Affordable Care Act: An Overview

Perhaps no other single piece of legislation in recent history has caused as much misunderstanding or controversy than the healthcare reform bill, aka Obamacare. Regardless of your position on the law, health care affects every citizen, so it's important to understand the basics.

The official title of the healthcare reform bill is the Affordable Care Act (ACA). It's actually two pieces of legislation: the Patient Protection & Affordable Care Act (PPACA) and the Health Care & Education Reconciliation Act of 2010, which includes the PPACA along with other education provisions. The ACA became law on March 23, 2010. Some of the law's provisions are already in place; others will begin in 2013 and 2014.

Broadly, the intent of the ACA is to provide quality, affordable healthcare for all Americans, including expanding and improving Medicaid coverage for children and low-income Americans.

Here Are Some Highlights of Healthcare Reform:

  • Today, consumers do not have to have health insurance coverage. However, beginning in 2014, the ACA will require most people to purchase insurance or pay a penalty based on income. Some individuals and families may be able to waive requirements for coverage if they meet certain eligibility criteria.

  • The new Patients' Bill of Rights institutes consumer protections, including coverage for pre-existing conditions, a patient's right to choose his own doctor, and safeguards against unfavorable actions and decisions by health insurance companies.

  • Healthcare reform expands insurance coverage for many citizens. Insurance companies must now provide coverage to children under 19 who have pre-existing health conditions or disabilities they developed before they applied for coverage. In 2014, the ACA will extend these protections to all Americans. Adults who have been uninsured for at least six months, and have been unable to secure coverage due to pre-existing conditions, will have a right to coverage. Parents can now keep children on their insurance plan until the child turns 26.

  • The ACA offers many no-cost preventive and screening services. Depending on your age, these may include cancer screenings, well-baby/child visits, vaccinations, flu and pneumonia shots, and blood pressure and cholesterol testing.

  • Patients are free to choose any available participating primary care physician or pediatrician as their doctor, and women can see an ob-gyn without a referral from another physician. Insurance will also now cover patients for out-of-network emergency room services.

In the second installment of this article, we review changes that affect insurance companies and seniors.


 

Sources:

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http://www.hhs.gov/opa/affordable-care-act/

WhiteHouse.gov. "Consumer Operated and Oriented Plans (CO-OPs)." Web. 21 February 2012
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DrsForAmerica.org. "Get the Facts: Busting the Top 10 Myths on the Affordable Care Act." Web.
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Howard, Beth. "11 Myths About Health Care Reform." AARP The Magazine. September 2012. Web.
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Nordstrom, Shawn. "Affordable Care Act Has Some Little-known Tricks Up Its Sleeve." LiveInsuranceNews.com. Web. 14 May 2012.
http://www.liveinsurancenews.com/affordable-care-act-has-some-little-known-tricks-up-its-sleeve/8512012/

Carey, Mary Agnes, and Gold, Jenny. "After the Election: A Consumer's Guide To The Health Law." KaiserHealthNews.org. Web. 8 November 2012.
http://www.kaiserhealthnews.org/Stories/2012/March/22/consumer-guide-health-law.aspx

WhiteHouse.gov. "Myths and Facts."
http://www.whitehouse.gov/healthreform/myths-and-facts#healthcare-menu

Healthcare.gov. "Summary of Benefits and Coverage (SBC) and Uniform Glossary." Web. 23 September 2012.
http://www.healthcare.gov/law/features/rights/sbc/index.html

Healthcare.gov. "Consumer Assistance Program." Web. 24 August 2012
http://www.healthcare.gov/law/features/rights/consumer-assistance-program/index.html

Healthcare.gov. "Appealing Health Plan Decisions." Web. 12 July 2012
http://www.healthcare.gov/law/features/rights/appealing-decisions/index.html

Healthcare.gov. "Grandfathered Health Plans." Web. 20 August 2012
http://www.healthcare.gov/law/features/rights/grandfathered-plans/index.html

Healthcare.gov. "Patient's Bill of Rights." Web. 6 February  2012.
http://www.healthcare.gov/law/features/rights/bill-of-rights/index.html

Healthcare.gov. "Children's Pre-Existing Conditions." Web. 2 August 2012
http://www.healthcare.gov/law/features/rights/childrens-pre-existing-conditions/index.html

Healthcare.gov. "Doctor Choice & ER Access." Web. 6 February 2012
http://www.healthcare.gov/law/features/rights/doctor-choice/index.html

Healthcare.gov. "Curbing Insurance Cancellations." Web. 27 January 2012
http://www.healthcare.gov/law/features/rights/cancellations/index.html

Healthcare.gov. "Insurance Choices." Web
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Healthcare.gov. "What is the Affordable Care Act?" Web
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