Brief Overview Of The Affordable Care Act

A Very Brief Overview Of The Affordable Care ActJuly 17, 2013 11:52 AM

According to the US Census Bureau, about 48.6 million Americans were uninsured in 2011. And that number is still on the rise. To help the uninsured find quality health insurance at a reasonable cost, the Patient Protection and Affordable Care Act (ACA) was passed and signed into law in 2010. Now America’s uninsured will have more opportunity and help in enrolling and obtaining health insurance than ever before.

Basic ACA benefits

• Lower cost health insurance that is available through a health insurance marketplace.
• Affordable doctor visits, preventative care, hospitalization and prescription drugs.
• Coverage for pre-existing conditions including pregnancy and disabilities.
• Localized help and resources to serve you wherever you reside.

Health insurance is now required

One of the fundamental impacts of the ACA is that everyone must have health care coverage, and those who don’t will pay a “fee.” The federal government has mandated that in 2014, every individual must purchase health insurance. With some exceptions, those who decide not purchase health insurance will be subject to an annual penalty tax, starting at $95 per adult or one percent of family income, whichever is greater. By 2016, the penalty will be $695 per adult or 2.5 percent of family income, whichever is greater.

Health insurance marketplaces

If you are uninsured, you will have access to health insurance through a health insurance marketplace, sometimes referred to as an exchange. States have the option of running their own exchange, operating an exchange in a combined effort with the federal government, or turning all operation of the health care marketplace over to the U.S. Department of Health and Human Services (HHS). Seventeen states and the District of Columbia have been conditionally approved to run state-based exchanges, while seven states have been conditionally approved for a partnership exchange and 27 have defaulted to federally operated exchanges.

The state exchanges, which open for enrollment October 1 for health insurance policies that take effect January 1, 2014, allow Americans who lack health insurance to compare, select and purchase health insurance policies. You can find help and additional information on the health insurance marketplaces, including learning which kind of marketplace is available in your state, at healthcare.gov.

Impact on Medicare recipients

Are you a Medicare recipient? If so, you will receive:

• One free “Wellness” visit per year.
• More preventative services like mammograms and colonoscopies, and there is no charge for the Part B coinsurance or deductible.
• Savings on brand-name drugs.

Below are some additional key benefits.

• There was a Medicare Part D gap referred to as the “donut hole.” Now, you get a 50 percent discount when buying Part D-covered brand name prescription drugs. Your pharmacy applies the discount automatically. By 2020, the donut hole will be closed completely.
• Your doctor gets more support. With new initiatives to support care coordination, your doctor may get additional resources to make sure that your treatments are consistent.
• Your Medicare coverage is protected. Under the ACA, your existing Medicare-covered benefits won’t be reduced or taken away.
• You will continue to be able to choose your own doctor.

The ACA ensures the protection of Medicare for years to come. The life of the Medicare Trust fund will be extended to at least 2029—a 12-year extension due to reductions in waste, fraud and abuse, and Medicare costs, which will provide future savings on premiums and coinsurance.

Impact on businesses

Small businesses with up to 50 employees do not have to provide healthcare insurance for their employees, although they have incentives to do so. These incentives include subsidized plans at lower costs and a tax deduction to offset the cost of providing insurance. [1]

Large businesses with greater than 50 employees must provide health insurance for their employees beginning in 2015. [2]

Income-tailored

The complex part of the ACA program is determining health care insurance premium rates that are based on individual income. The rates are on a sliding scale based upon your means so that it is affordable for most persons. If you are too impoverished to pay, there are Medicaid alternatives that include state administration.

Accessing information

Citizens looking for help and additional information on the ACA should first visit healthcare.gov. Here you may register your email addresses to obtain new updates as they become available. You can also tailor the information and make a personalized checklist through the tool provided on the website.

Required information may include whether you are registering as an individual, with a family or as a representative of a small business. As a business owner, you may buy your coverage for employees through the marketplace like individuals do. You must also disclose the state in which you reside, as your location is a critical factor in determining your options.

You will be required to fill out a government form that is like filling out your taxes. In fact, some of the information you report on the ACA form is compared with information that you reported on your income tax filing. There are 21 condensed pages on the form and lots of questions.

The ACA and its impact on you is incredibly important to understand, which is why it’s recommended that citizens who think they will be utilizing the ACA register at healthcare.gov.

[1] http://www.sba.gov/content/employers-with-up-to-50-employees
[2] http://www.sba.gov/content/employers-with-50-or-more-employees

James George began his career as an instructional media consultant and managed a broadcast quality tv studio for AT&T. He later became VP and Publisher for Hitchock Publishing Division of The American Broadcasting Companies. He was PR Director for Ensslin & Hall Advertising and managed the Media General Broadcast and Eden’s Broadcasting accounts as well as GTE. He founded Talon Publishing Inc which he sold to Daniel S. Appleton. Now, he writes thousands of articles on art, film, and politics.

Journalist and wife