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Understanding Obamacare: Some Options If Your Employer Provides Insurance Coverage

Mar. 12, 2014
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Question: What can I do if I don’t like the insurance I get through my employer?

Answer: The Affordable Care Act has the greatest benefit for those that purchase coverage either for themselves or for their employees, but if you are an employee who has access to work-sponsored health coverage, there are a few things to be aware of.

During the open enrollment period, which ends March 31, anyone can visit healthcare.gov to compare their options in coverage, even if you have employer-provided coverage. Historically, employer coverage has been much cheaper than buying a policy on your own because employers usually contribute a certain amount to offset an employee’s costs. With tax credits on the marketplace to make individual coverage more affordable there are many more options. However, if your employer offers coverage that meets at least the minimum value then you may not be able to access those tax credits for individual plans.

Why? Because the Affordable Care Act’s goal is to ensure every citizen has access to some form of health coverage, and is responsible with tax dollars by providing credits only to those who have no other options.

What is the minimum value in an employer plan? First, it must be affordable, meaning that coverage offered by an employer must be less than 9.5% of the employee’s annual income. It also needs to meet the minimum value—at least 60% of the total cost of medical services must be covered by the health plan. If neither of these criteria is met, you will find better and more affordable coverage on healthcare.gov.

But if your employer offers you coverage that is affordable and is of quality value then that might be your best bet. Employers now also have new options to offer health coverage, and people who leave a job, lose coverage or retire early have new health options to choose from, thanks to Obamacare.

—Kevin Kane, lead organizer, Citizen Action of Wisconsin

The Shepherd Express and Citizen Action of Wisconsin will answer questions about the Affordable Care Act during its implementation. Got a question? Email editor@shepex.com.


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