Other Exemptions & Opt-Out Options

Regardless of what you or I think about it, the U.S. Patient Protection and Affordable Care Act (ACA) known as Obamacare requires everyone to purchase an ACA-compliant health insurance policy or pay a penalty-tax unless you qualify for an exemption.

Chapter 2 :: SNEAK PEEK

Are You Exempt? Should You Opt-Out?

One of the most substantial Obamacare exemptions is for people who enroll in one of the Christian Health Care Sharing Ministries as discussed in the previous chapter.

The official Obamacare website publishes a list of exemptions here: Healthcare.gov/exemptions

You may notice that some media sources and even insurance sources omit Health Care Sharing Ministries from their reports.

For example, Kaiser (usually an excellent resource for reliable information) publishes a flowchart which lists six exemptions. Notably absent from that list (as of Nov. 2013) are members of Health Care Sharing Ministries. Other than that, their report is helpful. See their chart here: The Requirement to Buy Coverage Under the Affordable Care Act.

Conclusion: There's a lot of misinformation floating around out there, even from reputable sources. Remember the phrase, "buyer beware?" It's true.

That's one reason why I wrote THE Obamacare Guide - Christians are EXEMPT along with this website.

Health care for you and your family is important. As a minister of the gospel of Jesus Christ I have to say your spiritual care and welfare is most important, but access to good health care coverage is very important - whether it's through a Christian Health Care Sharing Ministry, a health insurance policy or Medi-Cal/Medicare.

Life is uncertain. One of my jobs is to help bring:
  • more certainty to your life in the areas of spiritual care and health care;
  • more truth & accurate information about the current state of affairs with Obamacare and all your health care options;
  • more practical solutions and answers about Obamacare so you can make informed decisions and be a good steward for yourself, your family, your work/ministry and of the time and resources God has entrusted to you.
In summary, Healthcare.gov/exemptions clarifies that you may be EXEMPT from the Mandate to purchase a health insurance product and EXEMPT from the Penalty-Tax if you meet one of the following requirements:
  • You are uninsured for less than three months of the year
  • You live illegally in the United States
  • You’re incarcerated, and not awaiting disposition
    • Note: You must be convicted, sentenced and serving time
  • You’re a member of a recognized Indian tribe
    • Note: You must have an American Indian reservation number
  • Your income is officially deemed too low
    • Note: However, you may qualify for Medi-Cal (Medicare outside CA)
  • The lowest-priced coverage would cost more than 8% of your household income
    • Note: However, you may qualify for Medi-Cal (Medicare outside CA)
  • You’re a member of a recognized religious sect with religious objections to insurance, including Social Security and Medicare
    • Note: You must also file IRS form 4029 waiving any and all eligibility for receiving Social Security and Medicare benefits.
  • You’re a member of one of the three federally-recognized Health Care Sharing Ministries
    • Note: This is what I'm talking about!
In adition to the above-referenced "standard" exemptions there are also "hardship" exemptions. You can see the official list at Healthcare.gov/exemptions.

The Opt-Opt Option -- Just Pay the Penalty-Tax

The Obamacare Mandate forces people to
  • buy an ACA-compliant insurance policy or
  • pay a Penalty-Tax,
  • unless you qualify for an exemption.
The Opt-Out Option is perfectly allowable. If you don't qualify for an exemption you can simply forego buying health insurance and let the IRS deduct a Penalty-Tax from your tax refund or your bank account (or levy you or arrest you if you don't pay).

The Penalty-Tax begins at 1% of your income in 2014; 2% in 2015; 2.5% in 2016; and there are maximum dollar amounts set for those years.

What are the Penalty-Taxes in the years following 2016? It will continue at the 2016 rate of 2.5% or higher and with no more maximum limit. Let's face it, we're talking about government with the power to raise taxes, so no one really knows how high it could go.

Obamacare represents the largest tax-increase in history, government control over one-sixth of the American economy, and government control over what health insurance products you can and cannot buy.

