Information on the Affordable Care Act

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Information on the Affordable Care Act

What is the Affordable Care Act?

The new health care law includes several authorities and responsibilities for the Department of Health and Human Services. The law also calls on the Department to publish information regarding these new authorities.

The most recent development with the law was the Affordable Care Act, enacted in March 2010. The Affordable Care Act is the final, amended version of the law, which was enacted in two parts: the Patient Protection and Affordable Care Act was signed into law on March 23, 2010, and then amended by the Health Care and Education Reconciliation Act on March 30, 2010.

This Act puts control of health care in the hands of individuals, families, and small business owners, and accomplishes the following:

  • Reduces premium costs for many working families and small businesses through tax relief
  • Requires preventive care to be fully covered without out-of-pocket expenses
  • Sets a maximum out-of-pocket expense
  • Provides individuals and families with the choice to remain with current providers and plans
  • Bans insurance companies from discriminating based on pre-existing conditions
  • Encourages private insurance companies to compete for business based on cost and quality
  • Enhances community-based care for Americans with disabilities
  • Provides opportunities for States to extend home care services to people with long-term care needs

Supreme Court Upholds Law
The issue of whether or not President Obama's Affordable Care Act was constitutional was brought before the Supreme Court, and on June 28, 2012, the court ruled in the act's favor. This decision came with a number of changes that affect the act. The most notable of these is the court's decision to limit the expansion of Medicaid, a program that provides health care to individuals with low income and disabilities. While the court did decide to limit the expansion of this program, Medicaid will still exist to provide services to those who need it.

Insurance 101:

What is a premium?

  • A premium is the amount you pay to an insurance company for a health insurance policy - this is usually a monthly payment.

How much does health insurance cost?

  • The cost of a health insurance varies from plan to plan. Below are some good questions for you to ask to make sure you are choosing the best policy for you and your family:
    • What benefits are offered?
    • How much will I pay before insurance coverage begins? (How much is the deductible?)
    • What will I pay for services after I pay the deductible?
    • In total, how much will I have to pay if one of my family members or I become ill? (What is the out-of-pocket maximum?)

Purchasing insurance plans with the lowest premium or with a very high out-of-pocket maximum can result in many services and treatments being uncovered by the plan.

What Health Care Options are Currently Available for Adults ages 26-64?

Most adults between the ages of 26 and 64 utilize either a private health insurance plan or a health insurance plan that is provided by their employer.

  • Private Health Insurance Plans for Individuals & Families. In most states, insurance companies determine what health insurance you are eligible for when you apply. This determination dictates (1) whether or not the company will offer you coverage, (2) the price at which the policy will be offered, and (3) what services that will be left out or limited by the plan available to you.
  • Health Insurance Through Work. Some employers provide options for employees to purchase health insurance for themselves and their family. Through coverage offered by employers, you or your family members generally cannot be turned away or charged more because of a pre-existing health condition. This protection is called "nondiscrimination." However, employers may refuse or restrict coverage for other reasons, such as part-time employment, as long as these reasons are unrelated to your health status and are applied consistently.

Use the tool at healthcare.gov to help you determine what insurance plan will be right for you!

References:

HealthCare.gov. (n.d.). Retrieved October 25, 2010 http://www.healthcare.gov/

Liptak, A. (2012). Supreme Court upholds health care law, 5-4, in victory for Obama. The New York Times. Retrieved July 6, 2012 from http://www.nytimes.com/2012/06/29/us/supreme-court-lets-health-law-largely-stand.html?_r=3&pagewanted=2&hp

Student health services at Calpulli Center: What health care reform means to you: Part I. (n.d.). Retrieved October 25, 2010 from http://shs.sdsu.edu

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