In less than three months the first open enrollment period will begin. On October 1st consumers will have the option to purchase health insurance under the Affordable Care Act or Obamacare. With the enrollment period approaching rapidly it is important for you understand how this is going to work.

Are You Eligible for Financial Assistance?

The Affordable Care Act (ACA) allows eligible consumers the potential of receiving financial assistance if the household income is lower than 400% of the poverty level. This financial assistance will come in the form of a tax credit or subsidy and it will be available for consumers to use to get qualified health plans that are available in the state or federal marketplace. In order to find out if you are eligible or not, you are going to have to complete an application provided by the federal government.

Steps to Accessing Plans and Applying for Subsidies

To access the plans that are ACA mandated you will be able to do so through the online public marketplaces or exchanges. In the exchanges, you will be able to compare prices and apply for subsides.

Private companies will have their own private marketplaces set up for consumers. They may have the same plans that are available in the public marketplaces yet they may have additional “off-exchange” health policies available. The private marketplaces are referred to as “web-based-entities”, WBE. WBEs have been around for quite some time in the individual health insurance market. They will have various prices and they will meet the ACA’s guidelines.

How Questions and Concerns Will Be Handed

Regardless, of whether you deal with the public marketplace or the private marketplace there will be assistance available to help you with any questions or concerns that you may have. The public marketplace (government run marketplaces) will have trained representatives available to help you throughout the process. However, they may or may not be licensed health insurance agents. So, they may not be able to provide you specific advice as to the benefits of the various policies.

If you use one of the private marketplaces (private companies) you will have the added benefit of being able to have a trained and licensed health insurance agent assist you throughout the entire process.

Overall, October 1 is approaching quickly and there is going to be a large amount of information going out to consumers relating to open enrollment and health insurance. It is important for you to know your options way ahead of time so it will not be as overwhelming. Your choice will come down to whom you think will offer you the best price and ease of application:  the federal/state government’s marketplace or the private companies’ marketplace.



The Affordable Care Act, often referred to as Obamacare, continues to be a hot topic of debate just months before it’s major initiatives are scheduled to come into play.

The Republican Party remains the most outspoken when it comes to trying to eliminate the program altogether or with multiple proposed Affordable Care Act changes.  While this law was voted on back in 2010, the concern remains that Obamacare will spark a chain of events that will trickle down to the tax payer’s pockets.

Some members of Congress are working together offering some proposed changes to the Affordable Care Act.  They are Sen. Susan Collins of Maine and Democrat Sen. Joe Donnelly of Indiana.  They are working to adjust the definition of a “full time” employee to someone who works a full 40 hours per week instead of the current 30 hours per week.

The Affordable Care Act proposed changes will try to address the concern that employers will reduce their employees working 30+ hours a week down to 29 hours or less, to avoid the requirement.  The concern remains that to avoid these fees more employers will look for ways around this penalty and that the ways around it will cause a loss of hours and money for American workers.  An employee that is currently considered part-time working an average of 35 hours per week may see their hours get cut to 29 hours per week to ensure they do not qualify as full time.  While this may not sound like much it results in a loss of $60 per week for someone who makes $10 an hour and over $3,000 in lost wages annually.

Some mandates of the Affordable Care Act such as the requirement that all companies with a staff of 50 or more full-time employees must provide coverage has been delayed. The White House announced on July 2, 2014 that they are postponing this mandate until January, 2015. Although the majority of big businesses provide health coverage already, this requirement will have the most effect on restaurants, retail stores, and major hotels that hire low wage earners.

The Donnelly-Collins Affordable Care Act proposed changes aim to give Americans back their lost work hours and to significantly reduce the number of businesses that are subject to the ACA penalties.

The University of California at Berkley Labor Center estimates that approximately 9% of employees in businesses that have 100+ workers work less than 40 hours per week.  Of this 9% approximately 1/5 are currently uninsured.

While some members of Congress are focusing their attention on Obamacare’s proposed changes, others are still so displeased with the act that they feel trying to change the law is not a valuable use of their time and energy.  They would rather see it repealed.


As many of you know, Medicaid expansion is part of the Affordable Care Act.  It is being met with varying levels of skepticism as politicians finalize concepts and hash-out conflict.  Much is being done on the front of Medicaid expansion and now states have been awarded the choice to accept or decline Medicaid expansion as a part of their state legislatures.

Over the past few months a number of states have chosen to opt out of Medicaid expansion.  Decisions against expansion are largely based on a growing level of economic uncertainty.

States against expansion believe long-term costs will cripple their economies and because of this they remain reluctant to move expansion through state legislatures.

According to RAND Health, an independent health policy research firm, states participating in the expansion would spend less on the uninsured over the next few years.  However; starting in 2017, states will be responsible for 10 percent of costs under the new model of expansion.  RAND researchers believe existing uncompensated care costs will outweigh the cost of expansion and would have no significant impact on state budgets, particularly in the early years of its implementation.

There are those; including Texas Gov. Rick Perry who remain skeptical and believe Medicaid expansion will lead to economic instability. The state of Texas has the highest amount of uninsured residents in the United States. This has become Perry’s platform in advocating his case against expansion.  Perry believes enrolling an additional 1.8 million uninsured as part of a state and federally funded initiative will have an adverse effect on the Texas economy.

As always in politics, there are two sides to every argument. Who are we to believe? As citizens we are often affected by the decisions our democratic leaders make. Forming an opinion on Medicaid expansion and determining how it will affect you personally will take some research on your behalf.


The Patient Protection and Affordable Care Act or more commonly known as Obamacare was signed into law on March 23, 2010.


As you know, a large amount of controversy continues to exist as new developments emerge the between the lines of black and grey. The 906 page document intended to protect patients and prevent insurance companies from dropping high-risk patients is an enigma; leaving many feeling flustered and uncertain.


There is no doubt; the implementation of the Affordable Care Act will affect every American in an abundance of ways. In a recent 5-4 decision, the Supreme Court ruled that the federal government’s previous attempt to abolish a state’s Medicaid funding is unjust and therefore states are now given the option to opt into or out of the Medicaid Expansion Program.


Additionally the court ruled that any uninsured American will pay a penalty in the form of a tax.


States whose governors stand against Medicaid Expansion go as follows…

  • Alabama
  • Georgia
  • Idaho
  • Iowa
  • Louisiana
  • Maine
  • Mississippi
  • North  Carolina
  • Oklahoma
  • Pennsylvania
  • South  Carolina
  • South  Dakota
  • Texas
  • Wisconsin

NOTE: This is the most current information provided by RAND Research, a non-profit research organization.  There are other states who governors oppose expansion, but due to the high-volume of contradictory information this remains to be the most comprehensive list.


So, what do the ramifications of Obamacare mean to the citizens who reside in states that have opted out of Medicaid expansion?


Many Americans will be left uninsured and will need to acquire health-care plans of their own to avoid paying a penalty.  Only those whose medical coverage exceeds 8 percent of their household income will be exempt from paying an annual penalty tax.


Citizens residing in states that have opted out of the Federal Medicaid Expansion may choose to consider some of the insurance policies offered in their state exchange program.

Most people like to know where they are going to end up before they start on their journey.

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Process of Using the Calculator

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