All arguments aside, ‘Obamacare’ means big changes to health care, insurance
By Sara Cardine 01/24/2013
Although the Patient Protection and Affordable Care Act, passed by a much-divided Congress and signed into law by President Obama in March 2010, has undergone political scrutiny and analysis from both Republicans and Democrats since its inception, most of its mandates will not take full effect until Jan. 1, 2014.
So this year is the perfect time for patients to learn more about their rights and protections under the act, as well as what their share of the burden of care will be, as state and local agencies prepare to put into effect its many changes.
One of the mandates of the Affordable Care Act is that all citizens will be required to have some kind of coverage, either through their employers or their own means. To create a more accessible health insurance marketplace, the law provides for the creation of state-run health insurance exchanges, which will be able to provide different coverage level plans and providing federal subsidies to low-income residents.
The state of California was awarded a $674-million federal grant earlier this month to create its own health insurance exchange. This will allow the state to broker cheaper plans for citizens and help people navigate their options, including eligibility for Medi-Cal, more effectively.
Insurance coverage under the new health care plan will open up affordable options to people with pre-existing conditions that may have disqualified them from coverage or subjected them to sky-high premiums. In the state of California, the Pre-Existing Condition Insurance Plan will cover a range of benefits, including primary and specialty care, hospital care and prescription drugs, according to the US Department of Health and Human Services’ Web site, healthcare.gov.
Preventative medicine as a key component of comprehensive health care will be emphasized as the ACA begins to take effect. Certain prevention-related treatments, such as colonoscopies, cancer and blood pressure screenings, may be available without a co-payment or increased deductible.
Similarly, services for women — from well-woman visits and reproductive services, including breastfeeding support and contraceptives counseling, to STD screening and domestic partner violence counseling — will also be offered with low or no deductible or co-pay.
Under the ACA, children will be able to remain covered by their parents’ health plans until they are 26 years old, to help those students whose educational careers are prolonged or who do not get insurance coverage from their employers.
In a Nov. 30 panel interview for NPR’s “Science Friday,” Margaret Flinter, a nurse practitioner and senior vice president and clinical director of Community Health Center, Inc. based in Connecticut, shared her hopes that relieving the burden of health care access could free up providers to focus more on their overall approach to treating patients — from using technologies like Skype for consultations with specialists to patients’ being able to have experts from different disciplines confer virtually over a possible diagnosis.
“It’s very exciting to think about once we’ve leveled the playing field a little bit, where our efforts don’t have to go into trying to scramble to find resources for people but can be put into the best use of them,” Flinter told NPR host Ira Flatow. “I think we’re going to see some really exciting advances.”
To read or browse through sections of the full Patient Protection and Affordable Care Act, visit healthcare.gov/law/full.