Care with Obamacare Healthcare Insurance
Care with ‘Obamacare’!

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On March 23, 2010, Obamacare, officially named “the Patient Protection and Affordable Care Act” (PPACA) was signed into law by President Barack Obama. Obamacare came into existence with the target to increase the rate of coverage and reduce the health care costs in United States.

A certain percentage of people who are not insured (privately, or through government-provided health insurance, or provided through employer) often face non-treatment days where they carry on without any medical care. This is a grave situation which affects life expectancy, general well being, productivity etc.

To increase the number of people covered by insurance, at lower health care costs is the purpose of PPACA. It is based on pillars of ‘mandates’, ‘subsidies’ and ‘tax credits’ to employers and individuals so as to have more number of people insured and covered. Mandates are strict compulsions for an individual or employer to have private health insurance in lieu of or in combination with a national health insurance plan. A tax credit may be given to disabled or elderly people, low income individual, or it may exist for certain mortgage programs etc.

All these measures, target to improvise the healthcare delivery and the overall health care experience in the United States. The PPACA represents the most significant government expansion and regulatory overhaul of the US healthcare system, since 1965.

Important changes planned with Obamacare
Obamacare is all about Universal health care which intends to encompass medical help/health care and financial protection to all its country men. It does not measure every insured person with the same yardstick, rather, the Patient Protection Affordable Care Act takes into account who is to be covered, what coverage is fit for him and what cost is covered/insured.

Some of the highlights of Obamacare pertains to the elderly, the dependent children, pre-existing conditions, issue of gender discrimination for insurance, mode of buying of health insurance, reduction in insurance premiums etc. We have explained a few important points for you:

  1. Subsidies– The low-income group of society (those who come under the 400% of Federal Line of Poverty) and employers are provided subsidies to purchase coverage plans at an average of 60% less than what they currently pay.
  2. Pre-Existing Conditions– There are a lot of changes coming up in 2014 pertaining to the pre-existing conditions:
    1. Insurance companies can not refuse insurance or ask more premiums from anyone with pre-existing conditions.
    2. People who have remain uninsured for a period of 6 months or more, and suffer from some pre-existing condition can not be denied insurance and are provided subsidies on premium through the temporary Pre-Existing Condition Insurance Plan.
    3. Currently, some insurance plans do not cover children under 19 those suffer from some pre-existing condition. Starting 2014, this will be abolished and they can be covered appropriately. However, it is possible that until 2014, in such cases, higher premium would have to be paid.
  3. Dependency on parents– With Obamacare, young adults (living alone or with the parents, married or school-going) till the age of 26 can be dependent on their parents. Starting 2014, even if such adults are covered at work, they can still stay dependent on their parents.
  4. Mode of buying health insurance– Starting October 1, 2013, online marketplaces known as exchanges will be open and health insurance can be bought online after through comparison and checking if someone is eligible for any kind of financial help. It will also be possible to check the eligibility for subsidies for out-of-pocket costs or for Medicare/Medicaid etc. These exchanges can be used by individuals, families or small business units.
  5. Gender Discrimination– Currently, insurance companies can charge higher premium based on gender as men visit a doctor/hospital less often than women. Starting 2014, no such discrimination will be made.
  6. Age– Currently, the elderly can be charged five times as compared to the youngs. With Obamacare, this won’t be possible and the younger generation would have to compensate for those who are older. There will be a pool that would see a mix of elderly sick people and young healthy people, this would lower the premiums for the older people.
  7. Changes in premiums – It is believed that with Obamacare, the monthly premiums may go up but at the same time, the coverage would become more comprehensive and in the end, the out-of-pocket charges would be less.
  8. Basic essential coverage– It will also become mandatory, the existence of essential coverage which includes certain minimum level of coverage. This would indicate emergency services, maternity care, mental health, pediatric care, outpatient care, hospitalization, vision and dental care for children, prescription drugs etc.
  9. Addressing the elderly– PPACA includes various provisions for making quality and cheap healthcare available to the elderly. This basically encompasses increased access to preventive care and the discounted rate of prescribed drugs. The seniors who reach the “donut hole”, a point when they are required to pay the full charge of prescription drug will get a 50% discount starting 2012 when they buy a branded drug and also they will be eligible to receive 14% discount on generic drugs. Also, since 2011, they are offered free cancer screenings, wellness checkups, vaccines, flu shots etc.

The Penalty for the uninsured!
Starting 2014, those who do not purchase insurance when they can still afford it, would be penalized. For an individual, the penalty would starts at $95 a year or up to 1% of income (whichever is greater), and by 2016, the penalty would go up to $695 per year or 2.5 % of income. For a family, the penalty would be $285 in year 2014 which may rise to 2.5 % of income or $2085 in 2016.

The whole purpose of these penalties is to ensure the minimum health coverage to everyone, to achieve the goal of universal healthcare.

What does the future holds?
With the noble mission to increase the rate of insurance coverage and to reduce the healthcare costs, the Patient Protection and Affordable Care Act, popularly called the Obamacare, a lot needs to be achieved. The existence of skilled healthcare personnel to the decision about the scope of online healthcare insurance marketplaces all seems to go a hard road. Where the elderly would be compensated for high premiums, the younger generation would come into a state where they need to pay high premiums. What would be their stand on this, whether they would prefer paying the imposed penalty or buy insurance with increased premiums is unsure and uncertain as of now? The future beholds a lot of behavior that can not be predicted as of now. What we can now understand that the measures adopted for the implementation of this law, would see an increase in the number of insured people, but it is also a question if the current shortage of primary care physicians would be tackled well enough and timely.

The future is nebulous but the present stands on the foundation of a good cause with the goal of quality and affordable care. We would invite your comments and opinions in our comment box. We would like to read and hear what do you think and how do you perceive the Obamacare under Barack Obama’s administration!

Category: Medical Insurance

June 26, 2013 at 10:07 PM

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