VA Health Care Coverage and the Affordable Care Act

Medical care is one of the fastest growing expenses facing Americans. To help make medical care coverage more accessible for all Americans, the government passed the Affordable Care Act, also known as Obamacare. The Affordable Care Act requires Americans to maintain health care coverage by January 1, 2014, with the idea being that more people covered by health insurance will reduce overall health care costs for the majority of Americans, and make it easier for people to obtain health care coverage.

VA Health Care and Affordable Care ActUnder the Affordable Care Act, people will have several choices regarding their health care coverage. They can choose to retain a health insurance plan that meets minimum essential health coverage standards, qualify for an exemption, or elect to pay a fine when filing their taxes if they are eligible for affordable health insurance, but choose to remain uninsured.

Most businesses over a certain number of employees are also required to offer health insurance coverage to their employees, which also makes health insurance more accessible.

VA Health Care Enrollment Satisfies the Minimum Essential Coverage

If you are enrolled in the VA Health Care system, then you should have the minimum essential health care coverage required by the Affordable Care Act. Eligible health care plans include the Veteran’s Health Care Program, Civilian Health and Medical Program (CHAMPVA), and the Spina Bifida health care program. However, it’s important to note that your entitlements under the VA system aren’t necessarily changed by the Affordable Care Act. Your benefits and coverage should remain the same as they were before the Act was passed. The health care law does not change VA health benefits or out-of-pocket expenses.

For many veterans, that means they will have limited health care coverage through the VA, and may have to pay out of pocket expenses for care they receive through the VA. For example, many veterans with a service-connected disability receive free health care coverage for the condition for which they have a service-connected rating. But other medical conditions that don’t have a service-connected rating may not be covered. You may still be able to seek medical care at a VA hospital or clinic, but you would likely have to pay a co-pay or use a different insurance plan to pay for the medical care if you don’t meet certain income requirements or disability rating requirements for free medical care.

Are you eligible for VA Health Care? Many veterans are unaware they are actually eligible for VA health care benefits. Click here to learn more about VA Health Care Eligibility. You can also check out our Veterans Benefits Guide to learn about other benefits you may be eligible to receive.

Penalties for Not Obtaining Health Care Coverage

Starting in 2014, The Affordable Care Act imposes penalties on individuals who have access to affordable health care, but choose not to maintain coverage. You will have to pay this penalty when filing your taxes. The fee schedule is the larger amount of:

  • $95 or 1% of your taxable income in 2014
  • $325 or 2% of your taxable income in 2015
  • $695 or 2.5% of your taxable income in 2016

If you are eligible for VA health care coverage, then it’s a good idea to at least maintain your VA health care enrollment, regardless of whether or not you use the services. This will help you maintain the minimum essential health care coverage and avoid paying any penalties.

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Date published: September 3, 2013.

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Ryan Guina is the founder and editor of this site. He is a writer, small business owner, and entrepreneur. He served over 6 years on active duty in the USAF and is currently serving in the IL Air National Guard. He also writes about money management, small business, and career topics at Cash Money Life. You can also see his profile on Google.


  1. Thomas Spitnale says

    I am a 100% permanently disabled per VA vet. I get all my medical treatment through the VA. My wife has CHAMPVA coverage. What do I need to do, i.e., who do I need to contact, so I will not be penalized for not having a health insurance policy for myself and my wife?

    • says

      Thomas, As long as you are in the VA system and are eligible to receive health care coverage through it, you are covered. Your wife should be covered through CHAMPVA. Neither of you should be penalized under the new Affordable Care Act.

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