In the United States, health insurance is tricky to navigate. It is a sector with a number of regional and national competitors whose coverage, pricing, and availability vary from state to state and even by county.3
A little over half the U.S. population has health insurance coverage as an employment benefit, with premiums partially covered by the employer.4 The employer cost is tax-deductible to the payer, and the benefits to the employee are tax-free (with certain exceptions for S corporation employees).56
Self-employed people (including freelancers and gig workers) can buy insurance directly from insurers on their own. The Affordable Care Act of 2010, commonly called Obamacare or ACA, mandated the creation of the ACA Healthcare Insurance Marketplace, which allows individuals to search for and purchase standard plans from private insurers that are available where they live. The costs of ACA-based coverage are subsidized for taxpayers whose incomes are between 100% and 400% of the federal poverty threshold.7
Some states created their own versions of the federal marketplace with features tailored to their residents.
People over the age of 65 and those with disabilities, end-stage renal disease, or ALS qualify to receive federally subsidized care through Medicare. Families whose incomes are near the poverty level are eligible for subsidized Medicaid coverage.
