Obamacare has not been high on my priority list even though it should be, because like many middle class Americans it’s going to change the way I buy and use health care.   I’d almost apologize for not understanding all the rules, but clearly *nobody* knows what’s up with the new system and equally clearly most of the comments and analyses from both sides are biased junk.    Here I’m going to try to post the few actual facts about the system as I learn them – though I’m also thinking of starting a website for this purpose.

ObamaCare “Individual mandate”.    This key part of ObamaCare will affect about 40 million Americans.   Not clear how it will affect those insured through their work, though most seem to think “not much”.   The Individual Mandate was upheld yesterday by the Supreme Court,  says that you need to buy health insurance or pay a fine.   The fine will start small and INCREASE annually.  At first the fine is small enough that healthy families like mine, who have used catastrophic high deductible insurance for decades.  [FYI America I think this was the solution to the health care crisis and we missed it – the Government should be providing high deductible catastrophic to everybody.  Routine health services should be subsidized to the degree people don’t skip them, but much of our care should be funded out of our own pockets, leading to competition and cost savings we’ve seen in, for example, the elective surgery sector.]

From what I know as of today families like mine may actually do better to pay the penalty and continue to “self insure” for most health costs.

What are the penalties for not obtaining health insurance from Obamacare?
2014:  $95  or 1% of your income, whichever is higher.
2015:  $325  or 2% of income.
Families 2014:  $285 per household or 1% of income, whichever is greater.
Families 2016  $2,085 per family or 2.5% of income.

More preventive care services will be covered:  mammograms, physical exams, colonoscopies and vaccinations will be fully covered by insurance companies.

Small Company Obamacare issues:
For companies with less than 50 employees the workers must obtain insurance themselves.   Companies with 50 or more full-time employees must start providing health insurance for all workers by 2014 or face penalties.

Entrepreneurs (I’m assuming this means most “sole proprietor” folks and very small businesses) will be able to use new entities (not yet formed) called “state exchanges” to buy health insurance.  These single business people will get a tax credit if annual individual income falls between 100% and 400% of the poverty line, which this year translates to $11,170 and $44,680.    The exchanges, in theory, will offer rates competitive with large group rates.   That said, in my experience large group rates and plans are often no better than individual plans, so I’m not convinced the exchanges will offer much in the way of advantages and may simply become another bureaucratic layer in the system.

Medicare and Medicaid:    It appears to me that folks covered by these programs will remain largely directly unaffected by ObamaCare, though clearly the new system will probably create changes in the way hospitals and doctors allocate resources, time, and innovation.

Stay tuned for more as we all figure this out together!