This Affordable Care Act summary is what I have concluded from my research
Creating an Affordable Care Act summary is complicated to say the least. Whether your concerned about yourself, your business, or your health care in general, this huge piece of legislation is about to impact the health care industry, health insurance industry, and where we receive our health insurance. I find many dynamics of the act interesting and have spent many hours researching the critical components of the health care law to understand how my family, my employer, and the economy might be impacted as the administration implements key provisions of the affordable Care Act. Below is a general summary of the critical provisions I feel will have the greatest impact on myself. This site contains many detailed pages if you’d like to find further details. This summary is general to give someone a digestible list of what to expect as it is implemented. Please see the Affordable Care Act timeline to quickly see when to expect provisions to be implemented.
Individuals will be accountable to carry health insurance coverage or be assessed penalties by the IRS. Individuals will responsible to share in the cost of health care. Penalties will increase from 2014 – 2017 for those who choose not to be covered. The IRS will not be able to enforce these penalties criminally like they do taxes. Individuals should expect greater access to health care and less control by insurance companies. Individuals will see dependents able to stay on their plans up to the age of 26, expanded preventative services without co pays, the elimination of pre-existing conditions, elimination of life time limits, and increase in annual limits. Individuals should receive resources to compare plans and understand health care coverage. Premium tax credits will be available for individuals and families between 100% and 400% of the Federal poverty line.
Affordable Insurance Exchanges:
Federal and State governments will operate exchanges in all states. Individuals and small businesses will have a competitive marketplace to acquire health insurance. Health care plan coverage levels will be certified and regulated by the exchanges. Individuals and small businesses will be able compare plans, understand coverage levels, and have access to applicable premium tax credits and cost sharing resources available. Resources will assist in enrolling in private health plans and other health plans such as Medicaid and Children’s Health Insurance Programs. Insurance exchanges intend to create competition between insurance providers to level the playing field and produce affordable health insurance premiums for everyone applicable to a typical large employer sponsored plan.
Small business finds their way into the Affordable Care Act summary in two ways. Small businesses with less than 25 full time and full time equivalent employees that have an average salary of less than $50,000 will be eligible for tax credits if they offer health insurance to their employees. Small businesses that have more than 50 full time and full time equivalent employees will face Affordable Care Act penalties if they do not offer health insurance to all of their full time employees. Employer insurance plans will eventually need to meet minimum requirements and contain essential health benefits for their employees. Employer sponsored plans will be determined un-affordable if they exceed 9.5% of the employees income.
Insurance companies will face greater accountability. 80 cents on the premium dollar will be expected to go towards medical costs or improving medical care. Lifetime and annual limits will be eliminated or increased over time. Pre-existing conditions will be eliminated along with regulating how insurance companies can discriminate, drop, and deny coverage. Premium increases over 10% per year will be scrutinized and resources will be available to appeal coverage decisions. Insurance providers and brokers will pay fees to fund the exchanges and states will dictate their involvement with the consumers through the exchange.
Preventative services will be accessible to our seniors without co pays or deductibles. Prescription drug costs will decrease. Resources will prevent Medicare fraud. Medicaid will be expanded to 133% of the Federal poverty line, opening the program up to many.
Primary Care Providers:
This Affordable Care Act Summary finds primary care providers a key component as provisions of the Act are implemented. Bonuses, training, scholarships, and loan repayment options will be available to incentivize the increased demand for primary care providers and nurses. Providers will be asked to become more efficient. Bundled payments will become common as providers are compensated for a complete procedure rather than for each component of the procedure. Our providers will find compensation as a group for a surgery more common than paying the surgeon, nurse, and anesthetist. Many Accountable Care Organizations are currently operating under this model saving millions in Medicare so we can expect it to continue. The demand for primary care providers is currently strained and we can expect it to continue as payments decrease and the number of people with access to health care increases.
These are the components of the healthcare law that I am watching closely. This site is filled with information and details regarding this Affordable Care Act summary. We update this site often as the administration and the Secretary of Health and Human Services release details that are undefined in the Act itself. It will be interesting as we find out if the benefits come to fruition and the costs to implement and operate become realized. We are about to change billion dollar industries in a stagnate economy. Regardless of who you voted for, every American should be watching as this incredible piece of legislation is implemented over the coming years. It will likely impact ourselves, our employers, and our economy as we make changes with far reaching implications to our health care.