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What happens if I don’t buy health insurance in 2014?


All Americans will be required to buy health insurance in 2014Come January 1, 2014, the Affordable Care Act (commonly known as the health care reform law) will require every American to purchase health insurance. That’s the “individual mandate” part of the law that you heard so much about last year.

So what happens if you don’t buy coverage? That’s what we’ll cover today. But first, let’s discuss the reason the requirement exists in the first place.

Why an individual mandate?

The idea behind requiring every American to buy health insurance is to get as many people as possible—young, old, men, women, healthy, sick—into the insurance pool. The more people in the pool, the more premiums are paid to help cover claims. It’s known as “risk management,” and because the ACA takes away the ability of insurance companies to deny coverage to people with pre-existing conditions, requiring healthy people to buy insurance is the only practical way to keep coverage affordable for everyone.

Put another way: If healthy people abstain from insurance and only sick people seek coverage, then insurance costs spiral out of control as insurers, who have no means of controlling their risk, are forced to raise premiums to pay claims.

Who is affected?

The people most affected by the individual mandate are those who are not insured. In 2010, about 16% of Americans carried no insurance. Those 49.9 million people are the ones who need to get coverage or risk paying the penalty tax.

If you have health insurance through an employer or through an individual policy purchased from a private health insurance company, you’re in the clear. Well, probably. I say that because there will be some instances where existing health plans fail to meet the coverage requirements of ACA, and these plans must be changed or dropped. Also, employers, who themselves have new rules and mandates to deal with, will have to consider their circumstances and decide whether to add, drop, or continue to offer coverage.

Your insurance options

So what kind of insurance do you need to avoid having to pay the penalty tax? Any one of the following sources will do:

If you don’t buy health insurance

If you choose not to buy health insurance, you may have to pay a penalty tax. The Internal Revenue Service (IRS) is charged with collecting it from you. When you file your taxes, if you have a gap in coverage for a continuous three-month period or more during the previous year, the IRS will take the penalty tax money out of your tax refund unless you meet one of the following requirements:

  • You are part of a religion opposed to acceptance of benefits from a health insurance policy
  • You are an undocumented immigrant
  • You are incarcerated
  • You are a member of certain Native American tribes
  • Your family income is below the threshold requiring you to file a tax return ($9,350 for an individual in 2010; $18,700 for a family in 2010)
  • You have to pay more than 8% of your income for health insurance, after taking into account any employer contributions or tax credits
  • You have a gap in coverage for less than a continuous three-month period (this exemption may only be used for one period without coverage in a year)

What will the penalty tax cost you? It depends on the year. The chart below shows the annual totals that may be assessed.

Penalty tax amounts



2016 and beyond

$95 per adult and $47.50 per child (up to $285 per family) OR 1% of family income, whichever is greater

$325 per adult and $162.50 per child (up to $975 per family) OR 2% of family income, whichever is greater

$695 per adult and $347.50 per child (up to $2,085 per family) OR 2.5% of family income, whichever is greater

What if you can’t afford health insurance? You may qualify for a subsidy from the federal government.

What do YOU think?

Are you one of the nearly 50 million uninsured Americans who will have to choose between buying a plan and paying a penalty? What do you plan to do?


