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What does the health insurance act mean for me?

people seek information on health insurance actOn March 23, 2010, the Affordable Care Act was signed into law by President Barack Obama. Some provisions of this act were immediate, while others were scheduled to take effect over the next several years. The government has set up a website to assist consumers in understanding the rights and benefits established by these new laws.

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For the last 20 years, each presidential administration has announced its goal to ensure that all Americans have access to affordable health insurance and medical care. Beginning with the Clinton Administration, the President and Congress have been battling over how to bring this goal into focus and make universal health insurance coverage a reality.

Why has this been a problem?

Health care has been a hotly debated topic for decades. Unlike many of our western allies and neighbors, the US avoids the idea of socialized medicine. Many citizens believe our government should keep out of people’s private affairs and let folks provide for their own health care needs.

Another large faction believes it is the government’s responsibility to take care of its citizenry, especially those who can’t take care of themselves. These are the people primarily responsible for much of the public health care legislation currently in effect, including Medicare and Medicaid, programs that were enacted in the 1960s.

What are the key features of the Affordable Care Act?

The key features of Affordable Care can be broken down into several categories providing consumers with:

Increased consumer rights and protections

A patient’s bill of rights was a major plank of the Affordable Care Act, and helps consumers make informed health care decisions. Many preventive health care services are now available at no cost. States are now required to sponsor consumer assistance programs. The Act also extends a consumer’s right to appeal insurance decisions and eliminates an insurance company’s right to deny coverage to a child, under the age of 19, with a pre-existing condition

More insurance choices for those needing insurance or who have been denied coverage

This provision created a pre-existing condition plan (PCIP) for adults, and extended coverage for children under a parent’s health policy, to age 26. In 2014, provisions of the Act allow for the creation of a new type of consumer driven non-profit health insurer, CO-OP, program. Insurance shopping will be easier in 2014 through newly formed, state-based, affordable insurance exchanges.

More value for each premium dollar spent

The Act holds insurers more accountable by placing limits on amounts insurance providers can spend on administrative costs, monies they don’t spend on improving health care services. In addition, insurance companies are now compelled to justify any rate increases in excess of 10%.

Annual policy limits are being phased out and lifetime limits on health care expenses have been eliminated. There have also been changes to flexible spending accounts. See IRS Publication 969, or visit the IRS website, for more information.

Better and more affordable access to needed services for the elderly

Medicare recipients are eligible for more benefits, free screenings and preventive services and prescription discounts. Seniors may also be eligible for a $250 rebate regarding a prescription drug coverage lapse in 2010. The new law strengthens the Medicare program overall while seeking to eliminate fraud, waste and other systemic abuses.

Beneficial new programs and tax breaks for small businesses

Tax credits help offset the costs of health insurance coverage for employees of small businesses and non-profit agencies. In addition, the creation of the ERRP, Early Retirement Reinsurance Program, provides financial assistance to companies who pay for the health benefits of early retirees, age 55 – 64.

What’s the latest news on national health reform efforts?

The Affordable Care Act, heavily contested and debated in Congress before its passage, continues to be argued in many states, as well as in various state and federal district courts.

In the more than 18 months since the passage of Affordable Care, portions of the new law has been challenged and either overturned or repealed. Additional legislative changes have been suggested that could affect American citizens now, and in the future.

What is clear is that America needs new health insurance initiatives that allow its citizens to afford basic health care without the threat of financial hardship. As citizens, we shouldn’t be afraid to visit a doctor or the emergency room of a hospital, or to seek treatment for an illness or injury. While these aren’t rights guaranteed by our constitution, they are benefits important to all members of our community.

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