The ins and outs of the affordable care act

The ins and outs of the affordable care act

• 1.
  A Brief Overviewof the Affordable Care ActJesse Bouchard
• 2.
  12 Important Benefitsof the Health Care Act (provided by Families USA)Make sure all Americans have access to affordable health careRegulate the marketplaceAssist small businessesImprove MedicareProhibit pre-existing condition denialsLimit out-of-pocket costsExtend coverage for young adults until the age of 26Expand Medicaid to low-income AmericansHelp make premiums affordableHelp ensure our health care dollars are spent wisely.Help prevent insurance company abuseInvest in preventive care
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  Ensure All AmericansHave Access to Affordable Health CareThose individuals who have been laid off or who work for small businesses will have access to affordable healthcare.Before this act these individuals had to either go uninsured or pay for extremely expensive private insurance.
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  There is noone state or federal entity that regulates all markets or controls the information the insurance companies must provide.With the Health Care Act new marketplaces (state-based exchanges) are being put in place that will provide individuals with information to help them choose the best insurance coverage they need at an affordable price.In these state-based exchanges insurers are required to make their plans easy to understand. In doing this the idea is to make these plans easy to compare therefore creating a competitive market.Each state is required to have these markets up and running by 2014. Regulate the Marketplace
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  Small businesses areconstantly struggling to provide affordable health insurance to their employees, but often it is such an expense they do not offer it at all; especially in our current economic dilemma. In 2010 approximately 4 million small businesses qualified for a tax credit to help with insurance costs. Assist Small Businesses
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  In 2010 mostpeople on Medicare received a $250 rebate check to help offset the costs of prescription drugs.Starting in 2011 Medicare recipients began receiving 50% off the cost of brand name prescriptions and further discounts on generics.The goal is to eliminate the “Doughnut hole effect” by 2020. The “Doughnut hole effect” is when those on Medicare reach their cap on prescriptions and they must pay full price for their drugs until they pay $3,610 out of pocket which is when Medicare will kick back in.Improve Medicare
• 7.
  According to areport by the U.S. Department of Health and Human Services: "12.6 million non-elderly adults- 36 percent of those who tried to purchase health insurance directly from an insurance company in the individual insurance market - were in fact discriminated against because of a pre-existing condition in the previous three years."Due to the new Care Act by 2014 Insurance companies will no longer be able to discriminate against individuals based on pre-existing conditions, age, gender, or health status.Prohibit Pre-existing Condition Denials
• 8.
  A myth regardinghealth insurance is that if you are covered you do not need to worry about huge increases in health care costs. Unfortunately this is not always the case. According to a report by Families USA approximately 1 in 4 Americans spent more than 10% of their pre-tax income on health care expenses. Due to the new Health Care Act there will be a cap on out of pocket health expenses and lower income families will also receive assistance with health care costsLimit Out-of-Pocket Costs
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  Under Health CareReform individuals under 26 will not need to worry about the cost of insurance because they are able to stay on their parents insurance plan while they are pursuing their career goals. Video of President Obama speaking with a student, Erick, who is in school to be a Physician. Click PlayExtend coverage for young adults until the age of 26
• 10.
  Currently Medicaid isnot available to all low-income individuals. You are also required to meet other requirements such as being pregnant or being a child.With the Health Care Act in 2014 Medicaid will expand to everyone, under the age of 65, with an income of up to 133% of poverty ($24,352 for a family of three in 2010). Most individuals 65 and up will qualify for Medicare.Expand Medicaid to Low-Income Americans
• 11.
  A study byFamilies USA showed that health insurance premiums have risen tremendously while incomes have remained at a constant. This has led to many families going without coverage or seeking private health insurance.Under the new Health Care Act those who have an income too high to qualify for Medicaid, but cannot afford individual health insurance, will be able to qualify for financial assistance.Help Make Premiums Affordable
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  The current systemdoes not offer many protections against insurance companies that raise premiums to spend money on marketing or to increase profits.With the new Health Reform insurance companies will have to change the way they do business. There will be new regulations on how insurance companies spend money. Companies in the large group market will have to spend 85% of premium dollars on medical care and quality improvements while companies in small and individual markets will have to spend 80% (Families USA).The new Act also helps states to review rate increases to ensure that increases are to serve customersHelp Ensure Our Health Care Dollars Are Spent Wisely
• 13.
  The process calledrescission has been a critical part of the debate on health insurance. In this process Insurances companies would drop individuals from coverage when they get sick or retroactively revoke coverage due to alleged fraud or misrepresentation.As reported by the LA Times an investigation by the House Subcommittee on Oversight and Investigations, three health companies "cancelled the coverage of more than 20,000 people, allowing the companies to avoid paying more than $300 million in medical claims over a five-year period."The new Health Reform law puts a stop to companies rescinding policies unless the policy holder actually committed fraud or intentionally misrepresented themselves.Help Prevent Insurance Company Abuse
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  With Health CareReform companies will be rewarded on the quality of care rather than the quantity promoting preventive care.This new law begins with Medicare and Medicaid by rewarding doctors for working together in providing high quality care. This also encourages hospitals, doctors and other providers to coordinate patients’ care to help prevent patients paying for the same tests or procedures twice.Invest in Preventive Care
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  Instituted March 23,2010Better health security by holding insurance companies more accountable Aims to provide health care for millions more and improve the quality of care receivedDecrease in health care costsGuarantees more choices that meet individual health care needsEnhances the quality of care for all Americans.Up to 20,400 individuals who typically hit their lifetime limits will benefit from the act (www.whitehouse.gov)Almost 102 million consumers will no longer have a lifetime limit on their policy. (www.whitehouse.gov)Facts
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  Click links below:HealthCare Reform Law Made SimpleOverview of Lesson
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  Click Here: TheAffordable Care Act – Implementation TimelineFor Further Information Concerning Affordable Health Care Timeline