The Kaiser Family Foundation’s “Focus on Health Reform: Summary of the New Health Reform Law”
HLT515 Social Behavior and Cultural Factor in Public Health
Week 8 Discussion
DQ1
In March 2010, President Barack Obama signed the Patient Protection and Affordable Care Act into law. Will this legislation help decrease or eliminate health disparities? Can it be more effective? Use the Kaiser Family Foundation’s “Focus on Health Reform: Summary of the New Health Reform Law,” assigned as reading for this module, for a reference.
ADDITIONAL DETAILS
The Kaiser Family Foundation’s “Focus on Health Reform: Summary of the New Health Reform Law”
Introduction
The new health reform law will help millions of people get better care, but it also has a lot of work to do to improve the affordability and quality of coverage. Here are some highlights from Kaiser’s “Focus on Health Reform: Summary of the New Health Reform Law.”
Highlights:
The health reform law also includes a number of provisions that will help people with pre-existing conditions get coverage, including:
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Insurers may not deny coverage to anyone based on their health status.
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People who are denied coverage because they have been diagnosed with a pre-existing condition can appeal the decision and get assistance from an insurance company for up to 12 months before they have to reapply for care.
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Beginning in 2014, states will be given more flexibility in designing their own insurance marketplaces. In addition, if you live in one of these states but move out of state or choose another kind of health plan outside the exchange (like employer-sponsored plans) then your new employer should automatically enroll you into its plan within 60 days after you leave your old job; however if it doesn’t do so within this timeframe then you may contact them directly with questions about enrolling again at no cost!
The law will extend coverage to over 30 million people by 2019.
As of December 21, 2013, the law has extended coverage to over 30 million people.
The law will help expand Medicaid (the state health insurance program for low-income people) and make it available to more people in 2014. This is important because many uninsured families do not qualify for Medicaid because they earn too much or have other resources that make them ineligible. The Affordable Care Act provides some financial help for those who are able to get regular health care but cannot afford it or have trouble finding a good provider that accepts their coverage plans.
The new law sets up State-based American Health Benefit Exchanges for individuals and small businesses
The new law sets up State-based American Health Benefit Exchanges for individuals and small businesses. These marketplaces will be run by the states, but they will be overseen by the federal government and help set up their websites.
The exchanges are a marketplace for people to buy health insurance, which is different from Medicare (which covers senior citizens) or Medicaid (which covers those without income). People who want coverage on the exchange can shop for plans online or over the phone with an agent. The exchanges will also provide information about how much you might pay in premiums each year and what benefits you could receive under your plan of choice—so it’s easier than ever before!
Insurance reforms will ensure that people with pre-existing conditions can get covered
The new health reform law will:
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Make sure that people with pre-existing conditions can get coverage. Insurers will be prohibited from denying coverage to people with pre-existing conditions, and they will also be required to cover those same individuals. This is an important provision because research has shown that many insurers have been charging higher rates for older adults or those with pre-existing conditions in order to offset the cost of covering younger and healthier customers who may not need as much care.
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Provide long-term care services at no extra cost. The federal government has committed $200 billion over ten years to pay for expanded Medicaid eligibility for long term care services such as nursing home care, home health aides, adult day care centers and other similar programs; this funding is expected to help prevent more than 1 million Americans from losing their jobs due lack of access
The law requires insurance companies to spend at least 80% of premium dollars on direct health care expenses and quality improvement efforts
The law requires insurance companies to spend at least 80% of premium dollars on direct health care expenses and quality improvement efforts. The requirement does not apply if the insurer has a “high deductible health plan,” which means the plan requires individuals to pay a certain amount before coverage begins (e.g., $1,200 per person).
Insurance companies can choose to spend more than 80% in any year; however, they must be transparent about how they spent their budgets and explain why they didn’t spend all of their money on patient care or quality improvement initiatives as required by this law.
To law helps make coverage more affordable
The Affordable Care Act is a law that helps make coverage more affordable, comprehensive and portable. To do this, it:
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Provides tax credits to help people afford health insurance coverage. These credits are based on income and family size, so they can lower the cost of premiums for those who qualify.
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Requires all Americans to have health insurance or face a penalty (called the “individual mandate”). This requirement applies regardless if you work or not; it applies even if your employer provides you with health benefits through a plan purchased through your employer’s group plan or other arrangements such as HSAs (Health Savings Accounts). If you choose not to buy insurance but still owe back taxes due from previous years that haven’t been paid off yet – yes, this includes unemployment benefits as well! – then there will be penalties assessed against some portion of those funds until full payment is made within 60 days after receipt by IRS agents patrolling local streets wearing bullet proof vests just waiting around corners ready at any given moment during business hours (and sometimes even days) looking for people who might need help paying their bills correctly because apparently these days nobody knows how math works anymore…
Conclusion
Now that you know all about health insurance reform, it’s important to remember that this law is still in its early stages and there are many changes ahead. The law will take effect in 2014, but the implementation process has been slow and complicated. We still have a long way to go before we see how these reforms affect us all as individuals. As we do our best to navigate through the coming years together, we hope this resource will be helpful in keeping you informed and up-to-date on what’s happening with our democracy at large!
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