Chapter 4: The Affordable Care Act and Other Health Plans

51  Kaiser Family Foundation’s: “Featured Affordable Care Act Resources,” Kaiser Family Foundation, https://www.kff.org/tag/affordable-care-act/.

51  2020 ACA primer: “Explaining Health Care Reform: Questions About Health Insurance Subsidies,” Kaiser Family Foundation, January 16, 2020 https://www.kff.org/health-reform/issue-brief/explaining-health-care-reform-questions-about-health/.

51  certain circumstances: “Dates and deadlines for 2020 health insurance,” HealthCare.gov., U.S. Centers for Medicare & Medicaid Services, https://www.healthcare.gov/quick-guide/dates-and-deadlines/.

51  Preventive health services: “Preventive health services,” HealthCare.gov., U.S. Centers for Medicare & Medicaid Services, https://www.healthcare.gov/coverage/preventive-care-benefits/.

51  Coverage for pre-existing conditions: “Coverage for pre-existing conditions,” HealthCare.gov., U.S. Centers for Medicare & Medicaid Services, https://www.healthcare.gov/coverage/pre-existing-conditions/.

52  Dental coverage in the marketplace: “Dental Coverage in the Marketplace,” HealthCare.gov, U.S. Centers for Medicare & Medicaid Services, https://www.healthcare.gov/coverage/dental-coverage/.

52  Birth control benefits: “Birth Control Benefits,” HealthCare.gov, U.S. Centers for Medicare & Medicaid Services, https://www.healthcare.gov/coverage/birth-control-benefits/.

52  Breastfeeding benefits: “Breastfeeding Benefits,” HealthCare.gov, U.S. Centers for Medicare & Medicaid Services, https://www.healthcare.gov/coverage/breast-feeding-benefits/.

52  Mental health and substance abuse coverage: “Mental Health & Substance Abuse Coverage,” HealthCare.gov, U.S. Centers for Medicare & Medicaid Services, https://www.healthcare.gov/coverage/mental-health-substance-abuse-coverage/.

52  Emergency services: “Emergency Services,” HealthCare.gov, U.S. Centers for Medicare & Medicaid Services, https://www.healthcare.gov/using-marketplace-coverage/getting-emergency-care/.

52  Pregnancy, maternity, and newborn care: “Pregnancy, Maternity, and Newborn Care,” HealthCare.gov, U.S. Centers for Medicare & Medicaid Services, https://www.healthcare.gov/what-if-im-pregnant-or-plan-to-get-pregnant/.

52  Mental health and substance use disorder services: “Mental Health and Substance Use Disorder Services,” HealthCare.gov, U.S. Centers for Medicare & Medicaid Services, https://www.healthcare.gov/coverage/mental-health-substance-abuse-coverage/.

52  Preventive and wellness services: “Preventive and Wellness Services,” HealthCare.gov, U.S. Centers for Medicare & Medicaid Services, https://www.healthcare.gov/coverage/preventive-care-benefits/.

53  Federal Poverty Level guidelines: “HHS Poverty Guidelines for 2020,” U.S. Department of Health and Human Services, https://aspe.hhs.gov/poverty-guidelines.

53  a flowchart: “Premium Tax Credit Flow Chart: Are You Eligible?” IRS, https://www.irs.gov/affordable-care-act/individuals-and-families/premium-tax-credit-flowchart-are-you-eligible.

53  Publication 5187: “Affordable Care Act: What You and Your Family Need to Know,” Publication 5187, IRS, https://www.irs.gov/pub/irs-pdf/p5187.pdf.

53  Instructions for Form 8962: “Instructions for Form 8962,” IRS, https://www.irs.gov/pub/irs-pdf/i8962.pdf.

53  Form 8962: “Premium Tax Credit (PTC),” Form 8962, IRS, https://www.irs.gov/pub/irs-pdf/f8962.pdf.

53  summary page: “About Form 8962, Premium Tax Credit,” IRS, https://www.irs.gov/forms-pubs/about-form-8962.

54  ACA navigator: Find Local Help,” HealthCare.gov, U.S. Centers for Medicare & Medicaid Services, https://localhelp.healthcare.gov/#/.

54  ACA calculator: Health Insurance Marketplace Calculator, Kaiser Family Foundation, https://www.kff.org/interactive/subsidy-calculator/.

54  an online tool: Income levels and ACA savings, HealthCare.gov, U.S. Centers for Medicare & Medicaid Services, https://www.healthcare.gov/lower-costs/.

54  an online map: “Insurer Participation on ACA Marketplaces, 2014–2020,” Kaiser Family Foundation, https://www.kff.org/private-insurance/issue-brief/insurer-participation-on-aca-marketplaces-2014-2020/.

55  homeless: “How to Claim an Exemption if You Were Homeless,” HealthCare.gov, U.S. Centers for Medicare & Medicaid Services, https://www.healthcare.gov/exemptions-tool/#/results/2018/details/homeless.

