Who Qualifies for Obamacare

The long and short of it is that all Americans qualify for ObamaCare, with a few exceptions. Whether you’re young or old, rich or poor, single, married or in a domestic partnership, you’re eligible to take advantage of the Affordable Care Act (ACA) and enjoy the benefits it offers. Through it, everyone — including the 15 percent of Americans who currently don’t have health insurance — will have access to affordable and high-quality healthcare and ensure their medical needs will be meet.

To further expound on this concept, let’s take a look at how ObamaCare provides health coverage to the Americans according to the following demographic factors.


Previously, many older adults weren’t able to get the healthcare services they need simply because it was too expensive for them. But this is no longer the case since ObamaCare strives to improve coverage for seniors and ensure they get the medical assistance they deserve. Specifically, the Affordable Care Act does this by making some necessary changes to Medicare to cut wasteful spending, minimize seniors’ out-of-pocket expenses on their prescriptions and give them access to preventive care and wellness visits.

But here’s what older adults should know: if they have Medicare, they don’t need to get an ObamaCare marketplace insurance plan on top of it. In fact, it’s against the law to buy marketplace insurance if they already have Medicare. Those who are over 65 and don’t have Medicare or employer-based coverage are the only ones who can get ObamaCare.

Of course, seniors aren’t the only ones who’ll enjoy the benefits of the ACA since younger people can take advantage of it, too. This comes from the fact that the Act allows young adults to stay on their parents’ health insurance until they reach 26 years old — whether they’re still studying and/or living at home or have become independent and gotten married. This can be greatly helpful for young professionals who are living on a limited income while striving to repay their student loans, save for their future and attain financial stability.


One of the great things about ObamaCare is that it helps in minimizing gender discrimination in terms of healthcare services. This comes from the fact that, with the Affordable Care Act, insurance providers can no longer charge women higher fees simply because they’re female. This is a huge improvement: before the ACA came around, women were paying around $1 billion more than men annually for identical health cover plans.

The Act also brings many improvements to women’s health services, giving them access to new screenings and preventive treatments without any charge. Medicare, for example, have provided millions of free mammograms, while more than 45 million women can now get mammograms without any co-pay. Breast cancer survivors, who were previously charged higher premiums or even denied coverage because of their pre-existing condition, can now enjoy excellent healthcare services without any discrimination. Pregnant women can get screened for gestational diabetes, while victims of domestic violence have access to counseling services.

Health Status

It has become normal for insurance providers to insist on higher fees for those who suffer from health problems and those who are at risk of developing illnesses. Fortunately, ObamaCare has put a stop to this practice. Now, people who have pre-existing conditions, have made several claims in the past and are working in an occupation that’s considered to be dangerous will no longer be charged more for their health cover. Insurance companies will also not be able to remove people from their coverage when they get sick. As a result, everyone can get the medical services they deserve, whether they rarely fall ill or have suffered from health issues for a long time.

It’s important to note that ObamaCare does allow insurance providers to vary their premiums based on several factors. These include geographical location, family size and tobacco consumption.

Employment / Socioeconomic Status

The Affordable Care Act has ensured that people, especially those who aren’t earning much, will have access to healthcare services they need and won’t postpone medical treatment just because they don’t have enough money. It has also paved the way for millions of employees to get enough health cover from their place of work. Large-scale employers, for instance, are required by the government to offer health insurance to their full-time workers by 2016, ensuring their staff will never go without any financial protection against illnesses and injuries.

One good thing about ObamaCare is that it provides financial assistance both to individuals and small business owners. For example, those who make less than 400 percent of the federal poverty level can receive subsidies for lower premiums in the form of tax credits, which are offered on the ObamaCare online health insurance marketplace. Those who make less than 200 percent of the federal poverty level can receive assistance for their out-of-pocket health insurance costs — as long as they buy their plan from the marketplace.

Small business owners can also enjoy similar benefits. Businesses who have less than 25 full-time employees who earn less than $25,000 annually can get subsidies on health insurance. Entrepreneurs who earn less than $250,000 per year are exempt from almost all the taxes that the Affordable Care Act Levies, as long as they provide health cover to their employees.

Who Is Not Covered by Obamacare?

As you can see above, almost every American is eligible to be covered by ObamaCare. But, as mentioned earlier, there are a few exemptions to the rule. The following people cannot be covered by the Affordable Care Act:

Illegal Immigrants: They’re exempted from the health insurance mandate, but they’re not eligible for Medicaid and insurance subsidies. However, they can still take advantage of emergency healthcare services.

  • U.S. citizens who have not enrolled in Medicaid even though they were eligible for it.
  • U.S. citizens whose insurance payments would cost more than eight percent of their overall household income.
  • U.S. citizens who are not otherwise covered and who opt to pay the annual penalty fee instead of buying health insurance.


The Affordable Care Act is one of the most revolutionary things that has ever happened to American healthcare. Those who are eligible for it should take advantage of the opportunity to get health cover and be financially ready for any medical challenge that may happen to them or their family.

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