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Key Provisions Of The Affordable Care Act

1902 words - 8 pages

The Affordable Care Act or “Obamacare” was designed to assure that all Americans regardless of health status have access to affordable health insurance. The Affordable Car Act was signed into law March 23, 2010. The primary goal of this act was to decrease barriers for obtaining health care coverage and allow Americans to access needed health care services (Affordable Care Act Summary, n.d). After the legislation is fully implemented in 2014, all Americans will be required to have health insurance through their employer, a public program such as Medicaid and/or Medicare or by purchasing insurance through the health insurance marketplace exchange (Affordable Care Act Summary, n.d). I will identify three parts of The Affordable Care Act that I believe are important. First, I will talk about the requirement that insurance companies are no longer able to deny coverage to individuals with pre-existing conditions. Secondly, I will explain why physician payments are being shifted to value over volume. Lastly, I will discuss Medicaid expansion and why some states are not expanding at all.
Pre-existing Conditions
The Affordable Care Act introduced a plan that would allow Americans with pre-existing conditions to obtain health insurance without the hassle of being turned down or fear of being charged higher premiums. The Pre-Existing Condition Insurance Plan was effective as of July 1, 2010. It allowed patient access to affordable healthcare in which they were previously denied due to their pre-existing condition (Affordable Care Act Summary, n.d.). Patients were required to be uninsured for at least six months before they obtained this form of health insurance. In January 2014, the PCIP plans no longer exist due to funding issues so Americans do not need the PCIP. Insurance companies can no longer charge higher prices for those individuals because it is now illegal under The Affordable Care ACT. In 2013, the health insurance marketplace allowed individuals with pre-existing conditions to purchase insurance at lower costs. If an individual has a heart disease for example, this new provision allowed them to obtain coverage at no additional cost. So now, insurance companies must give that patient coverage in addition to covering all of their medical expenses. I believe that this is a great arena to allow all Americans regardless of health status to receive medical care and quality of services. The purpose of this provision was to allow people with disabilities and /or illnesses to obtain health insurance they otherwise could not afford (Huntington, Covington, Center, Manchikanti, L. 2011).
Why did insurance companies charge these individuals with higher rates prior to the Affordable Care Act in the first place? The answer is simply higher cost. Individuals with pre-existing conditions drive up cost for “healthy” populations. It is known that individuals with higher needs will use the system more. Someone has to pay for rising cost and since individuals...

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