This has been very controversial. On one hand, people in that situation (i.e., having to pay full price for a health insurance policy in the individual market, which can easily cost 20+ percent of a person's income if they're just a little over the income limit for subsidy eligibility) are desperate for lower-cost alternatives. And if they're healthy, they may very well be willing to take a gamble and settle for a less robust plan that's easier to fit into their budget.
Few factors bear as heavily on the well-being of any state’s citizens as their overall quality of health. In evaluating the Best States for health care, access to preventative medical and dental treatment for children and adults alike is a key consideration. Since adoption of the Affordable Care Act of 2010, also known as “Obamacare,” the percentage of Americans without health insurance has reached a record low, falling below 10 percent. The measure has been politically controversial since its inception, and the Republican-run Congress and President Donald Trump have vowed to repeal Obamacare. A rollback of the law's mandate that everyone have coverage – either through employers or public health care programs – or pay a tax penalty passed in late 2017, posing challenges to millions who have found insurance under the law.
The Affordable Care Act has delivered health insurance for millions who were unable to find affordable coverage on the individual market in the past. And, while we strongly encourage our readers to take advantage of the comprehensive ACA-compliant coverage, we do recognize that there is a segment of the individual market population that is facing daunting rate increases. We realize that their coverage options may be limited.
So we can expect a slight decline in the value of premium subsidies in 2019, on the heels of two consecutive years when average premium subsidy amounts increased significantly. But the cost of your specific health insurance policy could go up or it could go down, depending on whether you receive a premium subsidy (most exchange enrollees do, but everyone who enrolls outside the exchange pays full price), and how much your plan's price is changing.

The new CMS rules, titled in true Trump fashion, “Final 2019 Payment Notice Rule To Increase Access To Affordable Health Plans For Americans Suffering From High Obamacare Premiums,” could potentially save you from paying a tax penalty this year. The new rule provides exemptions to residents living in counties where no health insurance companies offer coverage, or only one insurer offers coverage. The rule also states that those living in counties where the only available health insurance plans cover abortion can also be exempt from a tax penalty for 2018 if it goes against their religious beliefs.


Coverage limits: Some health insurance policies only pay for health care up to a certain dollar amount. The insured person may be expected to pay any charges in excess of the health plan's maximum payment for a specific service. In addition, some insurance company schemes have annual or lifetime coverage maxima. In these cases, the health plan will stop payment when they reach the benefit maximum, and the policy-holder must pay all remaining costs.

Minimum Essential Coverage (MEC) is the least amount of coverage that is required by Obamacare for an individual to be considered “compliant” and to avoid having to pay the Individual Mandate penalty if it were to be enforced. All ACA Marketplace plans and most major medical health insurance plans are considered MEC. Since the individual mandate tax penalty is gone as of January 1, 2019 it is unlikely that stand-alone MEC plans will have a significant roll in 2019.

Group health insurance in the United States has evolved during the 20th century. The idea of collective coverage first entered into public discussion during World War I and the Great Depression. Soldiers fighting in the First World War received coverage through the War Risk Insurance Act, which Congress later extended to cover servicemen’s dependents. In the 1920s, healthcare costs increased to the point that they exceeded most consumers’ ability to pay. The Great Depression exacerbated this problem dramatically, but resistance from the American Medical Association and the life insurance industry defeated several efforts to establish any form of a national health insurance system. This opposition would remain strong into the 21st century.
We would be willing to take on a significantly higher deductible in a catastrophic plan. Even $20 – $25k a year deductible in order to keep basic premiums low and pay for most things out of pocket. Depending on the landscape when we retire (whether subsidies still exist), we could COBRA until the end of that year and shop for a low premium plan for the following year. And like the good ole doc, we are beefing up our HSA accounts while we can to fill in gaps if we need to until becoming eligible for Medicare. Hoping to preserve them for later on though.
Since 1994, this web site has been a guide for consumers seeking straightforward explanations about the workings of individual health insurance – also known as medical insurance. Within this site, you’ll find hundreds of articles loaded with straightforward explanations about health insurance – and the health law – all written by a team of respected health insurance experts.
×