Obamacare: coverage for free? Not exactly . . .

I work part-time and don’t qualify for the plan at my work.  I’ve heard that in 2014, I’ll be able to get health insurance practically for free.  Is that true? I’m healthy as a horse, but I might get the insurance if it’s not expensive.   Where will I get it, if it’s not through my job?  Who will be paying for it, if I’m getting it for nothing?

Eager To Enroll

Dear Eager To Enroll,

Part of what you are hearing is true, and part is not exactly false but a tiny bit misleading.

Let’s start with the true part.  If you do not get health insurance from your job and your income is below a certain amount, then you will be able to get health insurance and pay less than the full cost.  Your family’s income needs to be less than 400% of Federal Poverty Limits.  For a family of four, that is $94,200 in 2013.  You can look up your income and household size at Families USA’s website.

Which brings us to the not exactly true part: you would get your health insurance for free only if you qualify for Medicaid.  You would qualify for Medicaid if you meet your state’s rules.  Some states are “expanding” Medicaid to cover everyone whose income is below 138% of Federal Poverty; other states are not.  In those ‘non-expansion” states, you would generally have to have young children at home to enroll in Medicaid.

To see what your options (including Medicaid) and subsidies will be, go to healthcare.gov.  Answer the questions after clicking “See Your Options” on the home page.  This will lead you to a page listing your options and estimated subsidies.  Scroll down to the bottom of that page and set up an account.  This will get you ready for October 1 when enrollment information will be published.

So, even if your health insurance won’t be free, it may cost you less than you think.  And it’s the government paying the cost – the difference between what you pay and what the plan actually costs.  (I won’t go into the gory detail of where this money is coming from.  This is its own controversial saga.)

You definitely should look at your options and find out your cost.  The goal, after all, is to get more people insured and spread the cost out over as many people as possible.

Linda Riddell

About Linda Riddell

A published author and health policy analyst with 25 years’ experience, Linda Riddell's goal is to alleviate the widespread ailment of not knowing what your health plan can do for you.