Usually in this column, you ask me questions about health care and I answer them. This week, however, is different. This week is BIG. So big, in fact, that I’m going to switch things up a little bit and I am going to ask you a question. Are you ready for it? OK, here it goes:
What is the best thing the Affordable Care Act has done, or is going to do, for you? I’m asking this question because this week marks the ACA’s second birthday.
On March 23rd, 2010 President Obama signed the Patient Protection and Affordable Care Act (aka “health reform law”) into law, and since that day we’ve been seeing steady improvements to Americans’ access to health care. This is a big deal! Even bigger a deal is the fact that starting next week the Supreme Court is going to start hearing the lawsuit against the ACA, and we want all of y’all to be aware of what you stand to gain – or what you stand to lose – based on their decision.
So I’ll make this easy on you – no essay questions. Instead, I’m going to give you some multiple choice options to pick from. What follows are what I consider the Top 10 ACA Greatest Hits.
Pick the one that you love the best, the one you wouldn’t want to be without, and then paste it to your Facebook status or tweet it out with the hashtag #hcr or #HealthCareWorks. Let your friends know how the Affordable Care Act is helping us all!
1. As of 2010, the lifetime caps on health insurance benefits that used to hurt the sickest insured folks are GONE. No more will a health insurance plan drop your coverage when you get so sick that your medical bills hit the roof. Now when you say you are insured, you can really mean it! Hooray for health reform!
2. Thanks to the ACA, kids can’t be turned down for health insurance based on pre-existing conditions. Whether your child has asthma, leukemia, or was simply born prematurely, insurance companies can no longer deny them coverage, nor as of 2014, can they charge sky-high premiums for any health condition. What’s more, kids can now stay on their parents’ insurance through the age of 26, even if they’re working, in school, or married. That’s helping a lot of young folks as they go out on the job market after high school or college and have trouble finding a job that offers health insurance. And as if all that weren’t enough, kids now receive preventive care (well-child exams, immunizations, etc) at no cost!
3. Women are looking at some seriously amazing benefits with ACA. First of all, starting in 2014, women can’t be charged more than men for the same health insurance policy like they can now. Being a woman won’t be a pre-existing condition anymore! Even sooner, starting in August of 2012, women will have access to all forms of prescription birth control for free! With no out-of-pocket costs, everything from the pill to shots, to IUDs, to tubal ligation help families plan better for their futures.
4. The Affordable Care Act is making sure that in 2014, all health insurance policies will cover 10 Essential Health Benefits. What are these benefits? Check it out: ambulatory patient services; emergency services; hospitalization; maternity and newborn care; mental health and substance use disorder services, including behavioral health treatment; prescription drugs; rehabilitative and habilitative services and devices; laboratory services; preventive and wellness services and chronic disease management; and pediatric services, including oral and vision care. WOOOOOT! Health care for all, and full coverage for varied health needs!
5. In 2014, ACA will mandate a Medicaid expansion that will dramatically change the health profile of low-income communities. In Texas, 2.5 million kids are covered under Medicaid, but only 225,000 of their parents are. In 2014, that will change, and hundreds of thousands of low-income adults, some of whom currently rely on expensive emergency room services for health care, will be able to visit a doctor instead. This will save us billions of dollars nationwide in uncompensated care, reduce emergency room overuse, and bring $76 billion in new federal Medicaid matching funds to Texas.
6. Because of the health reform law, many small business owners have access to new tax credits to help them buy health insurance for their employees, if they want to. It’s 35% now, and in 2014, the tax credit will go up to 50% of the employer’s premium. There will be no penalties or obligations for small business owners (50 or fewer employees) who choose not to provide insurance, but for those who do, the ACA will help many of them afford it through these tax credits on the Small Business Health Insurance Exchange (called SHOP).
7. Thanks to the ACA, in 2014 people who have to buy their insurance on the individual market (that is, those of us who don’t get insurance through our jobs, but still want to buy insurance) will be able to go shopping on the Exchange – where plans will have to compete side-by-side, using clear language. And help is available to people who want insurance, but can’t afford it. The government is making subsidies available to people with moderate incomes – if you earn approximately $90,000 or less (for a family of 4), you’ll receive sliding scale discounts to the cost of your insurance policy.
8. In 2014, insurance companies will no longer be able to deny ANYBODY coverage due to pre-existing conditions. Currently they can’t do it for kids, but in just over a year and a half, we all are covered by the health reform law. No exclusions, and they can’t charge you higher premiums, either.
9. For seniors and the disabled on Medicare, you are already receiving free screenings and preventive care. Also, the ACA is closing the Medicare prescription “doughnut hole,” by making prescription drugs more affordable. In Texas in 2011, the average savings was approximately $639 for each person who fell into the doughnut hole. By 2020, the gap in drug coverage will be completely gone.
10. For those adults who are in “limbo” waiting for 2014 – you can’t get insurance because of a pre-existing condition, but you don’t qualify for Medicaid or Medicare – you can join the ACA’s high risk pool, or Pre-exisiting Condition Insurance Plan (PCIP), which offers insurance to those people who can’t get covered today, but can’t wait for 2014.
All right, fellow Texans. That’s a hot list of great benefits, all thanks to the Affordable Care Act. Pick your favorite. Tweet it out, post it to your Facebook page. Let the ACA know that we are wishing it a HAPPY BIRTHDAY, and keep your eyes peeled for developments in the coming days as the Supreme Court hears the case.
To a well and healthy Texas,