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(Partner Article) The American Health Act, otherwise known as Patient Protection Care Act (PPACA) or Obamacare was promulgated after many twists in the US in March 2010 for an application to the 1st January 2014.

Since that date, all US residents, regardless of their nationality, must be insured by an insurance policy approved by the US Government and meeting certain criteria. Failing this, a tax penalty is applied. The purpose of this law was that health coverage be improved and more affordable for all Americans. However, this reform was never unanimous, and the recent elections brought to power a government that made the repeal of the law a priority. The point with the insurer for expatriates Azurexpat.

Update on Obamacare

For the moment, attempts to replace the system have failed. Obamacare remains in place. This means that all US residents, including expatriates, must be covered by health insurance. ACA compliant ", Meeting criteria of" Minimum Essential Coverage "(MEC). Among these many criteria of approval, there are several significant advances such as the management of maternity and newborn care, outpatient services, prevention, pediatric services, hospitalizations … This care must be able to be supported by the insurer without limit of amount. One of the major changes is also taking care of insured persons of the same age group at the same rate regardless of their medical history. Thus, insurers no longer have the opportunity to refuse the subscription of a sick person or under treatment.

During the tax return, a form sent by the insurer justifying the homologation of the contract must be attached. This is Form 1095-B. In case of default of insurance, a shared responsibility fee (penalty) is then applied for each month passed without insurance or with non-compliant insurance. This can take two forms according to the income:

  1. 2.5% of taxable annual income
  2. $ 695 per adult and $ 347.5 per child with a maximum of $ 2,085 per year per household

This is of course the strongest calculation that will be retained.

The uncertainty around Trumpcare

With the arrival of Donald Trump as president, political battles began to materialize the campaign promise of repeal and replace ". Even though several projects have failed for the moment, the philosophy remains the same. The background of the project is remove the insurance obligation, perceived by the Republicans as an attack on freedom.

On the other hand, it is planned to reduce the tax burden by cutting the budgets of Medicaid and aid for underwriting for the more modest. The last version of the text, abandoned in the Senate, included several strong provisions, such as the non-obligation for companies to cover their employees and the end of the unlimited support for essential care (ECM). In addition, the principle of pricing according to pre-existing conditions was resumed. Indeed, with Obamacare, all insureds of the same age group enjoyed the same rate, regardless of their state of health or medical history.

However, the president does not give up and makes the observation that, in the face of this failure to reform the existing law, we must simply remove Obamacare, and create a new reform of the health system from scratch. This could make a clean sweep of Obama's progress and leave the health sector on its own for months, even years, waiting for a new law.

What impact for expatriates?

After a period of uncertainty as to whether the Obamacare was applicable to expatriates or not, and to find out if its international health insurance plan was compliantwe are entering a period of uncertainty again.

So far, we consider that Obamacare is still relevant, with an obligation to be insured with a plan ACA compliant. Which means that the penalty remains applicable as well. Solutions exist allowing expatriates to comply and benefit from extended coverage.

However, some regretted their international health plan, which was often easier to manage and use. Indeed, the international plans allow care without deductible (deductible) and without obligation to seek treatment in a partner network to obtain a better reimbursement. If Obamacare were simply removed, these contracts could re-enter. Expats will have the freedom to choose their health plan again.


Note: "Partner Articles" are not articles in French Morning's editorial staff. They are provided by or written to the order of an advertiser who determines the content.

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