The Affordable Care Act is funded with cuts in government spending and tax increases on individuals without health insurance and businesses that do not offer coverage to their employees.
The Affordable Care Act prohibits private insurers from denying coverage to people with preexisting conditions and requires them to cover preventive services without additional charges.
Taxes
The Affordable Care Act is funded through both spending cuts and tax increases, with reductions to Medicare Advantage payments and employer health insurance subsidies being among those. Meanwhile, new taxes include a Medicare investment tax as well as an excise tax known as “The Cadillac Tax.”
The law also offers subsidies for individuals purchasing health coverage on their own through marketplaces, known as health exchanges. These subsidies take the form of tax credits calculated according to your income as determined by the federal poverty level; premium tax credits help lower monthly payments while cost sharing reductions lower out-of-pocket expenses for marketplace enrollees.
The Affordable Care Act also creates an engine of innovation by creating the Center for Medicare and Medicaid Innovation. This agency is intended to increase quality while decreasing costs; congressional Republicans have stated clearly their intent to balance their budget through drastic program cuts of trillions.
Medicare
The Affordable Care Act has helped Medicare costs significantly by shifting how providers are paid. It eliminates lifetime and annual dollar limits on coverage, bans preexisting condition exclusions and caps annual rate increases to reflect actual costs; and prevents Medicare Advantage plans from canceling policies or forcing members to switch to cheaper plans.
The Affordable Care Act creates demonstration projects to explore bundled payments for episodes of care, global capitated payment models for safety net hospitals, and new options for pediatric providers organized as accountable care organizations to share cost savings. It also grants states additional federal Medicaid funds per person.
Beyond insurance, the Affordable Care Act makes direct investments in community-based prevention, expanding primary care capacity, and improving information transparency. It establishes grants for health centers, the National Health Service Corps and school-based health centers while also offering small business tax credits to offset premium costs. Furthermore, private insurers must cover effective clinical preventive services without copayments or cost sharing obligations – representing a major paradigm shift between health insurance and clinical preventive services.
Medicaid
The Affordable Care Act (ACA) contains grant programs intended to increase the efficiency and effectiveness of Medicaid, Children’s Health Insurance Program (CHIP) and Medicare.
The Affordable Care Act (ACA) offers funding for demonstration projects to pay bundled payments for episodes of care that include hospitalizations; to make global capitated payments to safety-net hospitals and providers in order to reduce costs while improving quality; grant community health centers so they may support new services such as nurse-managed clinics; and increase access to community health workers.
The Affordable Care Act also contains premium assistance funds that assist people whose incomes do not qualify for traditional Medicaid to purchase private health insurance through exchanges. But due to Supreme Court action, this provision of the ACA was struck down and Congress could restore it; though Michener acknowledges this would be a challenge politically, as millions of low-income Americans could otherwise lose protection from catastrophic medical bills without this aid.
State Funding
Obamacare, or Affordable Care Act (ACA), includes several grant programs designed to strengthen state economies and meet community needs. These include individual insurance marketplaces, an assistance program for small businesses to purchase insurance policies and an expansion of Medicaid coverage to low-income residents. Furthermore, this sweeping health care reform mandates new approaches to improve quality while simultaneously cutting costs.
An important feature of the Affordable Care Act (ACA) is expanding Medicaid eligibility to people whose incomes fall up to 133% of the federal poverty level, requiring states to finance the nonfederal portion through general revenues (such as personal and corporate income taxes, sales taxes and funds raised through fees or taxes on healthcare providers) and other state resources.
Block grants provided by states can also provide funding streams that assist local housing activities; block grants should ideally help develop local affordable housing strategies.
