Health insurance

This is not meant to be a debate post AT ALL. I am purely here to just get an understanding because I really don’t understand how the US healthcare system works and I have to explain it in a few weeks. I have not lived in the US since about 2003, so I am not sure how things changed exactly since the ACA.

My questions:

Do you have to get a plan under the ACA (if your job doesn't offer health insurance)?

If you don’t, do you receive a fine?

Do you have to at least register with a health insurance and if you can’t pay the costs (contributions), do you have to pay them back?

When I lived there, you could go without and just face the problem of paying off medical bills if something happened. Risky chance, but you were able to do it.

Is it still the same? I’m wondering if the ACA changed that.

A quick summary of here. I’ll only do public insurance for this. You must be insured by law. It goes based on your income if you are self-employed. If you have a contract job, that job must cover your choice of insurance. If you are unemployed, the government covers your insurance. If you don’t pay (for not filling out unemployment or you are self-employed and didn’t feel like paying), then your bills of monthly health insurance add up and you can possibly go into debt. You also can receive a fine on top of this. The costs aren’t too much as they are income based. If you don’t pay after some time, they can send a repo man around (you don’t have to let them in). However, you are still entitled to care, and you will not go into severe debt for cancer treatment, for example. The only debt would be if you don’t pay your monthly contribution. There really is no reason to go this far as there are tons of programs to help.

What I specifically want to know is if the ACA stopped people going into debt for necessary treatments? What happens to you if you do not have health insurance? Is it still the same as it was when I lived there? If not, what has changed?

The price for ACA *doesn’t* come into this question as from what I understand it can get expensive.

Message edited 5/4/2021 10:17:59 AM.

Health insurance

I worked for an insurer for a number of years who participated in the roll out of ACA.

You are supposed to get an individual health insurance plan if your job doesn't offer health insurance - but most companies now are required to offer health insurance if they have more than a certain number of employees.

There is a penalty in your taxes if you don't have health insurance but it is nominal compared to the cost of health insurance so many choose to not be insured. Typically the younger/healthier individuals so that tends to drive the pricing of the plans higher as the majority of those who take on plans under ACA, are high utilizers of health insurance.

There is a loophole in the law that allows you to sign up if you need it as well.

I don't think it stopped people from going into debt as the plans that cover the most are extremely unaffordable so many who do participate opt for a simpler plan. But health insurance debt is different than other debts in the US and I do'nt think you lose all of your assets if you don't pay. I don't think there is that level of recourse.

Health insurance

The federal government did away with the penalty for not having any insurance as of last year. There are a few states that do still enforce a penalty, New York is not one of them.

Re: Health insurance

What is the employee number where a small business has to start offering health insurance?

OK, so some states enforce a penalty, but does that mean you have no health insurance whatsoever and it is possible to be in severe debt for cancer treatments, for example?

So you get a penalty and then no coverage whatsoever? Do I understand that correctly?

So for example, here if you don't pay the insurance company (let's say it is 200 a month), then eventually you get a letter saying you cannot go to a doctor, but you are entitled to emergency care and certain conditions (pregnancy, terminal illnesses, etc.) are covered, and children. It's just that 200 a month adds up and will eventually go into collections. But you still have health insurance.

Health insurance

It's 50 - if you don't offer health insurance to a company over 50 employees, the employer gets a penalty per employee.

Yes - there is a penalty and no coverage - but, if you get diagnosed with cancer, you can add insurance at any time.

If you don't pay insurance premiums here, they cancel your insurance and you are uninsured.

Re: Health insurance

Thanks, got it now!