Regulations are complicated. Healthcare insurance is baffling. Laws are complex. So, it stands to reason the Affordable Care Act exchange or ACA exchange—a combination of laws, insurance, and regulation—would be especially confusing. Even the health insurance marketplace itself has various names such as the exchange, Obamacare exchange, the marketplace, or the ACA exchange.
Let’s cut through the clutter of the ACA exchange and answer fundamental questions with straightforward answers.
The ACA Exchange: Basic Questions, Direct Answers
Question: What is the ACA exchange?
Answer: The Obamacare health insurance exchange is an online marketplace for obtaining health insurance.
Question: Who is the exchange for?
Those seeking healthcare insurance through the exchange must also:
- Live in the United States
- Be a U.S. citizen or national (or be lawfully present).
- Must not be incarcerated
Question: Where do I access the ACA exchange?
Question: When I go to the exchange, it says enrollment starts on November 1st, 2016. Do I have to wait until then?
Answer: Yes, that is when all aspects of the exchange will be finalized. It is the first day you can enroll, re-enroll, or change a 2017 insurance plan.
Question: Are there other dates I need to consider?
- December 15, 2016 is the last day to enroll or change coverage plans if you want or need coverage to start on January 1, 2017.
- January 31, 2017 is the last day to enroll or change a 2017 health plan. If you miss this date, you must qualify for a special enrollment period to enroll or change plans.
Question: How much will I pay for healthcare insurance?
Answer: The cost of insurance depends upon your household income for the year. Over 80 percent of people who apply are eligible for lower premiums. To get an idea if you will save, click here.
Question: Do I need a computer to apply for insurance?
Answer: No. There are four ways to apply.
- By phone
- With in-person help
- With a paper application
Question: If I don’t get any healthcare insurance, do I have to pay a fee? If so, how much is the fee.
Answer: Yes, if you go without healthcare insurance you most likely will have to pay a fee. The 2016 fee was 2.5% of your income or $695 per adult and $347.50 per child. The 2017 fee will be determined soon. Some individuals receive an exemption from the insurance requirement.
Question: I don’t have a job, do I still have to pay the fee?
Answer: It depends on your household income. If insurance is unaffordable, you may qualify for a fee exemption. Here are some exemptions and how to file for them.
Question: What if I simply refuse to pay any fee?
Answer: The IRS will hold back the fee amount from future tax refunds.
Visit the ACA Exchange
If you are hesitant to visit the exchange because you have heard nightmare stories about it, know that each year improvements are made. So, why should you visit it and familiarize yourself with it? Here are several reasons:
The exchanges are much improved
As mentioned, many of the snafus are fixed.
In 2016, 85 percent of enrollees qualified for subsidies.
No worries about health history
Pre-existing conditions are not a barrier to enrollment.
It’s easier to compare plans
There are now more decision support tools.
Protection against huge medical bills
The maximum out-of-pocket expenses for health plans in 2017 will be $7,150 for an individual, and $14,300 for a family
Steep penalties for being uninsured
The individual mandate penalty increased again.
Visit the exchange if for no other reason than to become an engaged healthcare consumer. You have very little to lose and healthcare to gain. No one ever wants to hear you say, “At least I HAD my health.”