Affordable Health Care
- CAF helps people enroll in health plans that best meet their needs.
- CAF directs individuals to resources that may provide financial assistance.
- CAF helps individuals understand the complex requirements of health insurance plans.
- CAF provides a limited number of 'special assistance' grants to individuals facing financial hardship as a result of health care costs not covered by insurance.
Click on your state to go to www.healthcare.gov or your state exchange.
If you're among the nation's self-employed, you've got plenty of company. According to the Bureau of Labor Statistics, an estimated 14.4 million Americans are
self-employed in 2014.
Being self-employed comes with obvious benefits: the ability to dictate your own hours, the independence to chart your own course and - many report - increased job satisfaction.
But self-employment also comes with its own unique challenges, chief among them the lack of corporate benefits. And conspicuously absent: employer-sponsored health coverage.
The challenge of finding affordable coverage
In fact, historically, one of the biggest problems facing the self-employed has been getting access to affordable health insurance. Individuals who left the corporate world behind often found their first major challenge to be the extension of their health insurance coverage.
Some turned to COBRA for that temporary coverage, while others obtained coverage through a spouse's employer-sponsored plan. But that option isn't available to everyone - and can be prohibitively expensive - so many sought coverage on the individual market.
There, they faced the often daunting prospect of medical underwriting. If approved for coverage, they often encountered high premiums and out-of-pocket costs. But often, they faced something worse: denial of coverage due to a pre-existing medical condition.
In 2014, the health insurance environment is looking up for many self-employed Americans. As a result of the Affordable Care Act - often referred to as Obamacare - it will be possible for anyone who's self-employed to be approved for coverage. At the same time, financial assistance provisions built into the law are designed to make it affordable regardless of one's income.
Under the law's individual mandate, all Americans are required to haveminimal essential health coverage - or expect to pay a penalty to the Internal Revenue Service. (The penalty applies only to those who can afford health insurance but who decide to forego coverage.)
At the same time, the law includes provisions that prohibit insurers from charging applicants more for premiums because of pre-existing conditions or their gender.
With health reform's state and federal health insurance exchanges now operating, the self-employed have access to major medical insurance, available through four metal plans: Bronze, Silver, Gold and Platinum.
The hallmark of these plans is the requirement that each provide a collection of mandated 10 essential health benefits, ranging from emergency services to hospitalization, mental health services and a broad collection of preventive and wellness services.
At the same time, the plans allow applicants to choose coverage with a range of premiums and a corresponding range of out-of-pocket costs. And, with all
plans, policy holders can expect a maximum out-of-pocket amount for each calendar year.
Whether or not the minimum essential coverage mandated by the law will be affordable to all Americans remains to be seen, but the law did include significant provisions designed to make coverage affordable. To help moderate- and low-income individuals and families, the law includes both premium assistance subsidies and cost-sharing subsidies.
Premium assistance credits are available for those with incomes between 100 and 400 percent of the federal poverty level (FPL). Cost-sharing subsidies, meanwhile, are available to those with household incomes between 100 and 250 percent of FPL.