Affordable Care Act Debate

The pros and cons of the Affordable Care Act. Ongoing debates and discussions on how it effects the public and businesses.

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Affordable Care Act


ACA


The Patient Protection and Affordable Care Act (PPACA) is the law by the United States Government to bring health care insurance affordable to all. The law was signed on March 23, 2010. The law requires US citizens and legal residents to have health insurance. The main goal is to improve the health care access to individuals and reduce costs. The ACA provides Exchanges from which health insurance can be purchased according to the individual needs. Employers can buy insurance to their employees using the exchanges. The law expands Medicaid to 133 percent of the federal poverty level.

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Coverage

As per ACA, health insurance plans cannot limit or deny coverage for children due to preexisting condition. Children under 26, can be covered under parent's health plan. In addition, health plans cannot cancel coverage arbitrarily and gives the consumers right to appeal if any payment is denied.

Market Place Coverage

Cost

With ACA, new health care plans do not have lifetime limits on most benefits. Before any premium is increased, insurance companies must publicly announce the rationale behind the hike. As per ACA, the premium you pay must be toward your health care and not for the administrative costs.

Plans and Prices

Care

With ACA health care plans, you may be covered 100 percent for preventive care and with no co-payments. Annual wellness checks are covered and you can select a doctor from the list of doctors available in your plan. ACA lets you avail emergency services outside of your health plan's network.

Rights and Protections

Penalty

As per the ACA, all citizens and legal residents must have health insurance year round. There may be a penalty for not having insurance. You can claim an exemption based on certain conditions. If you are covered under other plans, you can show that as a proof.

Fees and Exemptions

ACA for Small Business

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Affordable Care Act mandates that businesses provide their employees with health insurance for minimum effective coverage. Small Business Health Options Plan (SHOP) is available for businesses with 50 or fewer employees and the average salaries are $50, 000 or less. If small businesses buy health insurance for their full time employees using the SHOP marketplace, they may be eligible for tax credits up to 50% of the premiums. Create an account or find an agent to get started.



ACA: Pros

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Affordable Care Act is in its sixth year of implementation and has brought millions of consumers under the health insurance coverage. Some states have expanded the Medicare program as part of the Affordable Care Act and the number of insured has increased in all the states. As of March 2016, 20 million people have insured since the ACA was introduced in 2010. The young generation and minorities have seen an increase in the enrollment. The individual mandate and the employer mandate has forced many to take up health insurance as per the ACA. Here are some pros of Affordable Care Act:

  • Fair treatment by health care providers
  • Coverage for low income and middle income consumers
  • Enhance coverage for youth
  • Avoid waste in healthcare spending
  • Provide businesses a way to buy insurance for employers
  • Avoid overcharge by the health insurance companies
  • Control the rising costs of health care
  • Expand coverage for consumers with preexisting conditions


ACA: Cons

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The Affordable Care Act has faced many backlashes in terms of technology, insurance coverage loop holes, mandate rules, and so on. The law forced millions to buy health insurance but has not provided detailed information to the general public. The agents and brokers act as a barrier between the benefits and the common people. Consumer is still not able to decide which plan works best for them and how can they minimize the premiums without paying the penalties. Many faced penalties just because of the system crashes during the peak signing period. Businesses are confused as well as how to claim the tax credits and which plans to offer to its employees. The enormous documentation and conditions confuse the general public everyday. Here are some cons of the ACA:



  • The penalties are causing heavy burden to individuals as well large scale industries
  • The tax credits and eligibility guidelines are posing a big hurdle for many
  • Over-buying or under-buying is a common problem and the employer offered plans also may not be suitable for individual needs
  • Shorter enrollment periods with system crashes and limited guidelines confuse people
  • Long term cost curbing methods need to be defined more accurately
  • Marketplace options are misleading and comparing plans need detail assistance
  • When some states expanded ACA to Medicare, what is covered is still highly vague
  • Language barriers and lack of information is a challenge for immigrants

ACA Debate

ACA has been a revolutionary law in the US health care history. There have been many stories of how ACA was helpful or not helpful at all.



Here are the common questions in the ACA debate:

  • Have you enrolled in the Affordable Care Act?
  • Which metal plan did you use?
  • Are your employees satisfied with the SHOP?
  • How did it effect your business?
  • How did ACA change your life?
  • Did your health costs reduce?
  • Are you more comfortable with the insurance coverage you have?
  • What else would you like to be covered under the Minimum Effective Coverage?
  • What enhancements do you think is required for the ACA?
  • What are the loop holes that we need to be aware of?
  • What we need to ask an agent?
  • What are the limits and exceptions?
  • What other instructions and guidelines do you need?
  • How would it cost individuals and businesses if ACA is repealed?

Participate in the ongoing discussion and contribute to the debate.