Obamacare Healthcare Reform

Although the word Obamacare is tossed around a lot and everyone seems to have an opinion about whether it’s good or bad, not everyone understands exactly what Obamacare is.

Is it a type of health insurance you can sign up for like Blue Cross or United Healthcare? Is it a government-run health insurance program like Medicare or Medicaid? Is it mandatory ​​socialized medicine?

What Is Obamacare?

It’s none of these things.

Obamacare is a nickname for the set of health care reform rules found in the Patient Protection and Affordable Care Act. The Affordable Care Act, the ACA, the PPACA, health care reform, and Obamacare are all the same thing.

The term Obamacare was originally used by opponents of President Obama’s health care reform agenda. It was meant to be a derogatory term. But, it caught on with the general public since it was easier to say and more memorable than health care reform, the Affordable Care Act, or PPACA.

Now the word Obamacare doesn’t imply the user is against the set of reforms contained in the Affordable Care Act. In fact, President Obama announced that he likes the term Obamacare; he does care.

Can You Enroll in Obamacare?

Since Obamacare is a set of rules and regulations, you can’t technically enroll in Obamacare any more than you can enroll in the United States Tax Code.

However, the phrase "enroll in Obamacare" has loosely come to mean sign up for health insurance through the health insurance exchanges created by the Affordable Care Act. To enroll in Obamacare may or may not also mean to receive government help paying for health insurance such as the premium tax credit health insurance subsidy, since eligibility for subsidies depends on income.

Is Health Insurance Bought Through a Health Insurance Exchange Obamacare Insurance?

Kind of, but not exactly.

All of the health insurance policies sold through health insurance exchanges are policies sold by private insurance companies. For example, you could buy a health insurance policy from Kaiser, Anthem, Cigna, or Health Net depending on what health plan choices are available through your health insurance exchange. Since there is no health insurance company named Obamacare, you can’t really buy Obamacare health insurance like you can buy a Blue Cross health insurance policy.

However, all of the health insurance policies available through health insurance exchanges comply with the rules of health care reform found in the Affordable Care Act. For example, they all provide coverage for the 10 essential health benefits. This is also true of all individual major medical health insurance plans sold outside the exchanges too—as long as they became effective January 2014 or later, those are fully compliant with the Affordable Care Act as well.

In this sense, then, all of those private health insurance policies might be considered Obamacare insurance since they comply with the reforms of the Affordable Care Act, cover the 10 essential health benefits, and provide a certain minimum value. However, they’re technically not Obamacare insurance, they’re Kaiser, Molina, Ambetter, UnitedHealthCare, or whatever private health insurance company sold that particular health insurance policy.

When someone tells you they have Obamacare insurance, you can’t tell what kind of insurance they have without getting more information. You’re probably safe to assume that they have a health insurance policy that covers the 10 essential health benefits and complies with all of the requirements of the Affordable Care Act. They might have gotten their insurance policy through a health insurance exchange. Beyond that, you’ll need more information to know exactly what kind of health insurance they have.

And it's important to understand that the Affordable Care Act, aka Obamacare, also changed the rules for employer-sponsored health insurance, although the changes weren't as significant as they were in the individual market. The ACA also included the expansion of Medicaid, making millions of Americans newly-eligible for coverage. And the law even included some changes to Medicare, such as closing the donut hole and providing coverage for annual wellness visits. So although the term Obamacare is often used to describe individual market plans (and sometimes only those that are sold in the exchanges), the changes brought about by the law extend to nearly every part of the American health insurance system, and it's all under the umbrella of Obamacare.

Is There Health Insurance That Doesn’t Have to Follow Obamacare Rules?

Some health plans don’t have to follow all of the health care reform rules found in the Affordable Care Act. Short-term health insurance, supplemental health insurance, and grandfathered health plans are among them.

Grandfathered health plans are health plans or individual policies that were in existence when the Affordable Care Act became law on March 23, 2010. Although they have to follow some of the health care reform rules, grandfathered health plans don’t have to offer all of the protections found in newer health plans. For example, they don’t have to provide free preventive care or free birth control, and they can charge you more if you go to an emergency room that isn’t in their provider network. Grandfathered individual health insurance policies (the kind you get on your own, rather than through an employer) can still apply annual coverage limits, refusing to pay more once they’ve paid out a set maximum amount toward your health care expenses that year.

However, if a grandfathered plan makes too many changes, it will lose its grandfathered status and have to comply with all of the reform measures of the law. For example, if a grandfathered plan significantly increases its copay or coinsurance rates or deductible, it will lose grandfathered status. It will also lose grandfathered status if it cuts benefits.

Grandmothered health plans are also exempt from many of the Affordable Care Act's rules, although they will only be allowed to remain in force through the end of 2019. These are also known as transitional plans. There was no provision for them in the healthcare reform law, but they came into being when the government agreed to let them extend into 2014 in an effort to stem the furor over plan cancellations in late 2013. They have since been granted four additional extensions, allowing them to remain in force through 2019 if states and carriers agree to allow them to renew (the majority of states are still allowing them to renew). And additional extensions could be issued to allow these plans to remain in force past 2019.

Both grandmothered and grandfathered plans are no longer available for purchase. But if you still have one, you can keep it for as long as it's offered by your carrier. And if your employer has one, you can enroll in the coverage when you're eligible.

What If Someone Tries to Sell You Obamacare Insurance?

Be very careful if someone tries to sell you Obamacare insurance or sign you up for Obamacare. Although they could be using the term “enroll in Obamacare” loosely to mean “buy health insurance through your state’s health insurance exchange,” they might also be a con artist trying to sell you something that doesn’t exist.

If you want to enroll in Obamacare, you should contact your state’s health insurance exchange directly. There you’ll be able to choose from various different Affordable-Care-Act-compliant health plans sold by private health insurers in direct competition with each other (note that some areas of the country—particularly rural areas—only have one insurer offering plans in the exchange). You’ll know what you’re getting is a legitimate health insurance policy since the exchange vetted both the policy and the health insurance company selling it before allowing it to be listed on the exchange.

Your state’s health insurance exchange is also where you apply for help paying for health insurance. It’s the only place you can buy health insurance using government health insurance subsidies. There is only one official exchange in each state, so be wary of look-alike websites. Find out how to contact your state's health insurance exchange.

Still Confused About Exactly What Obamacare Means?

Even though you now know that Obamacare is just a catchy name for the health care reform rules of the Affordable Care Act, it can still be confusing when people use phrases like "enroll in Obamacare."

Because language changes over time and Obamacare is a relatively new word, the way we use the word is evolving along with health care reform measures. It will likely continue to change over the next few years, and we may find we have even more ways to answer the question, “What is Obamacare?” ten years from now.

In the meanwhile, if someone refers to Obamacare in a manner that doesn’t make sense to you, don’t be afraid to ask for clarification.

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