Beyond the headlines, hype and hearsay
Why study it?
Putting politics aside, putting aside all opinions of whether you love or hate the thing, we must figure out this Patient Protection and Affordable Health Care, aka Affordable Health Care (herein referred to as ACA) and what it means to us and our wallet. It’s here to stay—at least for now—so let’s go beyond the headlines, hype and hearsay and learn about it once and for all. According to a study by the Kaiser Family Foundation, since the passing of the ACA, 53% of Americans are confused by its content—and perhaps its intent as well. The study went on to declare that the 47% who claim to grasp it all; in actuality, possess a shallow understanding of this new law at best.
Having had the privilege to work for a retired U.S. Senator with the writing of his memoirs, I received a virtual glimpse into the senate chamber during the debating, voting and passing of the stimulus package and this health care bill. All I can say is that it was one of the most complex segments of that senator’s memoirs to write about, so I can’t even imagine having to actually live through it! Hundreds of amendments; the back and forth “We have our 60 votes,” “No, we don’t have our 60 votes,” debacle; and of course the filibustering. Oh my!
Just as this legislation took a month of Sundays (this phrase’s origin implies a very long and dreary time) to come into law, learning all about it will take a while as well. I’ll try not to make it a dreary and boring process for you as I dissect the pertinent points of this 906-page ACA. As we break down these components, and navigate them through our great big health care industry that is designed to—believe it or not—care for our health, it is my hope that we find our path of least resistance.
This ACA information to be presented in my upcoming blogs will come from various sources. While obtaining my Master’s degree in Health Law, our class received great insight from some law professors who manage dual careers in law and in medicine. I’ll use some of those academia sources. Some of my information will even be gathered from congressional reports. Mainly, though, I will derive my material from online sites and the numerous books and articles I’ve read on the topic. Regardless of the source, these blogs are designed to make you an informed consumer only, not to persuade you to agree or disagree with what the ACA aims to do.
With that being said, let’s dig into this material starting with important dates for you to consider. Some of these dates are just for informational purposes. Other dates are for you to be mindful of for purposes of compliance.
March 2010 – President Obama signed the Patient Protection and Affordable Care Act into law. This legislation is a comprehensive health insurance program that created a competitive health insurance marketplace. This reformed package will roll out in various phases over a four-year period and even beyond.
January 2011 – Medicare’s prescription plan donut hole begins to close. It will disappear completely by 2020.
September 2011 – Children can be insured as dependents on their parents’ insurance policy up to age 26. Children under 18 cannot be denied insurance due to pre-existing health conditions.
October 2011 – CLASS, which stands for Community Living Assistance and Supports, was an insurance plan that helped with the long term care of the elderly and disabled. You had to be over age 18 and working to be eligible. It was forced to be suspended by the White House when it couldn’t prove to be sustained through enrollee contributions.
June 2012 – the Supreme Court of the United States ruled in favor of the Obama Administration on almost all legal points, particularly the provision that states all Americans must obtain health insurance or pay a fine.
August 2012 – “Contraception Mandate” coverage went into affect, requiring most employers to provide their female employees with insurance plans that offer birth control without a co-pay.
October 2012 – the voluntary long term care program, CLASS, was available once again.
February 2013 – After nearly 50 lawsuits filed in federal court by various employers with religious objections, the Obama administration announced that certain employers would be exempt from the contraception mandate.
Future Dates to watch for
October 2013 – Individuals will be able to receive information about all the plans available in their area. They will also be able to start enrolling.
January 2014 – Each U.S. state (providing they comply) will participate in the Health Insurance Marketplace; whereas, health insurance will be sold to individuals and small businesses tailor made for their budgets. Americans who choose not to purchase coverage with at least “essential health benefits” could face a maximum penalty of $285 per year through the Individual Mandate Tax.
January 2015 – Americans who choose not to carry at least “essential “ health insurance plans could be liable for a maximum penalty of $975.
January 2016 – Americans who choose not to carry at least “essential “ health insurance plans could be liable for a maximum penalty of $2085.
In Part 2, we’ll look at the 23 groups that are affected by the ACA. Based on its provisions, I will share with you whether that means good news or bad news for each of those groups.
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Disclaimer: All studies, facts and statistics have been cited, although citations have been excluded from this copy. References are available upon request.