Learn What is the Affordable Care Act in America
The Patient Protection and Affordable Care Act (PPACA), which is commonly known by the name of the Affordable Care Act and nicknamed as Obamacare is the most important change to the U.S. health care system. Affordable Care Act was passed with the objective of overhauling the regulations in the USA related to healthcare and expand coverage to the American citizens. Major provisions of the Affordable Care Act came into force in the year 2014.
Goals of the Affordable Care Act
The Affordable Care Acts has three primary goals.
- Make Quality Healthcare Available to More People
The key goal of the Affordable Care Act is to make quality healthcare available to more citizens. To increase access to healthcare, the law provides subsidies to the citizens in the form of ‘premium tax credits’. These subsidies are available to all the households having income between 100 percent and 400 percent of the federal poverty level.
- Expand the Medicaid Program
The Affordable Care Act aims to expand the Medicaid program to cover all the adults with incomes below 138 percent of the federal poverty level. As many states have not expanded their Medicaid programs since they were made available in 1965, the Affordable Act aims to nudge more states to increase their coverage of this decades-old program.
- Extend Support to Innovative Medical Care
The final goal of the Affordable Care Act is to extend support to innovative medical care delivery methods. These new innovative medical delivery methods were designed to make healthcare delivery more efficient and lower the costs of health care.
Key Provisions of the Affordable Care Act
- Guaranteed Issue
Affordable Care Act prohibited the denial of insurance to any individual due to pre-existing health conditions. All the states are also required to provide insurance to children whose families did not have insurance.
- Equal Premiums
Premiums charged on individuals under the Affordable Care Act should be the same to all the individuals irrespective of their pre-existing medical conditions.
- Provisions of Essential Benefits
All the citizens covered under the Affordable Care Act should be provided with all the essential healthcare related benefits like ambulance services, emergency care services, maternity services, diagnostic services, mental healthcare, substance abuse disorder services, etc.
- No Coverage Caps
Lifetime and annual coverage caps that are generally imposed by the insurers on the patients are banned under the Affordable Care Act.
- Insurers Barred from Dropping Policyholders
Insurers are banned from dropping policyholders when they get sick and the claims made on the insurance company starts to mount.
- No Co-payments on Certain Services
Insurance companies are barred from demanding co-payments on certain important healthcare services like vaccinations, diagnostic services, and medical screenings.
- Caps on Marketing Spends
The Affordable Care Act stipulates that insurers should spend 80-85 percent of the premiums collected from patients on providing quality healthcare. Policyholders should be offered rebates if the spending on providing healthcare falls below 80-85 percent.
Effectiveness of the Affordable Care Act
The Affordable Care Act lived up to the expectations of the government and the citizens. The number of uninsured citizens fell by 50 percent by the year 2016. Despite the tremendous success of the Affordable Care Act in increasing coverage and reducing the healthcare costs, it faced severe political opposition and some top Republican politicians called for its repeal.
Opposition to this key health care reform stems from the views held by certain politicians that government should have no role to play in the healthcare sector. However, the Affordable Care Act got majority support by the year 2017. According to some analysts, the still prevalent widespread opposition to the Affordable Care Act might prevent all the American citizens from having access to quality healthcare in the near future.
Disability Insurance Explained: Learn about Disability Insurance in the US