Due to the failure of Obamacare to successfully begin enrollments on Oct. 1, 2013 -- and with the mandatory aspects of purchasing a health insurance policy or pay a Penalty-Tax scheduled to take effect on January 1, 2014 (though I'm fairly certain that date will be extended - and the dynamic version of the ebook will let you know about such changes as they happen) -- there is current and continuing "negotiation" about
  • WHEN the Penalty-Taxes will take effect,
  • WHEN people will be required to enroll in an Obamacare insurance policy (including individuals, families and small businesses), and
  • IF people will be able to keep their "old" policies (including individuals, families and small businesses).
  • I expect numerous changes, updates and challenges over time as Obamacare continues to unfold.
  • One of the benefits of ordering the free Obamacare Guide is I will keep you informed about future changes, updates and challenges facing Obamacare and affecting you.
For example, here are a few areas where changes, updates or challenges may be reasonably expected.

1. Advantage to Wait. Currently, a young person (anyone really) who doesn't qualify for an exemption can
  • opt-out and just pay the penalty-tax.
  • Then, if they ever need insurance they can simply buy it when they need it,
  • so they will be covered when the time comes that they have a need for insurance,
    • because they cannot be declined for pre-existing conditions.
2. Incentive to opt-out Many will simply pay the penalty-tax because purchasing one of the Obamacare-Mandated health insurance policies is expensive, especially to a young person or anyone who is currently struggling to make ends meet.

3. Marriage Penalty. Married couples under Obamacare are far less likely to qualify for tax-payer subsidies because their combined incomes can easily push them over the qualifying limits. The incomes of single people are not combined so it is far easier for a single person to qualify for tax-payer subsidies.

For all intents and purposes, this is a marriage penalty (whether intended or not).

An Insider's Perspective

As a health insurance broker I have access to virtually all California insurance plans and rates. So far I haven't seen a single case where any Obamacare plan is less expensive, has a lower deductible or a lower co-payment than comparable pre-Obamacare health insurance plans.

The fact of the matter is that compared to comparable pre-Obamacare health insurace plans, virtually all Obamacare plans are more expensive, with higher premiums, higher deductibles and higher co-pays.

The "Affordable" Care Act is proving to be unaffordable for many if not most Americans. Obamacare proponents tend to ignore the ugly side of Obamacare. They may have "hoped" that Obamacare would be affordable but the only cases I know of where people are paying less are cases where they qualify for tax-payer subsidies -- where our tax-dollars are bailing them out.

The current government argues that tax-payer subsidies keep the premium costs lower for people who qualify for the subsidies.

The REAL cost of your insurance plan is: What will you pay when your subsidy goes away? What it will cost you after the tax-payer subsidies are phased out?

You may qualify for a subsidy today, but what about next year, or next month? And how much will the subsidy be next year, and the year after that - or will there even be a subsidy program in the future?

There are no guarantees with tax-payer subsidies. Yet that's how the government is selling it, to make it appear affordable when it really isn't.

So, why not Opt-Out if you're relatively healthy, don't qualify for an exemption and can't afford to pay the higher premiums?

I'm not saying you should opt-out if you don't qualify for an exemption. But I did say I would present you with all your options.

Affordable Health Care

Unlimited Doctor Consultations Nationwide 24/7 AND additional benefits (for a flat rate of 50 cents a day or LESS per person). Next...

    Chapter Selection :: Understand All Your Options
    Introduction: THE Obamacare Guide is not like any other book on Obamacare

  1. Christian HealthShare for individuals, families, self-employed, churches & minstries

  2. Other Exemptions and opt-out options

  3. Doctor Consultation Nationwide 24/7 (by phone, video stream and email) for everyone

  4. Anciliary Healthcare Benefits (dental, vision, chiropractic, pharmacy, etc.) for everyone

  5. Private Healthcare Exchanges for individuals, families, self-employed & businesses

  6. Government Healthcare Exchanges for individuals, families & small business (SHOP)

  7. Medi-Cal - Medicare for qualified individuals

  8. Guidance to help you decide which choice is best for your and your family's needs

  9. Appendix A - Resources to help you with things that my book & website do not cover

  10. Appendix B - More Resources if you need group coverage for business, church or ministry

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