The Affordable Care Act…
formally known as the Patient Protection and Affordable Care Act (ACA), or informally as Obamacare, was signed into law in March, 2010. The ACA is a law enacted to ensure that all Americans have access to affordable health insurance. It does this by offering consumers discounts (known as tax credits) on government-sponsored health insurance plans, and by expanding the Medicaid assistance program to include more people who don’t have it in their budgets to pay for health care.
The ACA also changed some of the rules insurance companies have to follow. For example, in the past if you had diabetes or some other preexisting medical condition, you could be turned down for insurance or your cost for coverage would be astronomical. Now you can’t be turned down for any reason and the hope is that costs will be contained.
There are 10 essential benefits that every health plan must have by law:
- Outpatient care – the kind of care you get without being admitted to a hospital.
- Trips to the emergency room.
- Treatment in the hospital for inpatient care.
- Care before and after a baby is born.
- Mental health and substance use disorder treatment, including behavioral health treatment,
counseling and psychotherapy.
- Prescription drugs.
- Physical and occupational therapy, speech therapy, psychiatric rehab and more.
- Lab tests.
- Preventative services, including counseling, screenings and vaccines to keep you healthy
and care for managing a chronic disease.
- Pediatric services, including vision and dental care for kids.
Alright – let’s dispel a few myths about the ACA:
- It’s too complicated: the basics…32 million more Americans will be insured. The worst
insurance company abuses end. We will start improving quality and decreasing cost of care.
- It hasn’t helped anyone: it has helped adults and kids with preexisting conditions, 2.5 million
adults through age 26 can stay on parents insurance, and eliminates caps on how much is
spent on your care.
- We can’t afford to have it: we can’t afford not to. The right care at the right time at the right
place keeps people healthier for less.
- It hurts Medicare and seniors: it offers helps with prescription meds, check ups with no
company’s and sets up a better future for seniors and the doctors who care for them.
- It increases costs for families: costs were skyrocketing before this law. Now companies
have to publicly explain why they are raising rates and if they don’t spend enough on your
healthcare,they have to send you a rebate.
- It hurts small business: small business have options and if they choose to provide health
insurance, they get hefty tax breaks to help pay for it.
- It is unconstitutional: most law experts and judges say it is constitutional.
- It is about insurance, not health: it creates a national prevention fund that helps people live
healthier lives and trains more healthcare professionals.
- It is about insurance and not cost: the Medicaid and Medicare Center for Innovation is
promoting models, innovation and research to provide better care for less and improve
coordination of care.
- It is government takeover of healthcare: it is a partnership between government,
businesses, communities, HCPs, patients and hospitals. It strengthens the private
insurance market whole protecting people and their health.