I pay $350 a month for insurance premiums now. If I drop my insurance and pay the penalty,will the government cover my health care under the ACA. This would be way less expensive than paying for insurance through my employer.
Posted @ Sunday, June 23, 2013 11:06 AM by Randy Ellsworth
Randy, that's a great question. The short answer is that the government will not pay for your health care. You must have some kind of insurance (through an insurer or a government program like Medicaid or Medicare) or pay for your medical bills yourself. 
The penalty for going without health insurance in 2014 is $95 or 1% of your annual income, whichever is greater. 
Thank you for the question! Health care reform is a complicated topic.
Posted @ Monday, June 24, 2013 11:18 AM by Ryan Kanable
This is so unfair, I wonder what the penalty will be if for example in a married couple, only one of them is uninsured? 
Health insurance is expensive, even with the subsidies,here in california (with the exchanges), it still expensive and the coverage is not very good. 
We should not be forced to buy something we cannot afford, paying the penalty will be cheaper for us, at least for the first 2 years. This is just asinine
Posted @ Monday, July 01, 2013 9:08 PM by Gladys
Gladys, thanks for taking the time to ask a question. If one spouse in a couple opts to go without health insurance in 2014 and beyond, that spouse may be required to pay the penalty unless he/she meets the exemption requirements. 
The penalty for 2014 is $95 or 1% of your household income, whichever is greater. Plus, you still have to pay for any medical care you may need. 
For more information on this, see https://www.healthcare.gov/what-if-someone-doesnt-have-health-coverage-in-2014/ 
Thank you for reading our blog!
Posted @ Tuesday, July 02, 2013 7:57 AM by Ryan Kanable
We've all heard, ad nauseam, about the tax</n> for not purchasing insurance. But since Obamacare requires insurers to provide coverage without regard to preexisting conditions, shouldn't I simply wait until I'm diagnosed with a major illness before purchasing a plan? After all, no matter what what plan I purchase, I'm probably going to have to pay a $2,500 deductible, on top of premiums, anyway.
Posted @ Monday, July 08, 2013 6:57 AM by Barry
Thank you for reading and taking the time to comment, Barry. On the surface, this might sound like a good idea. But as you look deeper, it may not work out as you expect.  
In 2014, the penalty tax is small. In later years, however, it increases. After 2016, it might cost you $695 per adult and $347.50 per child (up to $2,085 per family) OR 2.5% of family income, whichever is greater. If you're single and make $50,000 a year, that's a tax of $1,250. Whatever amount you may pay, you're not getting any benefits in return.  
You could go without a health plan, but this is risky. The health insurance exchanges have annual enrollment periods, which means that you can't sign up whenever you want. If you miss the enrollment period, you're locked out until the next enrollment period unless certain conditions are met. Health plans sold on exchange and off exchange will have annual open enrollment periods that run from 10/1/13 to 3/31/14 (for 2014 only) and 10/15 to 12/7 in all subsequent years.  
If you are locked out of the marketplace and you get sick, you could be responsible for those health care bills until you can obtain coverage during the next open enrollment period.  
Going without insurance can be done, but it's not as simple as you might think and it may put your health and your finances at risk if you should get sick.
Posted @ Monday, July 08, 2013 1:55 PM by Ryan Kanable
Years ago I worked for a bankruptcy attorney. The 2 main causes for filing were divorce and healthcare bills. Every single client HAD insurance - not some, not most - ALL of the people who filed BK because of healthcare bills had insurance. My current employer is forcing me to choose between 3 equally bad plans. I dropped my coverage several years ago because they never paid for anything - nothing, not even RX. I've paid into the system for too long and have not gotten anything back, and 'NO' I am not healthy - I just can't afford the premiums AND the co-pay.
Posted @ Wednesday, July 10, 2013 9:43 PM by Les
OK well everything I read says in the exchange premiumns are like $900-$1700 a month for a family of 4. Sorry, but I do not have that kind of cash to spare. That is more than my house payment.
Posted @ Tuesday, August 20, 2013 3:19 PM by Pat
Pat, the premiums may indeed cost $800 or more per month for a family of four, but please keep in mind that you may qualify for tax credits (for Marketplace health plans only) to help cover part of the cost, depending on your income. You can check out the Kaiser Family Foundation's online calculator to see an example of how much help you might get. Here's the link: http://kff.org/interactive/subsidy-calculator/ 
Thank you for your comment!
Posted @ Tuesday, August 20, 2013 3:53 PM by Ryan Kanable
It has been my understanding that the fee assessed against the income of those with sufficient earnings but choosing against health insurance will be used to pay for the statistically-likely health issue. It does not seem to follow the logic of tit for tat if the fee disappears into a void.
Posted @ Saturday, August 24, 2013 11:29 AM by Michael
Michael, thanks for reading. The penalty tax money will be used to fund the Affordable Care Act's provisions, such as subsidies for low- and middle-income Americans and the expansion of Medicaid. If you're curious about how the ACA works, download our new brochure here: http://info.wpsic.com/aca
Posted @ Monday, August 26, 2013 8:29 AM by Ryan Kanable
Hi, Sue. Thanks for visiting our blog. For your protection, we have removed your post because it contained personal health information (PHI). Divulging this information may compromise your privacy and security, and we wouldn’t want for that to happen! 
I'm sending you an email right now with more information.
Posted @ Wednesday, September 11, 2013 8:08 AM by Ryan Kanable
If I opt out of Obamacare, will I be denied access to a physician, hospital or hospice?
Posted @ Thursday, September 12, 2013 4:52 PM by Mary
I don't want to be forced to buy Insurance i order to pay for others! I'm being punished for taking good care of myself. ANd the reason I'm healthy is because I spend more on eating organic, taking exercize classes. Guess I'll just have to kiss that goodbye. So much for freedom. By the way, I'm as liberal as they come.
Posted @ Friday, September 13, 2013 2:10 AM by Kandie Kato
I really believe the banks and the Insurance companies own the world. 
Posted @ Friday, September 13, 2013 2:12 AM by Kandie Kato
Kandie, this is exactly how I feel when I work long hours, make personal sacrifices, and risk my financial future to build my own small business, only to have the government tax it away into the hands of people who have modeled their life to subsist on food stamps and other govnment handouts. 
I'm all for helping those who are physically or mentally incapable of functioning in a competitive economy. In fact, my Christian ideology demands that of me. But I'm not for giving a single dime to those who are simply too lazy. I have been to the slums of Calcutta, and I have seen the truly poor of this world. On the whole, there are no poor in the United States.
Posted @ Friday, September 13, 2013 7:03 AM by Barry
Mary, if you opt to go without health insurance, it's up to the health care providers to determine if they'll work with you or not. Some hospitals won't treat you if you don't have insurance. Others want payment up front if you're uninsured. The only way to know for sure is to ask your doctor or local hospital about their rules. 
Thank you for reading our blog.
Posted @ Friday, September 13, 2013 9:48 AM by Ryan Kanable
Barry, I believe it more likely that you have not developed a sustainable business model if you are not able to grow it. Have you found many grocers who would prefer serving poor as known to live in Calcutta or the poor as known in Cleveland, OH?
Posted @ Friday, September 13, 2013 10:18 AM by Michael
If I was really Hitler, and I wanted a communist government where criminal white collar extortionists were rewarded by a president who was a CIA born and raised asset with a false name, false SS number and false credentials, I would think this was a great idea. Then there is reality. Most know what is behind this - Human Genome Project and the I-UV Exchange.
Posted @ Friday, September 13, 2013 4:46 PM by Hitler
I just got terminated from a well paying union job with good health care insurance last week (9/5/13) and am a healthy 50 year old. I will not be receiving unemployment and will have no job probably well into 2014. What will happen if I do not get health insurance in Oct or in 2014? Will my penalty be for 2014 be $95 or will they look back at my 2013 reported earnings when I was employed and say I was over 3 months without insurance (Sept/2013-Present) and penalize me 1% of my 2013 tax return earnings (~100K) which would be $1000?
Posted @ Saturday, September 14, 2013 11:36 AM by tom
what about those of us who qualify for no help at all from anyone for anything but still cant afford it?
Posted @ Sunday, September 15, 2013 2:07 PM by Mandy
I have checked around in California and the cost of health insurance and the deductibles have gone way up over last year. I feel like health insurance company's are taking advantage of the law and by giving less service and charging more money. at least for me the uninsured Obama care has really hurt me.
Posted @ Sunday, September 15, 2013 11:32 PM by clint
Tom, I'm sorry to hear about your job situation. If you choose to go without health insurance in 2014, you will likely have to pay the penalty tax. There are exceptions to the rule, which you can read about in our free brochure. You should talk to your tax professional about this. 
