The Affordable Care Act (ACA) offers tax credits to individuals who purchase health insurance on their own, establishes state or federal-based marketplaces, expands Medicaid eligibility and prohibits lifetime and annual limits on coverage. Women are protected against discrimination in individual markets by banning gender rating practices and providing access to key women’s health benefits.
1. The Patient Protection and Affordable Care Act
Obamacare, or the Patient Protection and Affordable Care Act, has multiple objectives. One is making insurance more easily available by eliminating barriers such as preexisting condition denial or policy cancellation without explanation.
Furthermore, the law prohibits discrimination based on gender and a range of other factors. Companies must implement an exceptions and appeals process accessible instantly via toll-free telephone number or Internet website.
This act expands Medicaid eligibility to individuals with incomes up to 133% of poverty level and allows states to create alternative health benefit programs – these may include networks of physicians or healthcare practitioners, partnerships or joint venture arrangements, health homes for high-need chronic care populations and innovative approaches such as accountable care organizations. Furthermore, funds have been set aside to promote preventive services; this should reduce preventable health-care costs while improving outcomes.
2. The Health Care and Education Reconciliation Act
The Reconciliation Act amends the Patient Protection and Affordable Care Act by creating new health insurance exchanges, expanding Medicaid eligibility, improving Medicare benefits, strengthening consumer assistance provisions, cracking down on fraud, and making other improvements.
This legislation increases Pell Grant funding, allocates federal grants to historically black colleges and universities like Tuskegee University, extends worker training programs, prohibiting insurers from imposing pre-existing condition exclusions on individuals and allows insurers to extend worker training programs.
The Reconciliation Act makes other modifications to Medicaid, such as expanding coverage of personal care attendant services and decreasing disproportionate share hospital payment cuts to primary care providers. It also expands access to freestanding birth centers and increases Medicaid primary care physician reimbursement rates to match Medicare rates. The bill also establishes demonstration programs to test payment bundling, a transition from fee-for-service billing models to monthly payments that cover acute and long-term care needs. The Reconciliation Act goes further to address Medicare prescription drug coverage gaps by offering low and middle-income beneficiaries one-time rebates from drug makers as well as 75% discounts by 2020 on brand name drugs and generics.
3. The Health Care and Education Reauthorization Act
Amend the Patient Protection and Affordable Care Act in order to create a health insurance market improvement program, among other purposes.
Part I: Promoting Health Insurance Market Innovation
Requires that the Secretary issue regulations establishing state health care choice compacts that would enable qualified health plans issued by issuers licensed in one state but covered by another to offer coverage in both markets without being subject to the laws and requirements of each purchaser’s home state. Such issuers must provide clear notification that their plans do not abide by all state-specific laws and requirements when offering such plans to consumers.
(Sec. 1001) Prohibiting lifetime or annual limits on the dollar value of health benefits provided under any plan.
Makes permanent the Indian Health Service Improvement Act (IHCIA) and Snyder Act as legal authorities for providing healthcare services to American Indians and Alaska Natives, and extends appropriations funds until FY2014.
4. The Health Care Reform Act
Even with opponents’ efforts at repeal, the Affordable Care Act has made significant headway in providing Americans with access to quality health care. It has reduced harmful practices like denying coverage to preexisting conditions or placing lifetime/annual benefits limits on them; expanded coverage for young adults staying on their parents’ insurance; and closed the so-called “doughnut hole” of Medicare Part D prescription drug coverage.
Health insurance marketplaces were also created, to allow individuals to purchase affordable coverage easily, and compare prices of different health plans online. Furthermore, Medicare reimbursement rates have been linked with quality of care metrics as well as reduced hospital readmission payments.
This bill would extend implementation of health reform law by mandating large employers to automatically enroll new full-time employees into qualified health plans and restricting their ability to opt-out of such coverage. Furthermore, this legislation amends the Internal Revenue Code in order to expand health savings accounts (HSAs) usage while also increasing contribution limits for group HSAs.
