Affordable Care Act was enacted after President Barack Obama signed it on 23rd March 2010. The law introduced wide-ranging health insurance reforms that made consumers in charge of their health care decisions. The objective of The Affordable Care Act is to make health care affordable, accessible and of a better quality. The law applies to all the divisions of society including families, senior citizens, businesses, and taxpayers. Those citizens who were not insured previously or those citizens who were insured but their policy did not provide them proper coverage and security are also included in the parameter of the Affordable Act.
Affordable care act ensures that American citizens are being provided with better health security. The act put forward comprehensive health reforms that expand coverage period, minimize health care costs, hold insurance companies accountable and enhance the quality of health care received by Americans (Rosenbaum).
The affordable care act is a compilation of two separate legislations; the patient protection and affordable care act and the health care and education reconciliation act of 2010. These two acts expands medical coverage to millions of low – income Americans and improves the quality of Medicaid and the children health insurance program (CHIP)
Key Features of the Act
Coverage: The act discards the pre - existing conditions that were previously required for children. Now any child under 19 years is eligible for the health care plans and benefits without any limitations. An adult under 26 is eligible for insurance coverage under parent health care plan (Blumenthal and Collins).
Furthermore, health care insurance could not be canceled now just on the basis of honest mistake, and people are granted the right for reconsidering the denial of payment ( Curbing Insurance Cancellations).
Cost: significant cost reduction measures have been taken, and new reforms were introduced year over year in this regard. Insurance companies are required to justify publicly and put forward the reason for any price increases. Additionally, previously put limitations of lifetime coverage are banned for all new health insurance plans.
Care: Under the reforms of the Affordable Care Act, people can now choose the primary care doctor from their network of the plan. Also, there were previously barriers on emergency services put by the insurance companies under which people were not allowed the emergency care outside their health plan network. These barriers are now removed, and people can seek emergency care at any hospital outside their network.
ObamaCare Benefits: the ACA Makes Health Insurance More Affordable and More Available (Benefits Of ObamaCare: Advantage of ObamaCare)
The Affordable Care Acts Provisions Summary
• Eligibility: Minimum income eligibility level has been reduced across the country to ensure that all the deserving American citizens receive best health care facility.
• Financing: all the financing of eligible adults will be done by the Federal Government. The financing will be done from the start of year 2014.
• Information technology systems and data: designs have been prepared for policy structure and financial structure to provide all the states with the immediate investment required for information technology systems. It is done to ensure that all the Medicaid systems are operational at the launch date January1st, 2014.
• Coordination with Affordable insurance exchanges: according to this system, now the families and individuals can apply for coverage through a single application. A single process is implemented to determine the eligibility for all insurance affordability programs.
• Benefits: newly eligible people for Medicaid will be given the benchmark benefit. This benefit includes the minimum essential benefits provided by the Affordable insurance exchanges.
• Community-based long-term services and support: this provision improves the funding and ensures that people receive services and support in their communities on a long-term basis.
• The quality of care and delivery system: This system improves the quality and delivery of care and reduces costs at the same time.
• Prevention: To promote prevention and public health and support the efforts made at local and federal level. The act has authorized heavy investments in primary care workforce to promote prevention (Koh and Sebelius)
• Children’s Health Insurance Program: This provision extends the Children’s health Insurance Program (CHIP) from financial year 2015.
• Dual Eligible: A new office will be created within Medicare and Medicaid centers to deal with individuals who are eligible for both the services i.e. Medicare and Medicaid.
• Program Transparency: this provision promotes the transparency in Medicaid policies and establishes opportunities for public involvement in the development.
• Program Integrity: These provisions deal with those individuals who are terminated from Medicaid or whose Medicaid payments are pending due to ongoing investigations or allegations of fraud. It also includes guidelines on prevention of inappropriate payments and false claims.
In 2014, federal website HealthCare.gov was facing technical problems due to which many consumers got frustrated as a result of long waits and gave up enrolling. However, in 2015 the problems were solved, and the enrollment process is now much smoother. As a result, up till 2015, more than 10 million people have enrolled themselves for health insurance in different US states under The Affordable Care Act (Armour).
The other side of the picture is that Obama Care plans promised that The Affordable Care Act would lower the insurance premiums by average $2500 per family. Despite such promise, according to an analysis conducted by PricewaterhouseCoopers, insurance premiums have increased by 7.5% in 2015 (Ramlet). If the rates continue to increase at such a pace, it will likely to limit the American citizen’s accessibility to health care facilities in upcoming years. It is estimated that over the next decade, uninsured Americans may increase by 10%.
Benefits Of ObamaCare: Advantage of ObamaCare. 2014. 28 April 2015 <http://obamacarefacts.com/benefitsofobamacare/>.
Curbing Insurance Cancellations. 26 February 2015. Web, 20 April 2015 <http://www.hhs.gov/healthcare/rights/appeal/curbing-insurance-cancellations.html>.
Armour, Stephanie. "Affordable Care Act Enrollment Near 10 Million." 4 February 2015. wsj. Web. 20 April 2015 <http://www.wsj.com/articles/affordable-care-act-enrollment-near-10-million-1423070147>.
Blumenthal, David and Sara R. Collins. "Health Care Coverage under the Affordable Care Act — A Progress Report." The New England Journal of Medicine (2014): 275-281. PRint.
Koh, Howard K. and Kathleen G. Sebelius. "Promoting Prevention through the Affordable Care Act." The New England Journal of Medicine (2010): 1296-1299. Print.
Lau, Josephine S., Josephine S. Lau and W. John Boscardin. "Young Adults' Health Care Utilization and Expenditures Prior to the Affordable Care Act." Journal of Adolescent Health (2014): 663–671. Print.
Ramlet, Michael. "A 10-Year Prediction for the Affordable Care Act." 29 August 2014. nationaljournal. Web. 20 April 2015 <http://www.nationaljournal.com/next-america/perspectives/a-10-year-prediction-for-the-affordable-care-act-20140829>.
Rosenbaum, Sara. "The Patient Protection and Affordable Care Act: Implications for Public Health Policy and Practice." PublicHealth Reports (2011): 130–135. Print.