Affordable Care Act

Affordable-Care-ActThis article is to explain the Affordable Care Act by informing you about how it works and the next steps you need to take in order to sign up. I am not writing this article to state my opinions on whether or not I agree with the Act, but this is simply for information purposes only. The bill contains so much more than insurance reform. There are also many changes in health care delivery, how we address chronic disease, and how we beef up our primary care workforce.

The Affordable Care Act (ACA) is a piece of legislation that attempts to reform the healthcare system. All Americans must have insurance coverage starting in 2014 or face penalties of 1% your family income or $95, whichever is greater. Enrollment begins October 1, 2013, with coverage starting in January 2014. Some say that the ACA is not very affordable because states like Florida have reported an average increase of premiums of about 35%, Indiana 72%, Ohio 41%, etc. A 21-year-old men will pay a lot more for a plan, but 42-year-old women and 62-year-old men will pay much less. The bill is spread out into 10 titles which I call ‘steps’ and below is an overview of them

Step 1: Quality, Affordable Care for All Americans

  • This first title of the law states that all families, individuals and small business owners are in control of their own healthcare
  • It will cap out-of-pocket expenses for healthcare (especially for people who can’t afford it)
  • Small business owners will be able to purchase their own coverage, and will receive tax credits for up to 50% of the cost of their employees health insurance
  • Insurance companies cannot deny coverage based off of pre-existing medical conditions

Step 2: The Role of Public Programs

  • The AHC simplifies enrollment
  • Reduces prescription drug costs and payments to subsidize care for uninsured Americans
  • Gives more Americans access to health insurance
  • Provides a more team based approach and provides home based care for the chronically ill
  • ***The Supreme Court had issues with this Title***

Step 3: Improving the Quality and Efficiency of Health Care

  • Healthcare institutions and professionals will be incentivized to improve care
  • It changes our current system from payment of ‘fee for service’ to payments based on quality of delivery

Step 4: Prevention of Chronic Disease and Improving Public Health

  • Promotes prevention, wellness and public health via unprecedented funding
  • Nutritional information will become more prevalent
  • Co-payments will be waved for preventative measures for seniors
  • Tries to prevent chronic illness because it is very, very costly

Wikipedia Chart

Step 5: Health Care Workforce

  • Helps fund and expand community health centers
  • Recognizes that we don’t have enough healthcare employees to take care of the whole country

Step 6: Transparency and Program Integrity

  • The ACA focuses on keeping citizens informed about healthcare
  • Greater transparency in nursing homes by placing regulations and incentive programs to help improve quality control
  • The Act reins in waste, fraud and abuse by imposing disclosure requirements to identify high-risk providers who have defrauded the citizens
  • States now have the authority to prevent providers who have been penalized in one state from setting up in another

Step 7: Improving Access to Innovative Medical Therapists

  • It states that we need to improve access to generic drugs

Step 8: Continuity Living Assistance Services and Supports Act

  • It is a bill that instituted a federally run long term care insurance program
  • Pretty much creates a similar system to our Social Security System … for health

Step 9: Revenue Provisions

  • Explains how it will all be paid… (your taxes)

Step 10: Strengthening Affordability and Quality in America’s Health Care System

  • States that Nebraska doesn’t have to follow the Medicaid (*The reason is because that Senator would only vote for the law if his state was exempt)

Questions, comments, suggestions? Post here, reach me on Twitter @ArberDoci

Want to read more about the healthcare act? Check out these links:


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