Obamacare or Affordable Care Act, which is intended to bring about a wave of reform in the American health care system, has broadly slotted categories for health insurance coverage. 50% of Americans will receive health insurance from their jobs. The ones who are already receiving health insurance will continue to do so with a host of additional benefits. These added benefits will be over and above the existing benefits of preventive care, hospital visits, doctor visits, maternity healthcare and prescription drugs.

For businesses employing more than 50 employees, it will be mandatory to provide health insurance to their employees. This will result in more people receiving health insurance from their jobs. If organisations with more than 50 employees are reported to not having bought insurance cover for its employees, then a penalty will have to be paid by them.This leaves small businesses that employ less than 50 employees with a choice to provide health insurance or not.

Most of these businesses have decided in favour of providing health insurance to their employees.Why?

Well, because it is an important growth tool! Firstly, it is an important means for recruitment and secondly, it is done with the view of retaining their top talent with better benefits. With the view to aid small business owners in providing healthcare for their employees, the government set up a program for employers. They opened up a health insurance option for small business owners – SHOP (Small Business Health Options Program) marketplace.

SHOP marketplace uses the Affordable Care Act (ACA) to provide employers with a special market place that grants benefits to small business owners for providing healthcare to their employees. These benefits may come in the form of, temporary tax breaks, etc.Furthermore, if employees of the small business have pre-existing illnesses or are sick at the time of enrolment, insurers cannot charge them any extra money.

So, what is the problem with SHOP?

Well, the one pressing issues with the SHOP marketplace is that only one coverage option is provided in 18 out of 32 states. This means lesser people are covered with the specific covers that they require. This beats the purpose of having SHOP then, because most people would still be exposed to most of the illnesses that they were trying to seek insurance for.

What’s more? The tax credit system that is intended to help applicants pay for the insurance has been reported to be difficult to navigate through.

So, that leaves such employees with only one option? The current group health insurance plans?

These group plans have higher premiums than individual plans! For, example, an average group insurance premium comes to about $6,000/ year for individual and approximately $16,000/ year for families. On the other hand, individual plans have premiums post subsidies, amounting to an average of $984/ year.

The solution? Well, Obamacare, of course!

ACA offers a third category of benefits to those seeking insurance. Businesses with less than 50 employees can now just give employees a hike in pay instead of buying them health insurance.

Why?

The employees can then go to the health insurance marketplace, which are set up by the local governments. In states where local governments don’t set them up, the Federal government will set them up.So, Americans won’t really notice the difference and this service will be accessible to everyone, equally.

What are the benefits offered in the health insurance marketplace?

Health insurance marketplace is like a mega mall of health insurance options, which has various private insurers competing for each person looking for health insurance! That gives the applicant, that is, YOU, the advantage!

You get to choose-

What kind of plan you want
What you want the plan to cover
And how much you are willing to pay for insurance!
People seeking insurance get to take their pick from a variety of plans options, namely, Bronze, Silver, Gold or Platinum depending on their specific preferences.

What are the perks of this health insurance marketplace?

Everyone is eligible for health insurance
Insurers cannot deny anyone health insurance
Men and women pay equally
Old people pay lesser than young people
Children can feature under their parent's plan up to the age of 26 years
No full premium rules
No extra charges for pre-existing illnesses
No extra charges for persons who are sick at the time of enrolment

So what is the catch? Why buy insurance now, if it can be bought later when illness kicks in?

Well, there is a short enrolment period and these plans can be bought only at that time. Added to that, the government will levy fines on individuals who do not have health insurance!

To combat all of these downsides, Obamacare offers individuals with the freedom to choose their own insurance plan that is tailor made to suit their specific needs.Moreover, caps on how much the insured pay out of their pockets have been brought in and caps on how much the insurers have to cover in case of long term care, etc. have been removed.

That means the insured pays LESSER now and the insurer pays MORE!