Why Obama persuaded Trump to leave Obamacare: what you need to know about this program

45 million Americans do not have insurance. Photo: depositphoto

In an interview with the Wall Street Journal, the elected President of the United States, Donald Trump рассказалthat it is quite possible that Obamacare will continue. The program can be adjusted or replaced with a similar one, but the essence itself will probably remain. Trump admitted that Barack Obama persistently asked him about this. Obamacare, affordable health insurance for Americans, has become a key plank of Trump's election campaign. And now it turns out that not everything has been finally decided.

We decided to collect all the information about the Obamacare program and understand why the health insurance system has become a hot topic in American politics.

Why do I need medical insurance

Insurance in America is based on the principle: while you are healthy, you pay insurance, when you fall ill - the insurance company with which the contract is made, pays for you.

One of the chapters of the Affordable Care Act (or “Obamacare”, as it is called by the people) says that every legal US resident is obliged to have medical insurance. Legal residents are US citizens, green card holders, refugees, people who have been granted asylum, as well as those who are in the US on a work or student visa.

Ways to get insurance

1. Get insurance at the expense of the state. Program Medicaid accessible for people with disabilities and low-income people, as well as for people older than 65 years (after 65 years, government-subsidized insurance Medicare).
2. Take out insurance with partial state assistance. This opportunity is available to low-income residents who are not covered by insurance by the employer.
3. Get insurance with the full or partial support of the employer.
4. If you are working and your employer does not pay for part or all of your insurance, you must purchase it yourself by choosing the best plan.

Employer's health insurance

In the US, many employers provide health insurance. Just keep in mind that there are nuances here: the employer is not always ready to pay your insurance premiums in full. You still have to pay for insurance, but cheaper than if you buy it yourself - part of the cost will still be covered by the company-employer. Specify whether the employer is not planning to deduct your part of insurance premiums from your salary. If the employer’s insurance plan does not suit you, you can apply for insurance yourself.

Programs for the needy

Since in some states the federal insurance program is allowed to supplement or change, offers in different parts of the United States may vary.

For example, in California created a state program Covered CA - An analogue of the federal insurance program. After processing the data about you, the system determines what insurance coverage you are entitled to. Medi-Cal is free coverage for low-income people in California, with an income of just over $ 16 000 per year. In other states, it has a different name.

And low-income residents of New York who do not qualify for free insurance offer a new program for 2016 year. Essential Plan. This is a government program with minimal monthly payments - only $ 20. For families with incomes below 138% federal poverty level, the program is free. A person who has an Essential Plan can afford regular check-ups, visits to a specialist, and payment for prescription drugs.

Poverty rate: 138% federal poverty level in 2016 is $ 16 242 per year per person, $ 21 983 is for a family of 2 people, $ 27 724 is for a family of 3 people, $ 33 465 is for a family of 4 people and etc.

Insurance covers help in the hospital. Photo: depositphoto

What are the types of insurance?

There are several types of insurance. The type of doctors and hospitals you will be able to use will depend on which type you choose.

1. HMO (Health Maintenance Organization): You can visit those health facilities that have a contract with the HMO (this does not apply to emergency care). You can contact specialists only in the direction from your therapist. Plus HMO - in low insurance premiums.
2. EPO (Exclusive Provider Organization) differs from HMO by higher fees, as well as by the ability to contact specialists without a referral. You will only have to visit those hospitals that have entered into a contract with the EPO (this does not apply to emergency care).
3. PPO (Preferred Provider Organization) - the plan with the highest cost of insurance, but also with the most extensive capabilities. You can be treated in any institution, with any doctors. If the doctor also entered into an agreement with PPO, then you will be offered more favorable conditions. PPO also does not require referral to specialists. PPO has the widest network of doctors.
4. POS (Point of Service Plan) puts the following condition: you can go to specialists only with the direction of the therapist, but this specialist can receive outside the network.

Depending on the size of the percentage of coverage of medical expenses, many insurance plans are divided into several major ones:

Bronze (insurance company pays up to 60%),

silver (insurance company pays up to 70%),

gold (insurance company pays up to 80%),

platinum (insurance company pays up to 90%).

Depending on the level of the plan, the cost of insurance rises and the amount you have to pay for medical services, a visit to a doctor or medication decreases.

Penalty for lack of insurance

There is a penalty for the lack of insurance In 2016, the penalty is up to $ 695 per person or 2,5% of taxable income (depending on which number is greater). They will exempt from the tax penalty if it exceeds 8% of annual income. In addition, the size of the fine today can not exceed the cost of the cheapest insurance plan that is offered in your state.

Is it possible to get medical care without insurance

ForumDaily already писал that 45 million Americans live without any insurance at all and only pay a fine; another 20 million have minimal insurance. How to get medical services in this case - read in our mother.

Government spending

According to Time money, in 2016, Obamacare cost a budget of US $ 110 billion, and a 10-year plan costs $ 1,3 trillion.

Read also on ForumDaily:

Medical insurance in the USA: how to start a choice

How to avoid a fine if there is no health insurance

The cost of medicine in the United States over 15 years has tripled

In the United States began to calculate those who cheat with medical insurance

Who can get Medicare and Medicaid

How to reduce the bill for treatment in an American hospital

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