Myth-Debunking: FAQ and Myths about the ACA and Obamacare

You have enough to worry about without having to wade through biased and inaccurate Media reports detailing the latest triumphs/disgraces of the ACA (a.k.a. “Obamacare”).  So, without bias or “doctoring” of facts, here’s what we’ve learned so far:


Q:  I thought this was called the AFFORDABLE Care Act—these new health plans cost more than my old plan!

A:  True—premiums are definitely higher now compared to policies from 2013 and earlier.
The “Affordable” part of this new system best relates to folks deemed “uninsurable” due to pre-existing conditions who were paying high premiums for plans with very high deductibles (for example, Texas Health Insurance Risk Pool policyholders).  In comparison, today’s ACA plans offer much better benefits and are generally more affordable.
“Affordable” can also refer to people who qualify for a Tax Credit (or “Subsidy”) to help lower their monthly premium to a more affordable amount.  This Tax Credit can only be used to buy plans offered “On-Exchange” (at and does involve a somewhat detailed application process.  More info on that here.


Q:  I don’t have coverage now (in 2014) and I don’t have a QLE for getting coverage in 2014.  Will I have to pay a penalty for not having health coverage?

A:  If you don’t have coverage right now because you either A) don’t want coverage for 2014 or B) missed Open Enrollment (which ended March 31, 2014) and don’t have a QLE to qualify you for 2014 coverage, you’ll probably have to pay a penalty for not having coverage this past year.
The penalty for 2014 is 1% of your annual household income (Minimum penalty: $95/Adult Individual, Maximum Penalty: the national average premium for a Bronze plan).  Several factors influence your 2014 penalty; please consult your tax preparer and for more information.


Myth:  Everyone has to buy Obamacare through the government—and it’s a nightmare.

Fact:  You can choose to not have coverage, but you’ll have to pay a penalty fee.  If you DO want coverage, you have two options:

  1. Get a plan directly from the Carrier (Aetna, Assurant, Blue Cross, Cigna, Humana, etc.), totally bypassing the Gov. Note:  You wouldn’t be able to use any eligible tax credit on this route.  This is quite honestly the easiest and most worry-free option.
  2. Get a plan through the Marketplace ( This is the route to take if you want to use any eligible tax credit to lower your monthly premiums.  The process can be challenging at times (it IS the US Government, after all!), but our Agency has experience navigating the Marketplace to help you avoid the hassle!

Myth:  I’ll save money by going through all on my own and NOT using an Agent.

Fact:  Prices are EXACTLY the same whether you go through an Agent or not.  In fact, YOU don’t even pay the Agent anything for his services—and the insurance companies do NOT charge you a cent more for using an Agent’s services.
So…why not skip the hassle and confusion?  For the exact same price, you’ll get personalized quotes and service throughout the application process and beyond!

Myth:  I can sign up on my own—and I don’t see why I’d need an Agent to help me after  I have my new coverage!

Fact:  It is to your advantage to work with an Agent; your Agent is your health insurance Advocate, helping you through the application process.
We have established relationships with all of the major medical carriers and know quite a few tips and tricks for getting your application submitted and issued as efficiently as possible.
Our services don’t end with your submitted application: should any claims, questions or issues arise in the future, your Agent is available to help you find resolution.

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