In a few months, the health insurance program of President Obama, the Affordable Care Act, more popularly known as Obamacare, will take full effect. With a few exceptions, the American public is expected to have health insurance coverage. Those who are not able to afford paying the premiums will get assistance from the federal government. For a Filipino immigrant who recently arrived from the Philippines, will he be expected to take advantage of the benefits of the Obamacare? What about those who have fallen out of status or whose authorized stay expired, will they be able to benefit from Obamacare?
Jesse and Ann are both green card holders. They have two minor children who are in elementary school. Jesse works as a contractor for a construction firm and Ann is left in the house to take care of his children.
Being self employed, Jesse does not have insurance coverage for himself and Ann. They live in California and Jesse earns $45,000/year. Instead of obtaining insurance coverage and paying high premiums every month, Jesse spent most of his money for their everyday living expenses.
Jesse heard that there is a mandatory requirement to get health insurance coverage beginning January 1, 2014. He still has no plans to obtain insurance but is afraid of paying penalties. If Jesse cannot afford health insurance coverage, how can he comply with the requirement of the Affordable Care Act to get insurance coverage? How can he get assistance from the US government?
The Current Health Care System
The health care system in the United States is flawed in many ways. It is private insurance most commonly provided through employers. The public health care system is limited only to seniors (like Medicare) or the low income (Medicaid).
Without insurance, the cost of healthcare is beyond reach by most Amercians and one devasting illness can spell the difference between a family being financially secure one day and bankrupt the next.
in an employer-based system, providing healthcare for the employees is a challenge, particularly for small business enterprises. Due to the constantly increasing costs of healthcare plans, business owners are sometimes forced to employ practices to limit or altogether avoid health care coverage for their employees.
When access to health care is not seen as a right but viewed as a privilege available only to those who can afford it, when society’s health care system is motivated by profit instead of the adoption of sound policies to promote health and invest in preventive care, problems are compounded to a point where nothing makes sense. Patients do not seek medical intervention until it is too late, emergency procedures become rampant, there are medical providers who may perform or limit medical procedure not on the basis of a patient’s needs but to increase a provider’s profit margin.
For the low and middle income immigrant families, obtaining health care insurance is not affordable. In some instances, even if they could afford the premiums, an insurance company could simply put a lifetime cap on coverage or even decline coverage arbitrarily because of “pre-existing” conditions.
Countdown to Obamacare
The Affordable Care Act (or Obamacare) is an attempt to curb these practices, put a rein on the rising costs of care, and address some of the problems of our failed health care system. Obamacare was enacted into law in 2010, some of its seminal provisions are already in place, others will be phased in incrementally. On January 1, 2014, the insurance mandate is to take effect. Obamacare requires citizens to obtain insurance coverage or risk paying penalty of $95 that will increase to $695 in 2016. “Health care marketplaces” were opened this October and are now operating through websites so the public may shop online for the best prices and services. Few states have their own healthcare exchange marketplace and if the specific state has no market place they can go to the federal website called healthcare.gov. As soon as an individual is able to identify a plan that suits his needs, there will be a computation on how much in premium he is to pay, less the subsidized amount from the federal government. Tax credits will offset the amount of subsidy and the individual will end up paying less premium.
In the case of Jesse and Ann, they may log on to the “healthcare marketplace” website and choose a plan that suits their needs. Whatever amount is the monthly premium, the government will share a portion of it through tax credits. Hence, if for example Jesse’s premium is $400, considering his income and size of his family, he will be provided with tax credits, which will reduce the $400 to a significantly low premium.
Obamacare will not affect those who have insurance coverage through their employment or those who are happy with their private insurance. Senior citizens with Medicare should not dropped off their Medicare coverage because Obamacare has no effect on Medicare. Also, veterans with Tri-Care insurance will not be affected by Obamacare.
Obamacare, while it is a marked improvement from the failed health care system it sought to address, is far from ideal. Specifically, the political wranglings in Congress, like the wranglings currently in play on the issue of immigration reform, caused a huge portion of the population to be forgotten on the fundamental question of access to healthcare. Undocumented immigrants, or the “TNTs”, are not covered by Obamacare.
(Atty. Lourdes Tancinco may be reached at law@tancinco.com or at 721 1963 or visit her website at tancinco.weareph.com/old)
