Monday, July 16, 2012

What Does the Affordable Care Act Do?

This blog is usually a venue for my academic writing, but I feel the need to break from that vein a little bit. Today's political climate is rather heated, and with the election nearing in November, political rhetoric begins to be thrown around with increased passion and decreased logic or original thought. Therefore, I feel it necessary to point out that there is more to the Affordable Care Act (deemed by some as Obamacare) than just the individual mandate that has bred a political firestorm for the past three years. Many of the facets of the act have already gone into practice, while others will not do so until 2014.

I do not intend this to be a partisan-fused piece, and most of the information is from healthcare.gov. Take it for what you wish, and please do not use the comments below simply to bash others and their beliefs or actions. Debate is welcome, as long as you keep it civil.

Implemented as of 2010
  • No lifetime coverage benefit limits can be placed on an individual.
  • Children can not be denied coverage due to a preexisting condition.
  • Preventative care coverage is expanded for many, eliminating co-pays for check-ups, mammograms, and colonoscopies (continued into 2011).
  • Young adults can remain on their parents' insurance until they are 26 years of age, regardless of marital status.
  • Seniors may receive expanded coverage for name-brand prescriptions, previously found in the "doughnut hole" of coverage.
  • Tax credits are available to small business owners for making health care coverage available (credits % set to increase in 2014). 
  • States are allowed to create their own Preexisting Condition Insurance Plan to provide an affordable plan for those who fall under this category. If they choose not to do so, the US Dept. of Health and Human Services will do so.
  • Insurance companies cannot rescind coverage to a sick individual based on a mistake made in the application process.
  • Blockers placed to begin eliminating annual limits to coverage benefits (completed in 2014).
  • Insurance companies are barred from hiking premium rates by more than 10% (new appeals procedures have also been put into place, both in the private and public spheres).
  • New incentives established to draw new doctors into primary care spheres, as well as incentives for those practicing.
Implemented as of 2011
  • Prices for preventative care coverage are dropped, to zero for many.
  • Funding to build/expand community health care facilities.
  • A greater portion of insurance premiums are required to be spent on health care coverage (80% for small group plans, 85% for large group plans).
  • Medicare recipients who are considered high-risk receive opportunities for greater coordinated care to avoid unnecessary readmission.
  • An advisory board was created to ascertain how to extend the life of, lower the cost of, and increase the health care for Medicare.
  • Cheaper options for at-home visiting care as an option to resident nursing homes.
Implemented as of 2012
  • Data will be collected of overall quality of health among different groups to assess racial/ethnic disparities.
  • Efforts being made to transition toward electronic record keeping and management to cut down on costs.
Implemented as of 2014
  • Tax credits for small business owners offering health benefits increase.
  • Affordable Insurance Exchanges will be established at the state level, providing a venue for individuals to compare private and public options together.
  • Annual limits of coverage benefits abolished.
  • Individuals will be able to apply their employer's premium match rate to whichever insurance coverage they choose to use.
  • Tax credits applied to individuals for those who qualify, can be applied monthly rather than yearly.
  • Coverage cannot be refused based on a preexisting condition.
  • Coverage cannot be refused, and rates cannot be hiked on account of gender.
and...
  • The dreaded individual mandate, referred to as the requirement for individual responsibility of coverage for all those who can afford it. If they do not, they will be required to pay a fee. "If affordable coverage is not available to an individual, he or she will be eligible for an exemption."

As I mentioned before, this is meant as a brief overview of what has been, and what will be implemented as a result of the Affordable Care Act, not as a partisan plea for one side or the other. In order to make an informed decision, one must seek out the information (of which I can only impart some). Please, any thoughts, comparisons, additions or omissions are welcome.

2 comments:

  1. Good job on your outline Steve. My input is a little off-topic but I feel it's important.

    Whatever you think of the ACA, there would be no need for it or anything like it if Americans would wake up to the fact that most of their illness results from improper diet. All dietary related problems are exactly that and no amount of medication can "cure" it. The biggest issue with health care right now is that we are adamant about treating symptoms not cause. I encourage anyone who is interested in being healthy to educate yourself in what the food you eat is doing to you.

    Thanks for listening :)
    eatcleanvegan.blogspot.com

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  2. Most is a hasty word, I think. For many things you are right, health related issues are a result of poor lifestyle choices, and a change in those choices can help solve those problems. However, there are many ailments that there is simply no diet or exercise that can fix, i.e. if someone's pancreas creates no insulin, they must have insulin shots or they will die; an otherwise healthy child develops a brain tumor, or leukemia. Diet and exercise are important, but I think it is not always as simple as that.

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