ? Is there any specific logic behind it?

2) What are the implications (good and bad) when a state accepts medicaid expansion ? My state is florida and just recently florida govr. said that he would accept medicaid expansion.

3) Please explain me the following calculator :

http://healthreform.kff.org/SubsidyCalculator.aspx

I filled up form " single person, age 28 and income $36,000." It says health insurance premium would be $3391 and govt subsidy is $0. So is this the amount of premium that a person in similar conditions (age, salary, single) needs to pay ? If yes, then which plan is it ? Bronze , silver , gold ?

4) Do you expect an increase or decrease in your health care premiums in 2014 ? (if health insurance benefits remain same)


Please don't get offended by my post. I am not criticizing obama care. I am just confused about few things as i was absent in the whole debate that happened few years back.

Thanks for any help!

[southernyankeebelle]

1. Why not go on the website at whitehouse.gov... I am sure they have information

on what you are looking for.

[Yo_Mama]

2. To try to answer some of your questions

Part-time employees - the reason why employers are not mandated to have coverage for part-time employees is that the costs would be too high in relation to their pay. The employer mandate is a multi-part mandate:
- The employer has to be of a certain size, and
- The employer has to provide approved coverage, and
- The employee's premiums for that coverage must not exceed 9.5% of the employee's wages.
That last is the kicker. A part-time employee obviously gets less pay, so employers would have to pay far more of the insurance premiums for a part-time employee. Making them do so was likely to put a lot of employees out of work entirely, so the law does not require it.

Medicaid expansion - this varies by state. States with a lot of lower income people would have to pay more. In the first few years the initial costs of the expansion are supposed to be paid for by the federal government, but after a few years the states are supposed to start picking up the tab. The most probable result in many states is that Medicaid benefits will be cut.

Kaiser calculator: There's nothing too mysterious about this. Your actual premium cost could be higher or lower (it looks likely to be higher). The most you would have to pay for health insurance and copayments in one year, assuming it is correct, would be $3,391 plus $4,167 in copayments. The insurance coverage would have a 70/30% ratio, meaning that if you needed healthcare, on average you would be responsible for 30% of the costs and the insurance would cover 70%. But that's just an average. Certain routine things would have 100% coverage, so some things would cost you more than 30%.

Most people will see increases in their premiums in 2014, because the mandated coverage is generally more expansive than plan coverages today. Some persons (in small groups with older demographics) should see a drop in premiums. Generally younger people with individual coverage are supposed to be paying higher premiums (because the extra cost to older persons is limited by law).

We won't actually know how this is going to work until about the end of 2015, because everything is lagging. Nothing's ready and even all the rules haven't been set yet.

[Joel thakkar]

3. Thanks for the detailed explaination

Most of my doubts are cleared now.

I am hearing that lots of companies and universities are now instructing to their workers to pay no more than 29 hours. Sad to see many greedy companies exploiting this loophole.