Trends, Best Practices, & Learning Opportunities

An Overview on Affordable Care Act (Obamacare)

The Affordable Care is a new healthcare reform in the US which increases the quality, availability, and affordability of private and public health insurance to 44 million uninsured civilians. In civilian terms, it is Medicare for All (proposed by Clinton Administration).

Key Elements Included in the Affordable Care Act (ACA)

  • Measures to include pre-existing condition coverage.
  • Expand Medicaid to 15.9 million civilians below 138% of poverty level.
  • State specific health insurance marketplaces (Exchanges).
  • Low to middle-income Americans can shop for free or low-cost health insurance.
  • Forbids insurance companies from plummeting civilian coverage if Americans make an honest mistake on their application or get sick.
  • Allows young adults to stay on their parents’ plans until they are 26 years of age.

The Affordable Care reform is a steppingstone to the future:

  • The healthcare system in the US is projected to cost citizens 2.8 trillion dollars in 2013 and would grow every year. It is being projected that Americans will spend 4.5 trillion dollars on healthcare in 2019.
  • According to a report by Health Care for America Now, America’s five biggest for-profit health insurance companies ended 2009 with a combined profit of $12.2 billion.
  • The top executives at the five largest for-profit health insurance companies in the United States combined to bring in nearly $200 million in total compensation for 2009. (Source)

The bottom line remains unchanged that ACA aids to restructure the healthcare system by giving more Americans access to reasonable health insurance while helping decrease of healthcare spending in the U.S.

ACA states the following areas in detail. Each topic is a title, which contains segments of necessities that reform health care system.

  • Title I Quality, affordable health care for all Americans
  • Title II The role of public programs
  • Title III Improving the quality and efficiency of health care
  • Title IV Preventing chronic disease and improving public health
  • Title V Health care workforce
  • Title VI Transparency and program integrity
  • Title VII Improving access to innovative medical therapies
  • Title VIII Community living assistance services and supports
  • Title IX Revenue provisions
  • Title X Reauthorization of the Indian Health Care Improvement Act

Do we really need this care?

YES! This Act would help 32 million civilians to afford healthcare who could not get it before. 95% of Americans will be insured. Though the high-earners might get some new taxes, especially on the employer mandate and individual mandate, but the flip side is that over half of the uninsured civilians can get free or low cost health insurance using their state’s Health Insurance Marketplace. Remember, the individual mandate says that you have to gain health coverage by Jan 2014, but if you are not, then pay a fee or get an indemnity if you can afford it.

With Maine to become the first state in the country to offer residents access to their personal health records via health information exchange, ACA is already creating waves across the nation. As of January 24th, according to the Obama administration, more than three million people have signed up for private health insurance on the federal and state health insurance exchanges. These numbers are sure to increase in 2014, which would eventually fulfill the objective of this Act.