Breaking down the Affordable Care Act
For decades, American presidents and legislative leaders have attempted to pass a law which would lead to greater accessibility to quality affordable health care. On March 23, 2010, the first national law addressing this issue was signed into law. The U.S. Supreme Court has just determined that the Act is, in fact, constitutional. Most of the provisions will take place by 2014. Following are some of the changes now in place:
- Young adults, up to age 26, may be eligible for coverage under a parent’s health insurance;
- Insurance companies may not deny coverage to a child due to a pre-existing condition;
- Seniors whose use of the Medicare Part D prescription plan leaves them in the “donut hole” coverage gap receive a 50% discount on brand name prescription medications. Seniors will see additional savings until the gap is closed in 2020:
- Seniors also have access to annual wellness visits without cost, including preventive services;
- A pre-existing condition insurance plan provides new coverage options to individuals who have been uninsured for 6 months due to a pre-existing condition. Pennsylvania also has such a plan in effect, known as the PA Fair Care Plan. In 2014, all discrimination against pre-existing conditions will be prohibited;
- and Small Employer Tax Credits help small businesses and tax-exempt organizations afford the cost of covering employees.
Starting in 2014, you will be able to shop for insurance and compare health plans in new, state-based, Affordable Insurance Exchanges. Pennsylvania has already been awarded grants for Planning and Level 1 development. Subsidies will be awarded to eligible persons to assist them in purchasing insurance.
One of the goals of this broad based law is to modify the focus of health care delivery from an “illness” model to a “wellness” model. For example, there are incentives for more physicians to go into primary care, and there is an expansion of coverage to include preventive measures.
To review the Epilepsy Foundation of America’s press release on the decision to uphold the Affordable Care Act, click here.