What is Obamacare?

In March, 2010, the Patient Protection and Affordable Care Act was signed into law. The Affordable Care Act (ACA) or, as it is sometimes known, Obamacare, was created to provide access to affordable healthcare to all Americans.

Approximately 15% or 50 million Americans do not have health insurance but just about everyone will be required to have some sort of health coverage as of January, 2014. Those individuals who choose not to have insurance may be required to pay a fee. 

The fee increases every year – beginning in 2014, it will be 1% of your income or $95 per adult, whichever is higher. Families would pay $47.50 per child up to $285 per family (or 1% of family income if that number is higher). 

In 2015, the tax penalty will be $325 per adult and $162.50 per child, with a maximum health tax penalty of $975 per family or 2 percent of family income, whichever is greater.

The ACA goes into full effect during 2016 when the numbers increase to 2.5% of income - $695 per adult and $347.50 per child, with a maximum penalty of $2,085 for a family.

These penalties are taken out of your tax return if you are expecting one, otherwise you are responsible for paying them. 

The other very important thing to remember is if you choose to pay the penalties you are also responsible for paying 100% of your healthcare costs.

You may already have insurance through your employer or already receive Medicaid. If so, then you don’t need to do anything. But the ACA helps you understand the coverage you’re getting and gives you more choice and control when it comes to your healthcare. In some states, including New Mexico, you could qualify for expanded access to assistance programs. This may make benefits available to a wider range of people and income levels.

If you're a business owner, you may be required to offer your employees affordable health insurance starting in 2015 – or pay a penalty. But small businesses – those with fewer than 25 employees – will be exempt from this requirement, and may qualify for the Small Business Health Care Tax Credit to help offset costs.

Under the ACA, you'll no longer be denied coverage if you have a pre-existing condition, such as diabetes or heart disease, and it makes it illegal for health insurance companies to arbitrarily cancel your health insurance just because you get sick. It holds insurance companies accountable for rate increases and ends lifetime and yearly dollar limits on coverage of essential health benefits. You also have the right to appeal any decisions made about your benefits by private companies.


Important dates:

January 1, 2014

Coverage may begin

March 31, 2014

Open enrollment for 2014 ends

October 31, 2014

Open enrollment for 2015 begins

December 7, 2014

Open enrollment for 2015 ends

January 1, 2015

Deadline for businesses with more than 50 full-time employees to offer health coverage


Your choice of doctors is protected under the new law and children under the age of 26 can stay on their parents’ insurance. In addition, you may be eligible for free preventive screenings, such as blood pressure and cholesterol tests, colonoscopies, vaccines, and more. There are a number of new preventive services for women including mammograms.

But where do you purchase insurance? From what is being referred to as a health insurance marketplace or exchange. October 1, 2013, was the first day of open enrollment where you can go online and shop for, compare, and purchase a healthcare plan from those available in your state. Information available at the marketplace includes options such as price, benefits, and quality ratings. You also may be eligible for tax credits or public programs to help you pay for your healthcare.

New Mexico’s health insurance marketplace is the New Mexico Health Insurance Exchange and starting in 2015, the state will provide quality ratings on a four-star scale based on consumer feedback.

If you have questions about enrollment you can also get in-person assistance and an online navigator program to help you complete eligibility and enrollment forms as well as explore other health coverage options.


For more information or to sign up go to www.healthcare.gov.


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