The individual mandate is effective beginning Jan. 1, 2014, so the IRS won't be looking back to 2013 for that. Your three-month period would begin Jan. 1, 2014. 
Depending on your situation, you may qualify for Medicaid, which counts as health insurance and would let you avoid the penalty tax. 
Of course, I hope that you find yourself a new career soon with an employer that provides a good health plan so you don't have to worry about this. But it's always good to be informed and prepared! Check out our brochure. Thanks for reading our blog, Tom.
Posted @ Monday, September 16, 2013 8:49 AM by Ryan Kanable
Mandy, subsidies are available for individuals up to 400% of the poverty level (which was $44,680 in 2012) to help pay health plan premiums.  
If your individual health plan through your employer costs more than 9.5% of your income, you can choose to get health insurance through your state's online Marketplace. 
I don't know what your situation is, Mandy, but you may want to speak to a financial professional about how you could work a health plan into your budget.  
Thank you for reading!
Posted @ Monday, September 16, 2013 9:06 AM by Ryan Kanable
This put a lot of individuals in a bind.what if u can't afford insurance and you make to much to qualify for state insurance. i think its another way for the government to get over i don't think people should be fine for this since its a law its up to the government to make everyone can qualify and still live
Posted @ Monday, September 16, 2013 2:59 PM by christinia
Granto, your comment has been removed due to your choice of language. Please see our Terms of Use for more information on how to share your opinion.  
Thank you for reading our blog.
Posted @ Tuesday, September 17, 2013 7:44 AM by Ryan Kanable
so will it be cheaper to move to mexico for me and my whole family
Posted @ Friday, September 27, 2013 8:26 PM by bruce
Regarding Obama care.. my health care premiums just doubled for 2014, not what I expected and not happy. I will vote Republican from now on and I am switching parties. I never thought I would say that.
Posted @ Sunday, September 29, 2013 2:41 AM by Peter Burnett
Peter Burnett, before you make one more mistake, consider looking at the exchange/marketplace in your state. It may be easier and better to change insurance carriers than to change a political party. By the way, PPACA begins in 2014 so perhaps your premium rise is due to executive decisions at home.
Posted @ Sunday, September 29, 2013 12:23 PM by Michael
bruce, hey man, so far you haven't looked at any of the marketplace offerings, right? Be fair now, you really don't know too much about the nature of PPACA, right? Nor about Mexico.
Posted @ Sunday, September 29, 2013 12:26 PM by Michael
Michael, thanks for the quick response. The premium increase was due to an executive decision in Washington, not in my home. There are several marketplace offerings in my neck of the woods, the least expensive starts at around $570, a 94% increase over this year! I monitor my health and my money closely, the only mistake I made is supporting Mr. Obama.
Posted @ Sunday, September 29, 2013 11:26 PM by Peter Burnett
Peter, while it's true that premiums are higher, there are (in most cases) richer benefits tied to them. Also, you may qualify for subsidies in the form of tax credits if you buy through the health insurance Marketplace, depending on your income, which can help offset some of the cost. If you live in Wisconsin, you can check out what subsidies you might be able to get through the federally facilitated Marketplace at www.healthcare.gov on or after Oct. 1. Before then, you can see subsidy estimates using the Kaiser Family Foundation's Subsidy Calculator.
Posted @ Monday, September 30, 2013 8:07 AM by Ryan Kanable
Hey Ryan, thanks for the info. I went to the subsidy calculator you provided and according to that, my income is above the subsidy level. Therefore my wife and I are to pay $17,936 per year, or 25.62% of my income, for the Affordable Care Act. If you factor in the maximum out of pocket expense of $12,700, I could end up spending $30,636 or almost half of my income, on Obama care. This is not affordable. I am opting out and I urge everybody else to do the same. Hopefully Obama Care will then collapse under it's own weight.
Posted @ Monday, September 30, 2013 10:46 AM by Peter Burnett
Mr Burnett, surely you know that PPACA was an idea put forward by the Heritage Foundation (1) and that (2) the legislation was approved by a majority of the congress of that year--not an executive decision at all. By the way, there are limits on out of pocket expense. But, hey, if worst comes, you will have a wonderful tax exemption.
Posted @ Monday, September 30, 2013 11:46 AM by Michael
Hi Mike, thanks again for your quick reply. Yes, I know that the ACA was passed by congress and not by an executive order. My use of the term executive decision was in response to your previous comment where you inferred my health care costs were a result of decisions I made within my home. I was trying to point out to you that Obama care was implemented in Washington, not at my home. As I write this, there is a possibility that the Republicans can force the President to wait one more year to start Obama Care. With some luck they will succeed and we will be having this conversation next year. Thanks for your input.
Posted @ Monday, September 30, 2013 1:31 PM by Peter Burnett
Obamacare has no teeth to collect the fine for not being enrolled in Health Coverage. The IRS cannot force you to pay, or threaten you with imprisonment. Read the Law.
Posted @ Monday, September 30, 2013 4:16 PM by Caleb
There is some really good discussion going on here! If you would like more information on the ACA, please take a look at our FREE brochure, 9 Things You Need to Know About the Affordable Care Act .
Posted @ Monday, September 30, 2013 4:31 PM by Ryan Kanable
Caleb, you have seen right through PPACA. Well, it might happen that you will not get a full refund because the fee/tax will be deducted. But wait a second, if you don't have health insurance but you do have a lump in your testicle, you will be required to pay for service. Perhaps you won't live long enough to get schmart, eh.
Posted @ Monday, September 30, 2013 6:35 PM by Michael
How is the penalty going to be determined from my tax return. What if Coverage is not bought by me and i work for a company. How will the government know whether i am covered by my company or not.
Posted @ Tuesday, October 01, 2013 10:23 AM by Sheila
Thanks for the questions, Sheila. 
If you have health insurance through your employer, your employer will report the value of your health plan on your W-2 form, which goes to the IRS. That's how the government will know if you're covered by your company or not. 
The penalty you pay for not having insurance, which will be 1% of your income for most people, is taken out of your tax refund or added to what you owe. Take a look at the IRS' Affordable Care Act Tax Provisions for Individuals and Families for more information. 
Thank you for reading our blog!
Posted @ Tuesday, October 01, 2013 11:24 AM by Ryan Kanable
I just got off the healthcare website. Due to the fact that I make a good living for myself and live alone I am required,even on the bronze plan, to pay $487 monthly with a $13,000 yearly deductible. So I will be paying that and yet still paying cash out of pocket for any medical treatment I receive because yearly I pay around $400 out of pocket for dr's visits now with a $5,000 yearly deductible beacause (unfortunately?)I am healthy. How is this fair?
Posted @ Wednesday, October 02, 2013 3:57 PM by Kay
Kay, It is not supposed to be fair, it is the Socialism at it's worst. Take from those who produce and give to those who don't. Equalization by making the strongest weaker.
Posted @ Wednesday, October 02, 2013 4:04 PM by Caleb
Insurance is something you have to pay for point blank.its a blessing to be able to afford it. Yes it is costly . I rather get caught with it than without.
Posted @ Wednesday, October 02, 2013 5:41 PM by Christinia Peake
If OBAMACARE is so wonderful why doesn't the one it is named after sign up for it?
Posted @ Wednesday, October 02, 2013 7:49 PM by Caleb
He sign up for it is when pass the bill and stood by what he stood believe in.
Posted @ Wednesday, October 02, 2013 8:44 PM by Christinia Peake
Obama Care is the worst government policy forced on the American people since the draft! First,it's not called a tax yet the government forces you to depart with your money, therefore it's a tax. You are forced to buy it and you WILL pay what your are told to pay. Your government has put it's foot on your neck and is twisting your arm behind your back as reaches into to your wallet. It's a mugging!! I have not talked to a single person who is paying less for Obama Care than they did for conventional health insurance. It is still not too late to email or call the President and your Congressman and let him or her know how you feel. Remember," If you let them, they will let you let them!"
Posted @ Thursday, October 03, 2013 3:06 PM by Peter Burnett
Mr Burnett, where have you chosen to "depart" to with your money? You certainly can choose the modest tax/fee and pay out of pocket for any medical needs. It is entirely your choice. By the way, why have you limited yourself to talking to "single persons". Try married folks, maybe folks with families. By the way, are you paid to post as you do?
Posted @ Friday, October 04, 2013 12:33 PM by Michael
caleb, perhaps you know that Mr Obama is a public servant, an employee of the American citizenry, and served by the same health plan that serves any civil servant who serves you in an SS office, or at the nearby airbase, etc. By the way, do you currently have health insurance? If you do, and surely being responsible, you do, what is your concern based on?
Posted @ Friday, October 04, 2013 12:40 PM by Michael
