http://AIADirectQuote.com How ObamaCare Health Insurance Subsidies Will Work. Heather Loughlin is seen on Monday, May 9, 2011 in Montpelier, Vt. Loughlin was working as a vice president at the Sugarbush ski resort when she was diagnosed with multiple sclerosis. Before long, she found herself no longer able to work and buying insurance with a subsidy from the state under a current program but with a private insurer. (Toby Talbot/AP Photo) Beginning in 2014, enormous insurance premium subsidies and payment supports will be available under the Affordable Care Act (ACA) to millions of lower-income individuals and families. While Obamacare could always be overturned before then, the law has been upheld as constitutional by the U.S. Supreme Court. And short of historic landslide victories in this November's elections by the law's largely Republican opponents, changing major aspects of it will be difficult.

1. How Obamacare Health
Insurance Subsidies Will
Work

2. Beginning in
2014, enormous
insurance premium
subsidiesand payment supports will be
available under the Affordable
Care Act (ACA) to millions of
lower-income individuals and
families.
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3. While Obamacare could always be
overturned before then, the law has
been upheld as constitutional by the
U.S. Supreme Court. And short of
historic landslide victories in this
November's elections by the law's
largely Republican
opponents, changing major aspects
of it will be difficult.

4. U.S. News spoke to officials in the
U.S. Departments of Health and
Human Services and Treasury,
which have primary oversight of ACA
tax and subsidy benefits. They are
producing a growing mountain of
rules to implement the law. Beyond
ideological and financial
disputes, the ACA is also an
extraordinarily extensive and

5. The law's consumer subsidies --
premium tax credits and help with
out-of-pocket health expenses -- will
be available to people who cannot
meet its individual mandate to have
health insurance, meaning they are
unable to find affordable coverage
from employers or other private
insurance plans.

6. The law's consumer subsidies --
premium tax credits and help with
out-of-pocket health expenses -- will
be available to people who cannot
meet its individual mandate to have
health insurance, meaning they are
unable to find affordable coverage
from employers or other private
insurance plans.

7. Instead, they will turn to the new
state insurance exchanges that are
scheduled to be created next year.
The law says states can create their
own exchanges or let the federal
government do it for them. Many
states, mostly those with Republican
governors, are holding off on this
decision until after the elections.
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8. Eligibility for supports will be
determined by the relationship of
individual or family gross income
levels to the national federal poverty
level (FPL). In 2012, the FPL is $11,170
for a one-person household and rises
by $3,960 for each additional family
member. For a four-person family, for
example, the 2012 FPL is $23,050. It
increases each year due to inflation
so will be a bit higher in 2014.

9. Higher health taxes have
gotten much of the attention
in the debate over health
reform. But the law also
includes two types of extensive
financial help for lower-
income Americans.

10. Under the ACA, individuals and
families with incomes from 100 to
400 percent of the FLP will qualify for
tax credits to reduce the premiums
for health insurance purchased
through the exchanges. In
addition, incomes from 100 to 250
percent of the FPL also will qualify
for help in paying out-of-pocket costs
for the co-pays and deductibles not
covered by their health insurance.

11. Both assistance
programs are tied to the
development of
standardized healthcare policies.
Modeled after the Massachusetts
health reform law, these policies
will be offered in four tiers --
bronze, silver, gold, and
platinum.

12. To qualify for a tier, the private
insurance companies developing
these plans must promise they will
cover specified percentages of the
typical healthcare expenses for
people covered by the plan. These
"actuarial value" thresholds are 60
percent for bronze plans, 70 percent
for silver, 80 percent for gold, and 90
percent for platinum.

13. The silver plans have a special role in
the tax credits and payment
subsidies. In a state insurance
exchange, the second cheapest silver
plan will become the benchmark for
tax credits. (Using the cheapest plan
might have led to insurers trying to
game the system.) Because
healthcare costs differ around the
country, this benchmark premium
will not be the same in every state.

14. However, the percentages of this
premium that can be received as
health insurance tax credits will be
the same. They are based on a sliding
scale of FPL percentages. People and
families earning 133 percent of
FPL, for example, will have to pay
only 2 percent of their income toward
the health insurance premium.
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15. They will receive the difference as
a tax credit. The payment limit for
those at 400 percent of FPL is
much higher -- 9.5 percent of their
income -- so their tax credit will
be smaller.

16. Here's the list of FPL percentages and
sliding scales of income that people
must pay toward their health
insurance premiums:
•Up to 133 percent of FPL: Payments
are 2 percent of income.
•133 percent up to 150 percent of FPL:
Payments begin at 3.0 and rise to 4.0
percent of income.

17. •150 percent to 200 percent of FPL:
Payments begin at 4.0 percent and
rise to 6.3 percent of income.
•200 percent to 250 percent of FPL:
Payments begin at 6.3 percent and
rise to 8.05 percent of income.
•250 percent to 300 percent of FPL:
Payments begin at 8.05 percent and
rise to 9.5 percent if income.
•300 percent to 400 percent of FPL:
Payments are 9.5 percent of income.

18. Your guide to the Affordable Care Act.
• Why do you need health
insurance?
• Where will you get health
insurance in 2014?
• Mistakes to avoid when buying
health insurance

19. •How to get the most for your health
insurance dollar
• How the health insurance
mandate penalty will work
• Should I pay the Obamacare tax
penalty?
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20. “Are You
Confused Yet
About Obamacare
And What Impact
It Will Have On

21. We cannot predict the outcome of
any future legislation or litigation
related to Healthcare Reform. As
described under “Item 1. Business—
Health Insurance Industry and
Market Opportunity,” we expect
Healthcare Reform to result in
profound changes to the individual
health insurance market and our
business.

22. Get a FREE quote on your health
insurance at:
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23. www.AIADirectQuote.com

24. “Remember It Is Not
What You Know, But
What You Do With
What You Know!”
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