Oregon Affordable Care Act Comprehensive Guide
In this article, you will learn about the Affordable Care Act health care reform laws in Oregon. You will get an understanding of how the health care law impacts you as a citizen of the state. Learn how to sign-up for Affordable Care Act, learn about the Affordable Care Act penalty and subsidies, and much more.
What is Oregon Affordable Care Act?
Affordable Care Act, also know as Obama Care, was signed into law in March 2010. The goal of Affordable Care Act is to provide US citizens with affordable health insurance and to reduce the cost of health care spending for families and in America.
The Key Points of the Affordable Care Act / Oregon Obamacare:
- Improving Quality and Lowering Health Care Cost
- Access to Affordable Health Care
- New Consumer Protections
- Individual Mandate | Employer Mandate
- Minimum Essential Coverage for each Health Insurance Plans
How to Apply for Oregon Affordable Care Act?
Oregon Affordable Care Act marketplace is run by the Federal government. Click on HealthCare.gov to access Oregon Affordable Care Act Marketplace. You can preview the different insurance plans and see participating doctors before selecting the final health insurance plan.
|State||Federal or State Marketplace||Website||Medicaid Expansion?|
When can I apply for Oregon Affordable Care Act (Oregon ACA)?
Oregon Affordable Care Act’s Open Enrollment 2015-2016 starts on November 1, 2015, and ends on January 31, 2016. To have health insurance coverage beginning on January 2016, you must apply before December 15, 2015, deadline.
In order to qualify for Tax Credit or Premium Tax Subsidies, you must purchase health insurance from the Affordable Care Act Marketplace during Open Enrollment period.
If you qualify for Oregon Medicaid health insurance, then you can sign-up Medicaid anytime of the year.
When is the deadline for Oregon Affordable Care Act (OR ACA)?
Important dates for Oregon Affordable Care Act deadlines: The absolute last day to purchase health insurance from the Marketplace is January 31, 2016.
- December 15, 2015: Last day to enroll in or change plans for new coverage to start January 1, 2016
- January 1, 2016: 2016 coverage starts for those who enroll or change plans by December 15.
- January 15, 2016: Last day to enroll in or change plans for new coverage to start February 1, 2016
- January 31, 2016: 2016 Open Enrollment ends. Enrollments or changes between January 16 and January 31 take effect March 1, 2016.
How much is Oregon Affordable Care Act?
There are four different plans within the Oregon Affordable Care Act. The metal plans represent the various levels of coverage you receive and what the plan pays on average. The plan levels DO NOT represent the quality of the health coverage/doctors you receive.
- Bronze Plan: The plan pays 60% of the cost, you pay 40% of the cost
- Silver Plan: The plan pays 70% of the cost, you pay 30% of the cost
- Gold Plan: The plan pays 80% of the cost, you pay 20% of the cost
- Platinum Plan: The plan pays 90% of the cost, you pay 10% of the cost
The cost of Affordable Care Act in Oregon depends on the metal plan you choose and the number of people in the household. Platinum plans have the highest insurance premiums (monthly cost) and Bronze plans have the lowest insurance premiums.
|State||Year||Avg. Monthly Silver Plan (before Tax Credits)||US Average|
What are the Oregon Affordable Care Act Eligibility Requirements?
In order to get Oregon Affordable Care Act, you must meet the following requirements:
- Must live in Oregon
- Must be a US citizen, national, or lawfully present immigrant
- Cannot be currently incarcerated (be in jailed)
- Have a valid Social Security Number
- and few other requirements
Do I need to get Oregon Affordable Care Act?
Yes, every individual in Oregon needs to have health insurance. The Individual Mandate of Affordable Care Act health care law requires US Citizen to enroll in a health insurance plan or pay a penalty. If you have Medicaid or company sponsored health insurance, you have met the insurance coverage requirement.
You can choose not to have health insurance, but you have to pay the penalty in addition to the hospitals/doctors medical fee if you do get sick.
How much is Affordable Care Act Penalty in Oregon?
The penalty (or also called individual shared responsibility payment) is calculated in two ways.
For 2016 year, the ACA penalty is as follows:
- By percentage of income (2.5% of household income or maximum of National Average Bronze plan premium)
- By number of people in the household ($695 per adult, $347.50 per child or maximum $2085)
You’ll pay whichever penalty is higher.
How much are Oregon ACA Subsidies? What are the requirements?
Affordable Care Act Subsidies are also called, “Premium Tax Credits.”
ACA subsidy lowers your premium – the amount you pay each month to your insurance plan.The amount of your ACA Subsidy depends on the estimated household income that you put on your ACA Marketplace application.
In order to qualify for Affordable Care Act Subsidy, your income must be between 100% to 400% of the Federal Poverty Level.
|Federal Poverty Level||Insurance Premium After PTC Subsidy|
|Up to 133% FPL||2% of income|
|133-150% FPL||3%-4% of income|
|150-2000% FPL||4%-6.3% of income|
|200-250% FPL||6.3%-8.05% of income|
|250-300% FPL||8.05%-9.5% of income|
|300-400% FPL||9.5 of income|
|Over 400% FPL||No Government Subsidy|
Medicaid Expansion under the Affordable Care Act
With the new health care reform, the Federal government offered incentives for states to expand the Medicaid program. 30 states out of the 50 states plus Washington DC expanded Medicaid program while 20 states decided not to expand Medicaid due to expected future cut back funding from the Federal government.
Oregon expanded the Medicaid program under the Affordable Care Act Health Care Reform.
Insurance Companies that offer Affordable Care Act Health Insurance Plans in Oregon:
The following insurance companies are offering Affordable Care Act Plans in the Marketplace.
- ATRIO Health Plans
- BridgeSpan Health Company
- Health Net Health Plans of Oregon
- Health Republic Insurance Company
- Kaiser Foundation
- Health Plan of the Northwest
- LifeWise Health Plan of Oregon, Inc.
- Moda Health Plan, Inc.
- Oregon’s Health CO-OP (Community Care of Oregon)
- PacificSource Health Plans
- Providence Health Plan Trillium Community
- Health Plan Inc.
Frequently Asked Questions (FAQ) on Oregon Affordable Care Act:
- Who runs the Oregon Affordable Care Act? Federal
- Where can I sign up for Oregon Affordable Care Act? Click here
- Do I need to get health insurance or Affordable Care Act? Yes, if not, you have to pay a penalty.
- How much is Oregon Affordable Care Act? Click here for the average ACA premium
- Did Oregon expand Medicaid under Affordable Care Act? Yes
Click here for more Frequently Asked Questions on Obamacare / Affordable Care Act.
For more Information on Oregon Obamacare / Affordable Care Act:
Federal HealthCare.Gov Marketplace
Oregon Division of Insurance
350 Winter St NE
Salem, OR 97309-0405
If you have a hard time affording health coverage and you have questions about eligibility for Medicaid or about current Medicaid benefits, go to:
Oregon Department of Human Services
500 Summer Street NE
Salem, OR 91307-1079
Oregon five largest cities in terms of population: Portland, Eugene, Salem, Gresham, and Hillsboro. You can apply for Affordable Care Act Health Insurance in any city in Oregon.