Kay, it may well be that your best bet is to pay the fee/tax, and continue with the self-insurance plan you currently have. After all, if you develop a condition that could turn your hair gray, you will only have to wait until the next open period to buy insurance. But perhaps your current plan covers you without upper limits, if worse becomes worst.
Posted @ Friday, October 04, 2013 12:44 PM by Michael
Michael, My concern is that tax dollars are being spent on people who do not contribute to society as a whole, and that this new OBAMACARE solution does not address that but merely puts the burden clearly on those who do contribute. My Insurance premiums are being raised because others feel they are entitled to a portion of my earnings. That my friend is called Socialism, We are a Constitutional Republic.
Posted @ Friday, October 04, 2013 5:18 PM by Caleb
Michael, no I am not paid to post, are you? You sound as if you have an interest in promoting the ACA. I'm just a guy and this is a pretty good place to let me voice my opinion. I think you owe me a beer now, my feelings are hurt.
Posted @ Friday, October 04, 2013 6:48 PM by Peter Burnett
Caleb, the last feller who looked down from a great height and claimed that 47% of his fellow citizens were without merit lost a chance to become an American president.Think of FICA; think of the success of your investments in Safeway. The 47% are doing way more than their part.
Posted @ Friday, October 04, 2013 11:00 PM by Michael
Mr Burnett, you are certainly entitled to your opinion, but not to your own facts. If you have an income of a kind that produces the kinds of costs you mentioned, you are a wonderfully lucky American. But I cannot think of a reason for you to use the marketplace format. Nor of a reason to choose beer over Irish whiskey.
Posted @ Friday, October 04, 2013 11:04 PM by Michael
Michael, First let me say that I am not perched from any great height but work every day to pay my way and families way through life. Second I am Responsible only for that of myself and family. Third, I do not need or want any of the government hand-outs because I am responsible. Fourth I have pulled out of helping to pay for your healthcare because the IRS has no teeth to come after me other than sending a annoying letter saying that I owe a tax for not buying, I can control what I pay in income tax so that the IRS cannot keep a return. It is called going GALT (look that up). There are plenty of us that have had our fill of paying the bills of those to irresponsible to get off their rears and make a life of their own and quit feeding of not the rich but the actual working middle class. Sounds to me Michael that you feel that we owe you something, that would make you a Entitlement Feeder.
Posted @ Saturday, October 05, 2013 7:11 AM by Caleb
Caleb, be serious now. How exactly do you get your product to market; how exactly do you obtain the necessities: food, water, light, etc without traveling on a course paid for by all tax payers. That includes men and women who do not pay income taxes, but who do pay FICA, sales and property taxes. They consume so that you can enjoy the quality of life you admire. By the way, if you currently have health insurance, you have no reason to bother with the marketplace offerings, or to be concerned about any fee/tax issues with the IRS. But even if you chose to pay the increasing tax/fee, it would be worth it to be free as you currently are.
Posted @ Saturday, October 05, 2013 11:05 AM by Michael
Michael, What would your idea of how much I or others earn should go to the Government? 10%, 20%, 30%, 40%, how much should free men have to pay to be free. You do not understand the very foundation this country was based on. The Government is to serve the People not dictate from a throne. Re-read my post and you will learn that I have no intention of paying into OBAMACARE or paying any Fee/ Tax, and will throw the annoying letters from the IRS in the trash where they belong. OBAMACARE is a Socialist Entitlement Program.
Posted @ Saturday, October 05, 2013 7:40 PM by Caleb
Mr Caleb this country is base on a good foundation compared to other counties. Don't think you are gonna Just throw letters from the IRS in the trash can and think something will be accomplished by this. Everyone know IRS is going to get there's one way only another. If you can afford insurance you should have it. If not you can go through state.When it all comes down to it everyone should have insurance. I said this before better to get caught with it then without. I really thinkthis can work. And maybe make the US a most healthy country .
Posted @ Sunday, October 06, 2013 3:01 AM by Christinia Peake
Christinia, Read the Law, before you comment on it, that way you might understand something about the conversation other than what OBAMA has told you on the T.V. screen.
Posted @ Sunday, October 06, 2013 10:09 AM by Caleb
Caleb, you have an interestingly old-fashioned way of using capital letters. Have you found that bake sales are a good way to cover medical expenses? If you have health insurance, you have no need to complain about PPACA. But if you mean to be a true GALT, you should aim to work, for minimum wage, 1 week per month. And claim every, I mean every, kind of federal and state benefit. From that you will have, tax free, about $27000 dollars. If you happened to earn about $60K from working 50 weeks a year, you would have remaining about $30K. Can you see the benefit there for a man who will be free and free and free? 
Remember the topic is PPACA and "What happens if I don't buy health insurance?". It is not political philosophy.
Posted @ Sunday, October 06, 2013 10:49 AM by Michael
The law makes perfect sense to me. Everyone should have insurance point blank
Posted @ Sunday, October 06, 2013 10:58 AM by Christinia Peake
Micheal your comment is oh so true.
Posted @ Sunday, October 06, 2013 6:43 PM by Christinia Peake
I'm kind of confused. I am covered under my husband's plan through his employer. Does this mean I still have to purchase a plan under my employer for myself? Someone told me that each individual needs to have insurance through their own employer if offered or else you would have to pay the penalty.
Posted @ Wednesday, October 09, 2013 7:43 PM by Amanda K
Thanks for asking, Amanda K. There's a lot of confusion about what counts and what doesn't.  
If you have insurance through your husband's employer, you're covered. The Affordable Care Act doesn't require you to enroll in insurance through your own employer, and you won't pay a penalty. 
Here's the tricky part: Sometimes, employers require an employed spouse with access to coverage through his/her company to get insurance through that other employer. It's a cost-saving policy some companies use that's not related to the Affordable Care Act, but it can throw a wrench in your insurance arrangements. 
Thanks for reading our blog!
Posted @ Thursday, October 10, 2013 8:27 AM by Ryan Kanable
I realize that if we have a low income we can qualify for subsidies, but what if we can't afford the monthly cost up front and wait for the subsidies at the end of the tax year?
Posted @ Sunday, October 13, 2013 3:21 AM by Tammy Davis
Many uninsured people may like the idea of OBAMACARE right now, but will soon realize that even after paying the premiums every month, they will still need to pay the doctor until they meet the deductible and after that will still pay a 40% co-pay. Unless they have a serious medical expense they may never see a benefit. And when they encounter financial troubles, healthcare premiums payments will be the first thing to go instead of mortgage, electricity, food, etc. And then they will still be fined for a lapse in coverage of more than three months even if they already paid for the first six months. I predict that not enough healthy people will maintain coverage, causing premiums to increase, causing more people to drop out, etc. until the system collapses.
Posted @ Monday, October 14, 2013 12:30 AM by Keith Rice
Tammy, you don't have to wait until the end of the tax year to get your tax credits. They're "advanceable," which means you can get the money right away. Please take a look at Section 5 on subsidies in our brochure, www.healthcare.gov/will-i-qualify-to-save-on-monthly-premiums/
Posted @ Monday, October 14, 2013 8:20 AM by Ryan Kanable
Keith, you are correct about needing to meet your deductible before health plans kick in. However, I'd like to add that the 40% coinsurance you mention is only for Bronze-level plans. If you choose a higher-level plan, that amount decreases accordingly. At the platinum level, for instance, you pay just 10% of the medical bill. See our blog post on The Marketplace for more on how the tiers work. Thanks for the comment.
Posted @ Monday, October 14, 2013 8:48 AM by Ryan Kanable
Keith Rice, are you one who favors bankruptcy over health insurance if the average tilts against you? By the way, do you currently have health insurance, or are you one who values bake sales when in need?
Posted @ Monday, October 14, 2013 10:29 AM by Michael
I predict a lot of healthy people will not sign up for this. I saw the plans offered in California, and the coverages are horrible with huge deductibles and co-insurance. What is the point of insurance if you still have to shell out like $5000 before it kicks in. 
Like who has that laying around. I think many will just pay the penalty and I hope so, it is asinine to force people by law to buy something and (expensive) as health insurance. I will certainly forgo it, I don't have any pre-existing conditions. This law is basically forcing people to take on another car payment, if you don't qualify for subsidies, like I don't. The plans that have less deductible cost over $400 a month, this is not affordable at all. 
I say stick it to them for passing this stupid law and don't buy it, pay the penalty, the whole think will fall on its face. After all they cannot refuse you treatment in the emergency room, and yes Bankruptcy is an option for such cases,
