Obamacare Bronze Plan

by / Wednesday, 17 April 2013 / Published in Bronze Plan, Metal Plans

The Patient Protection and Affordable Care Act, commonly called Obamacare or the Affordable Care Act, represents the most significant government expansion and regulatory overhaul of the U.S. healthcare system since 1965. The main goal of The Patient Protection and Affordable Care Act is reducing the number of uninsured Americans and lowering the overall costs of health care. When the federal health insurance mandate goes into effect, most Americans will be required to get health insurance or face a penalty.


Market reforms in the Affordable Care Act seek to improve the quality and availability of affordable coverage. The law will eliminate underwriting, guarantee the availability of coverage, limit the extent of age rating, and require that all plans offered through the exchanges meet a uniform standard of essential health benefits at four levels of cost sharing. It also imposes a certain amount of standardization by mandating that each plan cover a set of benefits, known as Essential Health Benefits, and by establishing categories of actuarial equivalence among qualified health plans. The Affordable Care Act identifies a range of services that must be included in the benefits package and requires preventive services to be covered.


The four levels of cost sharing rests with their actuarial values which are bronze, silver, gold and platinum. These tiers are used to set the minimum amount of coverage many people must have to satisfy the requirement that they be insured or pay a federal tax penalty beginning in 2014. All plans will cover certain essential health benefits determined by the U.S. Department of Health and Human Services. These requirements apply to all tiers of health insurance coverage, meaning that differences in the levels of coverage will reflect variation in cost-sharing, not differences in the underlying benefits. For example, someone who gets a bronze plan would have to pay 40 percent of health care costs, while the plan covers 60 percent. Most Americans will be required to get at least a bronze level plan unless they’re eligible for a religious or hardship exemption. The higher the actuarial value, the less patient cost sharing the plan will have on average. Under the law, the penalty for not buying health insurance is supposed to be capped at either the annual average Bronze premium, 2.5 percent of taxable income, or $2,085.00 per family in 2016.


Consumers anticipate some health care needs when choosing a plan, but many health care expenses are not predictable and some consumers are drawn to low cost-sharing plans because they prefer to minimize risk. Even when provided with information about the plans and their premiums, it can be hard for people to choose a plan that best meets their expected medical needs. Faced with this uncertainty, actuarial value presents a useful estimate of the expected percentage of health care expense that will be paid by a plan for people in a standard population. In a similar fashion, the Affordable Care Act requires exchanges to provide detailed plan information beyond actuarial values. This brings the unknown and unpredictable into real-life applications of health insurance and likely medical needs, this is just one of the ways that health care reform plans on helping residents of the United States make the best possible choice for themselves and their families.

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