Obamacare, officially known as the Affordable Care Act (ACA), was signed into effect nationwide in 2010 and enforcement began in 2014. The intent of Obamacare was to increase access to healthcare through expanding Medicaid programs, protecting consumers from being discriminated against due to pre-existing health conditions, opening a regulated Marketplace to shop for cost-efficient health insurance options, and requiring all U.S. citizens to have minimum health insurance coverage.
Obamacare’s Effect on Maryland Health Insurance
Maryland was an early adopter of Obamacare and immediately implemented Medicaid expansion. In addition, they were the first approved state exchange. As a result, they have successfully reduced their uninsured rate from 12.9% to 7% in 2016, well below the national average. There is continued enrollment in the Maryland Medicaid program, so this number may fluctuate. (According to Gallup, the national average was 11.5% in 2016).
What Maryland Residents Should Know About Obamacare in Maryland
The Pros and Cons of Maryland Obamacare
Maryland Obamacare has made health insurance coverage available to hundreds of thousands that could not previously afford care by expanding the Medicaid program. The state has also been successful in enrolling 123,000 residents through the state exchange where 94% residents received a subsidy to offset the expense of coverage. In addition, Maryland stressed the importance of individuals owning their own care by taking advantage of wellness programs and early screenings. Finally, Maryland continues to be innovative in their approach of how to help their citizens in obtaining coverage. In 2016, they participated in a pilot program of utilizing brokers for all phone calls into the exchange in order to offer more assistance.
There are criticisms of Obamacare in Maryland that while access to health insurance coverage has increased, the Maryland middle class has actually suffered significantly due to the increase in high deductible plans and rising rates. In 2017, there will be double-digit rate increases, which will significantly increase the financial burden for those that do not qualify for a subsidy. In addition, there has been a notable struggle with the technology utilized in the state exchange. While this seems to have leveled out, it did cost Maryland a lot of time and expense to resolve the issue as well as frustrated their residents.
Obamacare Health Plan Categories and How Much You Will Pay
When shopping in the Maryland Obamacare Marketplace, there are four primary health plan categories you can choose from: bronze, silver, gold, and platinum. The categories determine the percentage of healthcare costs that the plan will pay for over a course of a year. The remaining percentage is what you will be expected to pay.
These percentage differences greatly impact how much you may expect to pay on care. Think about it this way: If the bronze plan pays for 60% of a benefit, then as the patient, you can expect to pay for the remaining 40%. While this plan will cost you less monthly, it leaves you financially responsible for a larger dollar amount than a platinum plan, which pays for 90% of a benefit.
Here are the different kinds of Obamacare plans as well as the average amount of healthcare services each plan pays for:
- Bronze plan - 60%
- Silver plan - 70%
- Gold plan - 80%
- Platinum plan - 90%
How Do I Sign Up For Obamacare In Maryland?
The Maryland Obamacare Marketplace and exchange can be accessed through the Maryland Health Connection or by calling (855) MHC-8572.
What Are The Obamacare Marketplace And Exchange?
The Maryland Health Connection is Maryland’s official health insurance marketplace. MHC is a state-funded health insurance exchange. You can apply for coverage by signing up at Maryland Health Connection.
Do I Need To Use An Exchange?
To access public health insurance, you will need to go through the Maryland Health Connection. The only exception to personally using the exchange to sign up for Obamacare in Maryland is if you are able to seek help from a Maryland certified counselor or a private insurance agent who can discuss your options and select a plan, on your behalf, through the exchange.
How Do I Use An Exchange?
You can use the exchange one of four ways:
- Visit Maryland Health Connection
- Use the telephone support assistance available by calling (855) MHC-8572
- Find a local certified counselor
- Seek help from a private insurance agent
What Does It Mean To Be On-Exchange or Off-Exchange?
On-exchange generally refers to purchasing health insurance coverage from the Maryland Health Connection while off-exchange normally refers to purchasing private health insurance coverage from a private company.
When Is The Obamacare Enrollment Deadline And What Do I Do If I Missed It?
The Obamacare open enrollment period for 2017 in Maryland is from November 1, 2016 until January 31, 2017. If you miss enrollment, you would need to qualify for a special enrollment period due to a qualifying life event or purchase short-term individual private insurance to avoid a penalty.
What Is The Obamacare Penalty If I Don’t Buy Health Insurance?
If you do not buy Obamacare or other qualifying health coverage (also referred to as “minimum essential coverage”) you will be subject to a tax penalty for each month you go without coverage. This fee should be paid when you file your federal tax return. In some special cases, there are exemptions to this penalty.
The Obamacare penalty for 2016 is either 1) 2.5% of your household income, with a maximum of the price of a Bronze plan sold through the Marketplace, or 2) $695 per adult and $347.50 per child under 18 yrs of age with a maximum of $2,085. You will pay whichever of the two options is higher.
The Obamacare penalty for 2017 is fairly similar to 2016 with the percentage fee of 2.5% remaining the same, however, the flat fee will be adjusted for inflation.
What If I Cannot Afford Obamacare?
If you cannot afford to pay for Obamacare coverage, you may be able to qualify for a government subsidy. For more information on government subsidies visit the HealthCare.gov website.
What Are The Alternatives To Obamacare in Maryland?
Any health insurance coverage that meets the minimum essential coverage, as set forth in the Affordable Care Act, can be used, whether this coverage is received through an employer, private insurance company, or purchased through a private exchange.
There are several alternatives available when selecting coverage. You can select one of the available alternatives on the Marketplace, purchase one of the many options available on the private exchange, or see if you are eligible for subsidies through Maryland Health Connection.