Posted @ Tuesday, October 15, 2013 8:15 AM by Gladys
Hi, Tammy. Thanks for visiting our blog. For your protection, we have removed your post because it contained personal health information (PHI). Divulging this information may compromise your privacy and security, and we don’t want that to happen! I’m sending you an email right now with further details. Thanks for reading!
Posted @ Tuesday, October 15, 2013 8:25 AM by Ryan Kanable
Gladys, you have grasped the very basics of the PPACA. Especially if you live in California. But wait, conservatives rarely take risks of the kind you would choose because their house and their car are worth more than $5000. Are you currently one who is without health insurance? You know, you won't have to spend on the deductible if you choose not to have a physical or if you can choose not to have a heart attack.
Posted @ Tuesday, October 15, 2013 9:59 AM by Michael
Gladys, you have grasped the very basics of the PPACA. Especially if you live in California. But wait, conservatives rarely take risks of the kind you would choose because their house and their car are worth more than $5000. Are you currently one who is without health insurance? You know, you won't have to spend on the deductible if you choose not to have a physical or if you can choose not to have a heart attack.
Posted @ Tuesday, October 15, 2013 9:59 AM by Michael
Gladys, I do believe that my comment is on point, but I do not believe two in a row make it stronger.
Posted @ Tuesday, October 15, 2013 12:15 PM by Michael
"You know, you won't have to spend "on the deductible if you choose not to have a physical or if you can choose not to have a heart attack. 
Micheal what do you mean by this? I don't understand your response 
If you are trying to convince me to buy health insurance, well I will not, shell out $300 to $400 for decent coverage that I may or may not use.
Posted @ Tuesday, October 15, 2013 9:27 PM by Gladys
Gladys, the word "accident" has no boundaries. Certainly, you can choose not to buy health insurance. And perhaps you can choose to be injured in an auto accident or a house fire or an industrial event so that you can be covered. The thing of it is that one does not use an accident but is used. So, the end question is: are you conservative enough to protect your home, your car, your investments?
Posted @ Wednesday, October 16, 2013 10:21 AM by Michael
I cannot afford $300 to $400 a month to pay for health insurance even if I wanted too, paying for rent, food and electric is more important. i"am sure many are in the same boat about this, many people cannot afford what is basically another car payment. 
Also I do not have a home or any assets to protect or investments. I have a car sure but not worth much either. So hospital wants to sue me, their is nothing they can take from me. 
Posted @ Wednesday, October 16, 2013 8:22 PM by Gladys
Ok, so I don't pay attention to news, and here it is October 16 that I just heard that Americans are required to buy insurance. But since I can't find some simple info(or I'm overlooking it.) I'm going to ask. 
First. I am unemployed and have been since 2011. I get foodstamps so I don't starve. Other than that. I get no money. I can't afford to pay for insurance when I have nothing to pay it with. How do I get health insurance?
Posted @ Thursday, October 17, 2013 12:56 AM by Jenna
Jenna, I'm sorry to hear about your work situation. It's a tough place to be. To get insurance, you can check and see if you're eligible for Medicaid in your state. 
Another option you have is to go without health insurance. If you don't make enough money to have to file a tax return, you are exempt from the penalty tax under the Affordable Care Act. But then you're on the hook for any medical expenses you may incur. 
Thanks for reading our blog and good luck with your job search!
Posted @ Thursday, October 17, 2013 8:50 AM by Ryan Kanable
Gladys, I cannot help but think that you can look for the subsidy that is available for certain income earners. Your report of expenses suggests it will be worth your time. The value of accessible medical attention when one is stressed by daily life cannot be overestimated.
Posted @ Thursday, October 17, 2013 12:43 PM by Michael
So,Let me understand this. if I don't pay for ins. they will take money from me,money that I don't have and take it from my Tax return , how about if I don't pay taxes, then they have to put me in jail. and then my family will be hurting with no income coming in then what. This Pres. needs to be removed. every thing was good the way it was in the past. this is all for the government to stay a float and for them all to keep getting high wages and for us little guys to sink. this is very Bad,very Bad
Posted @ Monday, October 21, 2013 6:42 AM by willie
Willie, thanks for reading our blog. You are correct. There is a tax penalty for not having health insurance in 2014. And it's true (as it has always been) that if you don't pay your taxes, you might go to jail. Of course, I encourage you to follow the law. If you don't have a lot of money, it might be worthwhile to check into Medicaid coverage for your family and to talk with a tax professional about how best to deal with the financial requirements of the Affordable Care Act. 
Thank you for your comment.
Posted @ Monday, October 21, 2013 9:09 AM by Ryan Kanable
Willie, what have you been using to protect your family's standard of living up to this point against the hazard of a major illness? Many folks have gathered from reports in various media that PPACA provides support for low income earners. In fact, if you have a good sized family, you can earn quite a good deal of money, obtain health insurance, and keep a fair part of your earnings. But you do have to choose because no one is going to do that for you. By the way, if you let the government take care of your money, thinking oh boy a refund, perhaps you should review your w-2 form again.
Posted @ Monday, October 21, 2013 11:22 AM by Michael
Willie, isn't it great the type of arm twisting that this law is. Here the law is forcing you to buy something that is unaffordable for most or pay a tax penalty, just love the freedom we have! 
Posted @ Monday, October 21, 2013 7:52 PM by Gladys
will aca take into consideration the rapant abuse of drugs( street and rx and alcohol) and the fact that i have to pass a drug screen to earn the tax dollars that are taken out and used to pay all the subsidized insurance plans? and please dont use the "its a disease" cop out, lots of times drug use is a personal choice , and hmmm tobacco , alcohol and rx drug use kills more people every day , more than any gun ever has
Posted @ Tuesday, October 22, 2013 10:01 AM by travis
Thanks for the question, Travis. The ACA does not address illegal drug use. That's covered under criminal laws. As for prescription drugs, alcohol, and tobacco, health plans under the ACA must provide screening services and counseling as part of "essential health benefits." 
Passing a drug screening is the decision of your employer and not a part of the ACA. 
Also, people who use tobacco may be charged more for their health plan premiums under the ACA. 
Thank you for reading our blog.
Posted @ Tuesday, October 22, 2013 10:17 AM by Ryan Kanable
We don't have insurance because we can't afford another bill. We live paycheck to paycheck and my husband makes decent money. He can get insurance through his employer. My employer doesn't offer it because I'm considered part time. Can my husband get his insurance through his work and then can I get insurance for me and my daughter through the marketplace?? just based on my personal wage?
Posted @ Wednesday, October 23, 2013 9:39 AM by Debbie
Debbie, the blog posts indicate that each adult must have insurance or pay the fee/tax. Thus a look at a healthplan page is an important step for you. "Decent income" is a beautiful term who meaning shifts from zone to zone. The key finding will have do with cost of living in your area measured against the poverty level. Perhaps there is some level of public support for your total.
Posted @ Wednesday, October 23, 2013 5:53 PM by Michael
Debbie, sorry for the delayed response. I had to check on a few things. In Wisconsin, if one spouse has group coverage through his/her employer, that coverage must be offered to the dependents as well. Laws in other states vary, but I wanted to let you know about that, just in case that gives you another option. 
If you want to get coverage through the Marketplace, and you're married, you must file a joint tax return in order to get subsidies, which means the subsidies are based on your total household income, not just yours. 
Thanks for the great question!
Posted @ Thursday, October 24, 2013 8:49 AM by Ryan Kanable
Does household income mean base pay or pay plus overtime? My husband works overtime occasionally, so his pay is never the same from year to year. Is it based on gross income? Trying to find someone in my area to speak to face to face. Frustrated!
Posted @ Thursday, October 24, 2013 6:20 PM by Debbie
Debbie, household income is the total amount of taxable income you put on your annual income tax forms. For help finding someone to speak to in your area, you can find local help via the official health care reform website. You can also talk to your local insurance agent. Thanks for the questions!
Posted @ Friday, October 25, 2013 7:51 AM by Ryan Kanable
The Affordable Care Act is affordable because of the government subsidies. Where does the government get money for these subsidies? I thought we were already 17 trillion dollars in debt. 
Posted @ Saturday, November 02, 2013 11:03 AM by Paul Alderdice
