Government Watch

Obamacare: 5 Facts You Need to Know Before 2015

Years after its enactment, the Patient Protection and Affordable Care Act, better known as Obamacare, remains as controversial as ever. While Obamacare became law in 2010, provisions of the healthcare reform legislation have come into effect at various times in the years since, and parts of the program have changed over time as well.

Whether you love or hate the ACA, it’s still important to know how the legislation affects you and what you must do to remain in compliance with its guidelines. To make sure you’re up to date on the latest provisions of the Affordable Care Act, here are five facts about Obamacare that you need to know for 2015 and beyond.

1. Open enrollment for Obamacare 2015 starts in mid-November.

Last year, people could apply for coverage under the Affordable Care Act beginning on Oct. 1. As we enter the second year of the program, the open enrollment date has been pushed back to Nov. 15, meaning you still have some time to consider your options and weigh whether you should make any changes to your coverage. Open enrollment will be available through Feb. 15.

2. Obamacare penalties for lack of coverage will rise in 2015.

Tax penalties for not having required health-insurance coverage took effect last year, with maximums of $95 per adult and $47.50 per child up to a family maximum of $285, or 1% of your income above the filing threshold. Those penalties were bad enough, but they’re slated to rise substantially next year.

In 2015, you’ll face a maximum penalty of as much as 2% of your income above the tax-filing threshold; for lower-income taxpayers, penalties will soar to $325 per adult and $162.50 per child up to a family maximum of $975. Although hardship provisions will prevent some people from having to pay penalties, the stakes are clearly rising for those who don’t obtain health coverage.

3. Your eligibility for Obamacare subsidies could change.

Subsidies for Obamacare policy premiums are based on the federal poverty level and on your income. Because your insurance company won’t know what your most up-to-date income prospects are, your estimated costs for coverage will be out of date and could be dramatically incorrect.

The poverty level for 2014-15 is about 1.6% higher than the corresponding value used to calculate subsidies for Obamacare last year. With that minimal rise, the more important factor is whether big changes to your income will affect your eligibility. Given the huge differences in subsidies depending on how much you make, accurately estimating your income is crucial to determining your actual cost.

4. Insurance companies will likely compete more effectively on Obamacare in 2015.

Preliminary information on pricing for Obamacare policies in 2015 is available, and ValuePenguin’s Jonathan Wu said you might want to take a closer look at choices among different insurance companies. Wu told the Washington Times that some of the more expensive plan options are likely to get cheaper in 2015, while those companies that priced their policies extremely competitively appear to be taking steps to boost their premium revenue. That’s not unusual for maturing insurance markets, as insurers become more comfortable with the risks they’re taking on. As a result, if you got a bargain last year, your premiums could rise — but plans that seemed out of reach in 2013 might get closer in line with the market, expanding your options.

5. You can change Obamacare plans in 2015.

One of the best features of Obamacare is that you can switch among different tiers of coverage as your health changes. So if you were on a bronze plan in 2014 and your health worsened, then take a second look at whether higher-level plans would reduce your total costs. Remember: you might pay more in monthly premiums, but if it reduces your total out-of-pocket expenses, the savings can more than make up for those higher premiums.

There’s a lot to know about the Affordable Care Act, but the more you find out, the better you’ll be in making the most of your benefits. These five facts will take you a long way toward getting the best coverage you can from Obamacare.

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