By Emily McKinley, Health Information Specialist
March 23rd marks the second anniversary of the Affordable Care Act. On this date two years ago, President Obama signed into law comprehensive health care reform legislation. The law and its provisions have and continue to be implemented in a stepwise approach such that Americans should reap the full benefits by 2014.
In general, the ACA provisions are designed to improve the quality and lower costs associated with health care, provide consumer protections, mainly in regard to insurance coverage, and increase access to care, especially among lower income, uninsured and underinsured populations.
In 2010, notable consumer protections included eliminating lifetime limits and regulating annual limits on insurance coverage. Annual limits for essential health benefits will be phased out by 2014, protecting the most medically fragile individuals and their families from exorbitant medical costs related to hospital stays, rehabilitative and habilitative services, among others. Additionally, insurance companies were prohibited from denying coverage to individuals who made simple and explainable errors on their insurance coverage applications.
2010 provisions also provided for individuals with pre-existing conditions. Children under the age of 19 years can no longer be denied coverage on the basis of a pre-existing condition while adults with pre-existing conditions have the option of accessing insurance pools previously unavailable to them. Once again, greater protections for adults with pre-existing conditions will be phased in by 2014. Furthermore, young adults won protection in that they were granted access to parents’ insurance plans until the age of 26, if not offered an employee-sponsored health insurance option.
Moreover, in 2010, programs were initiated and funded to provide greater access to health care services to those who are uninsured and underinsured by increasing access to Medicaid as well as increasing payments for rural health providers.
One 2010 provision directly affects all Americans: now individuals can receive preventative health services without paying additional copayments or out-of-pocket expenses. This provision is aimed at serving the entire nation while lowering the nation’s overall health care costs, especially those associated with acute health care episodes and emergency services.
2011 continued to usher in ACA legislative provisions, most of which were focused on regulating the insurance industry and reducing overall healthcare costs. The ACA established the Center for Medicare and Medicaid Innovation, which was designed to target and implement cost-saving measures for state- and federally-funded programs while improving the overall quality of care. Moreover, insurance companies must now use at least 80% of consumer-paid premium dollars on health care expenses and quality improvement measures.
Also notable in 2011, the Community First Choice Option made Medicaid funding available to individuals with disabilities who wish to receive services in their homes and communities vice nursing homes and other institutions.
As the ACA continues to unfold provisions aimed at improving quality while lowering costs of health care, providing greater health care access to all Americans, and protecting consumers, the law will have significant challenges. In fact, just after the celebration of the second anniversary, oral arguments challenging various provisions and the overall constitutionality of the ACA will be heard by the United States Supreme Court. The Court’s ruling, due by July 2012, may drastically change the face of the act and protections granted to Americans. As always, Family Voices will endeavor to keep our consumers informed regarding changes and how they may affect your accessibility to and affordability of care.
For more information on the Affordable Care Act or the provisions mentioned in this article, please visit the Family Voices Indiana blog at http://fvindiana.blogspot.com or the ACA website at www.healthcare.gov.