Paul, the text of the bill has been online for months. The source of funding is revealed in specific items. For instance, by reducing the amount of fraud in Medicare requests for supplies or for shoes for folks who turn out to have no feet. It may interest you to know that the debt load associated with the founding of this Nation was, in 2012/13 dollars about the total of debt you mention. That debt was paid up by 1835. It may also interest you to know that the salary and benefits paid to early presidents was about the same as what Mr Obama receives in 201/13. 
Perhaps it may be that you have seen figures from the CBO indicating a reduction in the deficit of a fairly great amount that follows the rollout of PPACA. 
By the way, you do know that about 80% of American citizens have insurance, thus not candidates for insurance offered by healthcare exchanges.
Posted @ Saturday, November 02, 2013 9:25 PM by Michael
Paul, thank you for the question. The answer is complex. Funding for the ACA comes from a variety of sources. One of the biggest sources is a new annual fee on health plans, paid by health insurance companies, that goes into effect in 2014. Other major sources include an annual fee on pharmaceutical companies, begun in 2013, based on their sales; a 2.3% excise tax on medical device manufacturers that went into effect in 2013; and a 10% excise tax on indoor tanning services, which went into effect in 2010. A 40% excise tax on high-cost, or "Cadillac," health plans begins in 2018.  
For more information, please see the Congressional Research Service's report on this topic.
Posted @ Monday, November 04, 2013 12:22 PM by Ryan Kanable
My question is if I don't have health insurance in 2014 can i still have my prescriptions filled at the pharmacy by me paying cash as usual? I can't afford health insurance due to my financial situation.
Posted @ Tuesday, November 12, 2013 9:32 AM by Mike
Mike, if your pharmacy continues to accept cash, then you should still be able to get your prescriptions filled as usual. 
Thanks for the question.
Posted @ Tuesday, November 12, 2013 10:11 AM by Ryan Kanable
Mike, before you abandon hope, given a "financial situation", it surely would be worth your time to check into the exchange in your area. Subsidization is available for certain income levels. Access to the necessary information is available via mail or telephone as well as the internet. 2 of the access points are not likely to freeze up.
Posted @ Tuesday, November 12, 2013 11:08 AM by Michael
If I have health insurance through my job but my husband who doesn't work does not have insurance will we get penalized when filing taxes this year?
Posted @ Sunday, November 17, 2013 7:08 AM by Jeannette
Jeannette, the penalty for not having health insurance doesn't begin until 2014, which means that any penalty you may have to pay would happen at tax time in 2015. You should speak to your tax professional about the penalty and how it may affect your taxes. 
Thanks for the comment!
Posted @ Monday, November 18, 2013 10:08 AM by Ryan Kanable
Jeannette, an even more interesting question: if your husband begins to experience chest pains before the penalty phase begins, who will cover his expenses? It may be that your income divided by two will provide a subsidy for the cost of his private insurance through the healthcare plan exchanges.
Posted @ Monday, November 18, 2013 10:26 AM by Michael
Good Day everybody, my names is joyce, am from the Switzerland, i want to give thanks and honor to Dr. Ogudugu for the great work he did for me, he brought my lover within 24 hours which i never taught it will ever come through in my life, but this great man Dr. Ogudugu proved to me that powers can do wonders, i got his contact from a friend who he helped, this friend of mine told me that this man is great but i felt as hmm are you sure? cause i hardly believe those kind of things,so she told me not to worry that when i contact him, that she is guarantee me 100% that my lover will come back that if it does not work that she will be the one to give me back my money, to show her sincerity to me, she gave me her car that if it does not work that and she did not pay me the money that i spent that she i should collect her car and she gave me all the documents, i was so so surprised she was very serious about it so that was how i contacted him and i told him what i want he just told me that everything will be done within 24 hours so with the assurance my friend gave me i was having confident, so in the next 24 hours that he told me i just heard a knock on my door i never knew it was mark, so that was how i opened the door the first thing he did was to go on his knees, he started begging me to forgive him that he is very sorry for everything, i was really surprised and was also happy, so that was how i forgived him and now we are living together happily than ever before, and am using the media to invite my friends on my wedding which will coming up on 24/12/2013, am very happy thanks be to Lucy who gave me his contact and honor be onto Great DR.Ogudugu who helped a lot, if you need his help or you want to thank him for me you can contact him through his email address oguduguspelltemple@gmail.com
Posted @ Saturday, November 23, 2013 9:05 PM by joyce
Joyce, thank you. I cannot think of any post that has had so deep a connection to the benefits of PPACA as this that you have submitted. I am sure that Mr Obama joins me in thanking you.
Posted @ Saturday, November 23, 2013 11:12 PM by Michael
My family can barley pay what bills we have now, so how are we supposed to be able to purchase health insurance? If we have to pay health insurance then we will probably end up losing our home or truck, What kind of religious group opposes to accepting health insurance? I might have to join them, or the people at the homeless shelter.
Posted @ Sunday, December 01, 2013 6:09 PM by James
James, you may want to see if you qualify for subsidies to help pay for your Marketplace health plan. More information on how you might be able to save money is available at HealthCare.gov. Thanks for reading our blog!
Posted @ Monday, December 02, 2013 9:43 AM by Ryan Kanable
If one decided not to sign up for Obamacare when do the penalties become payable, on your 2013 taxes payable by April 15, 2014 or payable on your 2014 taxes payable by April 15, 2015?
Posted @ Monday, December 16, 2013 7:09 AM by Jeffrey
Jeffery, that's a great question! If you choose to go without a health plan in 2014, the penalty will be applied to your 2014 taxes, which you will file in 2015. The other penalty, of course, is the huge financial risk you're taking by not having a health plan. 
Thanks for reading our blog!
Posted @ Monday, December 16, 2013 7:57 AM by Ryan Kanable
One more question, what happens if you sign up on the 16th but you missed the December 15 timeframe. What happens then?
Posted @ Monday, December 16, 2013 8:14 AM by Jeffrey
Another great question, Jeffrey. Here's how it breaks down: 
During open enrollment, if you enroll between the 1st and 15th day of the month and pay your premium, your coverage begins the first day of the next month. So if you enroll on Feb. 10, 2014, your 
coverage begins March 1, 2014. 
If you enroll between the 16th and the last day of the month and pay your premium, your effective date of coverage will be the first day of the second following month. So if you enroll on Feb. 16, 2013, your coverage starts on April 1, 2014. 
In order for the penalty tax to kick in, you have to be without coverage for three consecutive months, so you would not be hit with the penalty for missing the deadline. 
For more information, check out our free brochure on health care reform.
Posted @ Monday, December 16, 2013 8:44 AM by Ryan Kanable
Ok, I have been reading some of these questions and comments not all of them. My questions is if I go with a catastrophic plan that only covers major medical would a hospital still treat me if say I had a really bad rash or the flu and needed medical help? I mean I would have catastrophic but I wouldn't call the flu or a bad rash like hives to be catastrophic. My husband and I can not afford to pay the 300-600 a month for coverage that is crazy we pay $160 a month currently and have a 3600 deductible if we go Obamas way we'd have a 12000 deductible how is this fair to the middle class?
Posted @ Tuesday, December 31, 2013 10:59 AM by stacey
Stacey, it seems to me that you might want to read your current policy to see if you have annual and lifetime caps on coverage in the event of catastrophic issues. But surely you would seek help in a clinic for a rash or the flu (get your flu shot soonest, ok) rather than seek help in an ER. 
As for total cost, have you considered to what extent your costs will be deductible from your tax return?
Posted @ Tuesday, December 31, 2013 12:23 PM by Michael
Stacey, thanks for reading our blog. If you go with a catastrophic plan, you still get three primary care visits per year and free preventive care. 
They're called "catastrophic" not because they only cover catastrophic health issues, but because the deductible level is so high that you need to use a LOT of health care before the benefits kick in. They're intended to protect you from financial ruin if you would require substantial health care, like a major surgery, cancer treatment, or recovery in a hospital after an accident. 
Costs related to a rash or the flu still count toward your deductible, but you'd need many of those doctor visits to meet your deductible. 
To answer your question, yes, a hospital should still treat you. However, that decision is up to each individual hospital. 
When you're considering plans, make sure you check into subsidies. That might help make your health plan for affordable. 
Thank you for the great question!
Posted @ Thursday, January 02, 2014 8:25 AM by Ryan Kanable
The company i work for dropped our insurance courage claiming after 1/1/14 their premiums would go up 100%. So now im forced to purchase insurance on my own. Im pricing insurance everywhere i could find and im not able to payout about $400 per month and still have about a $6000 deductible. How can the Obama administration say they care about us American people.
