Health Care Reform Myth Busters


| 3 min read

MYTH: There’s a government health plan. FACT: This is no “Obamacare Plan.” The insurance companies offering coverage on the Marketplace are private companies, heavily regulated by the federal government. Depending on their county, Michigan residents will be able to compare up to 16 insurance companies side by side when selecting their plan on the Marketplace. MYTH: Health care reform means higher premiums. FACT: Some people’s premiums will increase, some will decrease. For example, before the Affordable Care Act (ACA), older people could be charged up to five or six times as much as younger people for the same coverage. Now, older people can only be charged three times as much, bringing their rates down. Government-sponsored subsidies may be available to those below 400% of the poverty level. Subsidy calculators, such as, are available online to help you estimate your costs based on income and family size. MYTH: You won’t receive your premium tax subsidy until April each year. FACT: The premium tax subsidy is based on your reported income on last year’s IRS tax statement and your family size. Once your subsidy has been established, you can choose to apply the credit in one of several ways:
  • Apply none of it to the monthly premiums, and receive the lump sum as a tax credit in April.
  • Apply all of it to the monthly premiums to lower the amount paid each month.
  • Apply some of it to the monthly premiums to lower the premium, and get the rest as a tax credit. This option may help avoid owing the government if your income increases during the year.
MYTH: Congress is exempt from the ACA. FACT: Congress will not be allowed to remain on the Federal Employees Health Benefits program. They will instead enroll in the District of Columbia small-business Marketplace and will not be eligible for subsides regardless of income. They will be able to receive a federal employer contribution, but only if they enroll in a specific ACA plan. (Source: U.S. Office of Personnel Management). MYTH: I can only reach out to my own insurance agency for help. FACT: Insurance agents and Health Plan Advisors are valuable resources and a good place to turn for help in understanding coverage options and different plans and price points. Blue Cross has experts available on the phone to answer questions for individuals at 855-892-8089, regardless of whether or not they have BCBSM. You can also search to find a navigator, application assister, certified application counselor or government agency to provide personal help in your community. The federal government also has live chat at and a toll-free call center. For more information on health care reform, visit Photo Credit: andercismo Updated: 11/19/14
MI Blues Perspectives is sponsored by Blue Cross Blue Shield of Michigan, a nonprofit, independent licensee of the Blue Cross Blue Shield Association