The Affordable Care Act (ACA) is NOT government-managed healthcare, such as Medicaid or Medicare. The ACA is primarily a regulation law, instituting several rules on Private Insurance preventing certain abusive practices in order to benefit consumers.
Insurance companies cannot :
Insurance companies must:
- Deny or delay coverage due to pre-existing conditions,
- Place annual or lifetime caps on services,
- Drop policies due to chronic or severe illnesses,
- Raise rates without providing clear explanations.
- Protect your choice of doctors,
- Provide free preventative care,
- Allow young adults to remain on their parents’ insurance plan until age 26.
The ACA law also allows individuals and families to earn a tax credit, known as a subsidy, which helps to pay for their private insurance.
The tax credit is paid directly to the taxpayers’ insurance company each month and the taxpayer then pays the remaining premium.
To determine if a person qualifies for the subsidy, they must apply through the Marketplace and estimate their adjusted gross income for the 2014 year:
The ACA law was originally written to provide Adult Medicaid for those individuals and families that do not qualify for the subsidy; however, the Supreme Court ruled that each state could decide to either accept or deny the federal funds set aside to expand Medicaid. North Carolina chose to refuse the additional federal funds, leaving 300,000 to 500,000 adults without insurance.
- An individual must earn between $11,490 and $45,960 to qualify for the subsidy;
- A family of 4 must earn between $23,550 and $94,200 to qualify.