Posted @ Sunday, January 05, 2014 9:18 PM by Tim
Sorry to hear about your situation, Tim. Make sure you take a look at the tax credits (subsidies) that are available to help offset your premium cost. You can check out how much you might qualify for using the Kaiser Family Foundation's calculator
Thanks for reading our blog!
Posted @ Monday, January 06, 2014 7:40 AM by Ryan Kanable
Hey, Tim. Are you looking at the exchange plans for your state? A serious question that must be asked by men and women who find themselves in your situation: what exactly is the employer doing with the money formerly used to provide a benefit for the folks who make the company profitable? Your numbers suggest that you no longer have a living wage. Perhaps a good time to look into a union label, eh.
Posted @ Monday, January 06, 2014 11:25 AM by Michael
If I chose to not get insurance, and pay the penalty, can I get insurance when I get sick?  
If so, how much will it cost, and how many days would I be insured?  
What would my out of pocket costs be (80th percentile), while waiting to acquire insurance.
Posted @ Wednesday, January 08, 2014 9:22 PM by Joe
Joe, under the new law, you can only enroll in a qualified individual health plan during open enrollment, unless you have a qualifying life event (marriage, a new child, moving, losing your health coverage). For 2014, open enrollment ends Mar. 31. If you miss that window, you have to wait until the next open enrollment period, which has proposed dates of Nov. 15, 2014, through Jan. 15, 2015. You cannot simply sign up when you get sick, unless you happen to get sick during open enrollment. 
The cost and coverage would depend on the health plan you choose, so I can't really answer that part of your question. 
Your out-of-pocket costs while you go without a health plan would be the total cost of whatever health care you require. If you're not insured, you pay for everything. 
Thanks for the question, Joe. This is a confusing point for a lot of people. I hope I've helped clear it up for you.
Posted @ Thursday, January 09, 2014 7:53 AM by Ryan Kanable
I make $36,000 a year before taxes. After taxes I actually bring home $21,000. The government plan thinks that I can afford $235 dollars a month for a health care plan that has a $6,300 deductible. So in a year if I get sick I will be paying $9120 for health care out of pocket. the following year would be the same. This is assuming that my sickness allows me to still work and pay my premiums. that is 43% of my actual income without any benefit. Please tell my where the benefit happens.
Posted @ Friday, January 10, 2014 6:46 AM by Ken
Ken, the benefits you get from your health plan include coverage for preventive care, emergency and inpatient hospital care, prescription drugs, and more.  
Another benefit of having a health plan is that when a major health issue comes up, it won't bankrupt you
For example, if you're meeting your entire $6,300 deductible annually as you suggest, you likely have a serious medical condition, which means your actual medical bills are probably much higher and being paid by your health plan. This keeps you from having to file for bankruptcy. 
The health plan premium you cite is about 7.8% of your income (before taxes), which is below the 9.5% threshold for affordability in the Affordable Care Act. If you're healthy and not using any benefits, you will pay your $2,820 premium for the year and have the peace of mind of knowing that, if a major health issue or an accident should happen, you're covered. 
Thank you for the question!
Posted @ Friday, January 10, 2014 8:38 AM by Ryan Kanable
Ken, you have not reckoned the tax reduction benefit from the medical costs. I would encourage you to begin to examine the reasons that your job pays only $18 per hour. Take a look at what the job paid 5 years ago. Use an inflation calculator to see what would be the wage if inflation was factored in. By the way, the plans you have examined are not "government" plans. They are plans created by private insurance companies who intend to make a profit while delivering 80% of premium cost to service providers in a customer's interests. And if you become ill with one of the conditions that drags on for a year or three, you will not get a cancellation letter from a company. Sometimes as comforting a feeling as having a bank account.
Posted @ Friday, January 10, 2014 11:24 AM by Michael
I am just wondering what happens if I do not get the Obamacare insurance, but I am Getting married this year August 9,2014 to a man in the military, and in turn they put me on the Tricare insurance with him. Do I still get penalized for not getting the Obamacare this year in my tax refund for next year.
Posted @ Saturday, January 18, 2014 9:37 AM by Breonna Gillispie
Breonna, plainly the timing of your marriage and the application of the regulation protect you on that point. Perhaps you have learned of a way to prevent serious illness between January and August. If so, tell others, ok?
Posted @ Saturday, January 18, 2014 11:42 AM by Michael
Breonna, if you go without health insurance for a continuous three-month period in 2014, you will be responsible for paying the penalty tax. So if you wait until August to get a health plan, you WILL be paying the penalty, unless you are exempt from the requirement. 
You can read about how it works in section 1 of our free brochure, 9 Things You Need to Know About the Affordable Care Act.
Posted @ Monday, January 20, 2014 8:01 AM by Ryan Kanable
I guess the hardest thing to understand is WHERE our administartionexpects us to get the extra money to pay for coverage? I basically live paycheck to paycheck (like a large # of us. At the end of any given month I am scraping until the next check comes in. I do NOT have $400 to cover my medical premiums...and that is with the tax subsidy. The bottom line is...if you don't have the money, you don't have the money! So, I can pay my rent or mortgage and eat or pay an insurance premium and I don't know....stop buying food?
Posted @ Monday, January 27, 2014 5:05 PM by Andrea
Andrea, there are no less than several individuals and/or organizations ready to help you learn to manage your income. It surely cannot be comforting to know that you live paycheck to paycheck. But wait, what happens to your fiscal state if, land forbid, you become ill with one of mankind's scourges? Perhaps a sit down with your employer? Perhaps a check with the nearest unionized neighbor.
Posted @ Monday, January 27, 2014 9:45 PM by Michael
Andrea, I don't have a good answer for you. Everyone's situation is different. If you can't afford health coverage, you may qualify for a hardship exemption under the Affordable Care Act. Otherwise, you'll be paying the tax penalty when you file your 2014 taxes in 2015. 
Thank you for your comment!
Posted @ Wednesday, January 29, 2014 8:04 AM by Ryan Kanable
I can not afford this I barley make 400 dollars a month in wages. But yet the cheapest rate I can get is 300-400 a month come on you call this affordable. Not every american gets paid 100,000 a year like Congress.
Posted @ Thursday, January 30, 2014 5:11 PM by Billy Mayes
Billy, you really have not tried to access the healthplan exchange in your state, right? Sidenote: a member of Congress earns 174000 a year + 75% employer subsidy for his or her health plan, chosen off the healthplan exchange either in DC or in their own state. The fact is that you would seem to qualify for Medicaid--unless of course you live in one of the states whose governors have decided that no more folks are entitled to sleep peacefully at night because they have health insurance. Not uncommon in areas where "I've got mine" is like a secret handshake.
Posted @ Thursday, January 30, 2014 6:22 PM by Michael
My husband has insurance through his job. If I miss the March 14 deadline, will I still be able to enroll in his health plan at open enrollment in September 2014?
Posted @ Friday, January 31, 2014 12:16 AM by Barbara
If you have an individual plan today, and let it lapse, don't you still have 30 days to re-instate it?  
If so, couldn't you let your plan lapse every other month (paying for it every other month), then go back on (if needed) and then you would never have a 3 consecutive month lapse in coverage and would not need to pay the penalty?
Posted @ Friday, January 31, 2014 6:15 AM by OC
Reading this more, so even non-Marketplace obtained individual plans will all only allow enrollment in the open enrollment period?  
Even if so, seems if you have qualifying events (lose insurance through employer, get married, etc), then you can enroll outside of open enrollment?  
If so, couldn't you just take any job with insurance and then quit to be able to re-enroll (if needed?) Or a single person could just run to Las Vegas to get married? 
Seems like this will increase job hopping and insurance switching, not make things more stable.
Posted @ Friday, January 31, 2014 6:39 AM by OC
Billy, if you make $400 per month, that's $4,800 per year, which is below the federal poverty level. This means that you are exempt from the individual mandate and its penalties.  
You also likely qualify for Medicaid. You should take a look at the Medicaid program in your state. A great place to start your research is on the federal website
Thank you for your comment!
Posted @ Friday, January 31, 2014 7:57 AM by Ryan Kanable
Thanks for the question, Barbara! You can certainly sign up for your husband's plan later in the year, but keep in mind that you'll have to pay the tax penalty for not having insurance. 
In 2014, if you go without a health plan for three consecutive months, then you will have to pay the penalty when you file your 2014 taxes in 2015. This year, that's 1% of your household income or $95, whichever is greater. 
You'll also be on the hook for any medical costs you have this year until you sign up. Open enrollment ends March 31, so you still have time to get a plan if you want coverage this year. 