55  eviction or foreclosure: “How to Claim an Exemption Because You Experienced Eviction or Foreclosure,” HealthCare.gov, U.S. Centers for Medicare & Medicaid Services, https://www.healthcare.gov/exemptions-tool/#/results/2018/details/eviction.

55  utility shut-off notice: “How to Claim an Exemption Due to a Utility Shut-off,” HealthCare.gov, U.S. Centers for Medicare & Medicaid Services, https://www.healthcare.gov/exemptions-tool/#/results/2018/details/utilities-shut-off.

55  domestic violence: “How to Claim an Exemption if You Experienced Domestic Violence,” HealthCare.gov, U.S. Centers for Medicare & Medicaid Services, https://www.healthcare.gov/exemptions-tool/#/results/2018/details/domestic-violence.

55  a death in the family: “How to Claim an Exemption Due to the Death of a Close Family Member,” HealthCare.gov, U.S. Centers for Medicare & Medicaid Services, https://www.healthcare.gov/exemptions-tool/#/results/2018/details/death-in-family.

55  a natural disaster: “How to Claim an Exemption Due to Fire, Flood, or Other Disaster,” HealthCare.gov, U.S. Centers for Medicare & Medicaid Services, https://www.healthcare.gov/exemptions-tool/#/results/2018/details/disaster.

55  bankruptcy: “How to Claim an Exemption if You Filed for Bankruptcy,” HealthCare.gov, U.S. Centers for Medicare & Medicaid Services, https://www.healthcare.gov/exemptions-tool/#/results/2018/details/bankruptcy.

55  medical expenses: “How to claim an exemption for unpaid medical expenses,” HealthCare.gov., U.S. Centers for Medicare & Medicaid Services, https://www.healthcare.gov/exemptions-tool/#/results/2018/details/owe-medical-expenses.

55  caregiver expenses: “How to claim an exemption due to increased expenses caring for a family member,” HealthCare.gov., U.S. Centers for Medicare & Medicaid Services, https://www.healthcare.gov/exemptions-tool/#/results/2018/details/care-for-family.

55  child medical support: “How to claim an exemption for a child who’s medically supported by another party and not eligible for Medicaid or CHIP,” HealthCare.gov., U.S. Centers for Medicare & Medicaid Services, https://www.healthcare.gov/exemptions-tool/#/results/2018/details/medicaid-chip-denied.

55  eligibility appeals: “How to claim an exemption if you were uncovered while waiting for a successful appeal.” HealthCare.gov., U.S. Centers for Medicare & Medicaid Services, https://www.healthcare.gov/exemptions-tool/#/results/2018/details/eligible-based-on-appeal.

55  ineligible for Medicaid: “How to claim an exemption if you would have qualified for Medicaid if your state had expanded coverage,” HealthCare.gov., U.S. Centers for Medicare & Medicaid Services, https://www.healthcare.gov/exemptions-tool/#/results/2018/details/secretary-hardship.

56  Healthcare,gov: “Out-of-pocket maximum/limit,” on ACA-covered health expenses,  HealthCare.gov., U.S. Centers for Medicare & Medicaid Services, https://www.healthcare.gov/glossary/out-of-pocket-maximum-limit/.

56  struck down: “Obamacare Insurance Mandate Is Struck Down by Federal Appeals Court.” New York Times, December 18, 2019, https://www.nytimes.com/2019/12/18/health/obamacare-mandate.html.

56  3 million people: “Short-term Plans Enrolled 3 Million People, House Committee Finds,” Modern Healthcare, June 26, 2020, https://www.modernhealthcare.com/insurance/short-term-plans-enrolled-3-million-people-house-committee-finds.

57  a guide: “The expansion of short-term limited-duration policies and implications for patients,” Milliman, https://milliman-cdn.azureedge.net/-/media/milliman/pdfs/articles/patient-implications-brief-20200224.ashx?

58  a million people: “New York State Investigates Christian Health Cost-Sharing Affiliate,” New York Times, January 8, 2020, https://www.nytimes.com/2020/01/08/health/christian-health-insurance-subpoena.html.

59  studies regularly find: “VA Health System Generally Delivers Higher-Quality Care Than Other Health Providers,” RAND Corporation, April 26, 2018, https://www.rand.org/news/press/2018/04/26.html.

59  Wounds of War: Suzanne Gordon, Wounds of War: How the VA Delivers Health, Healing, and Hope to the Nation’s Veterans (Ithaca, NY: Cornell University Press, 2018), https://www.amazon.com/Wounds-War-Delivers-Veterans-Politics-ebook/dp/B07BTCBP64/ref.

60  extensive survey: “2018 Survey of Veteran Enrollees’ Health and Use of Health Care,” Advanced Survey Design, January 9, 2019, https://www.va.gov/HEALTHPOLICYPLANNING/SOE2018/2018EnrolleeDataFindingsReport_9January2019Final508Compliant.pdf.

61  preferred generic drugs: “2020 Tier 1 Copay Medication List,” Veterans Health Administration, https://www.pbm.va.gov/PBM/Tiered_Copay/Tier_1_CO-PAY_MEDICATION_LIST.pdf.