Thanks for reading our blog!
Posted @ Friday, January 31, 2014 8:04 AM by Ryan Kanable
OC, you are correct in saying that all health plans are now only available during open enrollment unless you have a qualifying life event that gives you a special enrollment period
So, theoretically, you could quit your job to change health plans. But if your employer offers a health plan, that wouldn't make much sense. You could also get married, which would allow you to change your health plan. 
Changing jobs and getting married are both large, life-changing events. Doing either one often just to switch a health plan doesn't seem like a very likely choice for most Americans. 
Thank you for your questions!
Posted @ Friday, January 31, 2014 8:20 AM by Ryan Kanable
Child support has been taking my taxes for years! Stand in line! Been homeless for months. Finally have a job, but I cant afford to have a job and pay insurance
Posted @ Thursday, February 06, 2014 9:32 PM by RDP
RDP, if you can't afford a health plan, you may qualify for Medicaid. You can find out if you qualify here
Glad to hear you found work! Thanks for the comment.
Posted @ Friday, February 07, 2014 8:02 AM by Ryan Kanable
I agree with many people on here. I cannot afford $400 a month with such high deductibles. We are at the 42% of poverty level as a family of 5 and a yearly income of $12,000. my state didn't expand medicaid so myself and my spouse do not qualify. Our 3 children are on medicaid and we receive foodstamps but our monthly income only amounts to $1000. I have rent, utilities, gas, car payment, household necessities and food that our foodstamps do not cover and after all that I may have $30 leftover. My employer does not offer health insurance we do not qualify for any subsidies or tax credits. So please tell me how we are supposed to pay $400 a month that we DO NOT HAVE?
Posted @ Saturday, February 08, 2014 1:04 AM by britt
Hi, Britt. I'm sorry to hear about your situation. If your state ISN’T expanding Medicaid, you have limited income, and you don’t qualify for Medicaid under your state’s current rules, then you don't qualify for either Medicaid or lower costs on private health insurance.  
However, you can find out about how you can get low-cost health care at a Community Health Center near you. 
Because your state did not expand Medicaid, you can file for a hardship exemption to avoid having to pay the penalty tax. 
Thank you for the comment.
Posted @ Monday, February 10, 2014 8:22 AM by Ryan Kanable
I am currently single and uninsured. However, I am getting married on April 12, 2014. It is my understanding that if you are not enrolled in a health care plan by March 31, 2014 you will pay a fine. Is it worth is for me to just wait until April to be enrolled on my husbands insurance and pay the fine?
Posted @ Tuesday, February 11, 2014 11:53 AM by Rochelle
Rochelle, I can't tell you if it's worth it or not. That's up to you. But I can tell you that if you go for a three-month period without insurance, you will be paying the penalty at tax time.  
For 2014, the penalty is pretty small; it's just $95 or 1% of your income, whichever is larger, for the whole year. But, the penalty is applied per month. So if you go without a health plan until April, that's only four months, so you would only pay 4/12, or 1/3, of that amount. Using the $95 amount as a base, you'd pay a penalty of about $32, roughly speaking. If you make a salary in the neighborhood of $40,000 a year, your penalty would be more like $133 (again, very roughly speaking). 
So is it worth it? Your call, Rochelle! Thanks for the question.
Posted @ Tuesday, February 11, 2014 12:16 PM by Ryan Kanable
So, lets say I choose not to purchase insurance and just pay the penalty and then I get sick or have to go to the emergency room or try to see a doctor? Will I be denied access to hospitals and or doctors? At this point the cheapest plan I can get will cost me $197 for the premium. I just don't have an extra $197. I have explored my options and in order to try and afford this, I would have to shut off my cell phone (my only phone), turn off my internet, and turn off my cable. All of those accounts will force me to pay penalties for early cancellation. It actually works out, at least this year, to pay the penalty.
Posted @ Wednesday, February 12, 2014 2:31 PM by Andrea
FYI.. I work for a small family owned business. (under 10 employee's) My employer has always paid for our health care. Used to be 100%...that whittled down to 75% and now they will not offer coverage at all. Obama care seems to be hurting a lot of people in my position.
Posted @ Wednesday, February 12, 2014 2:36 PM by Andrea
Andrea, any denial of health care service is up to the health care provider. Different hospitals, clinics, and doctors have different rules to follow. For routine/preventive care, some may take cash and some may refuse to help you. In any case, you cannot be denied emergency medical attention. The Emergency Medical Treatment & Labor Act, passed in 1986, ensures public access to emergency services regardless of ability to pay. 
There are times when we have to make tough choices. Whether or not your Internet and cable TV are more important than your health plan is one of them. I'm sorry to hear that your employer has decided to stop offering coverage. Tax credits are available to small business owners who offer a health plan.  
Thank you for your comments, Andrea.
Posted @ Wednesday, February 12, 2014 4:08 PM by Ryan Kanable
It's not a matter of whether or not it's more important than health care. It's not. Having a phone is not negotiable. TV and internet are, the cost of cancellation prior to agreement terms being met are steep though. It is my only form of entertainment. I can't afford movies, vacations, new clothes, dinners out, things like that. I work really hard to cover my own expenses and have NEVER had any state or government assistance. I also don't really see the point in paying for a health insurance premium that will still not afford me to use the insurance. I would have to save a few months to pay a $60 co-pay and or medication costs. On the flip side, I KNOW people who have hardly worked or contributed to society that are given better benefits than I can get or afford. Feels like I am being penalized for having a job and trying to take care of my stuff. In the words of our California Governor, "Those who have less will get more." I am just disgusted by the whole thing! I appreciate you letting me vent! I know this doesn't solve anything but, I sure feel better! lol
Posted @ Wednesday, February 12, 2014 4:34 PM by Andrrea
It appears I spelled your name wrong before, Andrrea. Sorry!  
If you don't qualify for Medicaid, but make too little to afford a health plan, you may qualify for a hardship exemption. If the lowest priced plan is more than 8% of your income, you can apply for a hardship exemption to avoid the tax penalty. Here's more information on exemptions
Again, thanks for reading and commenting. And venting! Sometimes venting is good.
Posted @ Wednesday, February 12, 2014 4:50 PM by Ryan Kanable
My husband and I had been carrying Individual Medical Insurance from Kaiser Permanente since Dec 2011 till Dec 2013 using our after-tax income. The plan is high deductible($5000) plan, and out-of-pocket maximum is also $5000; it also has preventive care items just like the ACA's plans. But our premium is $198(50 years old) and $147 (42 years old)for each of us. We eat organic, whole plant-based diet and have routine exercises to stay healthy. The medical insurance is more for catastrophic. Now with Obama-care, we can't keep our original plan any more since it is said by KP that the plan is not appliance with ACA's requirement(the pre-existing condition terms). We haven't registered the new insurance plan from marketplace yet since the new premiums with high deductible as $4500 and annual out-of-pocket maximum as $6350 will be $359(51-year-old) and $261 (42-years-old). The premiums increase 72% with higher out-of-pocket. Thus the reality is that we-the healthy ones are doomed to be punished because of ACA. Our income is just above the subsidy line $1000, so we don't qualify the subsidy. For those who were not responsible for themselves, they are even happy now with food-stamp, free medical care.  
As time passes by, now we have to evaluate the risks about buying or not buying medical insurance in 2014.
Posted @ Thursday, February 20, 2014 6:13 PM by Esther
Thanks for sharing your story, Esther. Everyone's experience with health insurance is changing because the rules have changed. The healthy people now pay more, while the sick pay less. The young pay more, while the old pay less. Men pay more, while women pay less. Depending on which group you're in, this is either good or bad for you. I wrote a blog post about how premiums might change last year that provides more information. 
It's up to each person or family to decide what type of health insurance is best. For those who want to check quickly to see if they qualify for subsidies, here's a chart showing income levels.  
If you don't qualify for subsidies, it might pay to shop off-Marketplace to increase your options. But keep in mind that open enrollment for ALL health plans ends March 31 this year. So don't put it off! 
Thank you for reading, Esther.
Posted @ Friday, February 21, 2014 7:55 AM by Ryan Kanable
Esther, it might be a good time for you to sit down with your employer to determine whether you are paid at the fairest rate, given the new and improved regulations for health insurance. It might not hurt to take another look at your former policy to see if it included annual or lifetime caps. And finally, perhaps give some thought to what you have to lose if worse becomes worst and you cannot cover your medical bills.
Posted @ Friday, February 21, 2014 11:43 AM by Michael
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