Affordable Care Act/Obamacare Turns 3
This weekend marked the third birthday of the Patient Protection and Affordable Care Act (PPACA), most commonly referred to as Obamacare. There are things that worked well, there are things that faced some challenges and then there are the big things we are still waiting for. What can be said for sure; we have had three years of a deeply divided government and country when it comes to their views of the law. Below is the list of the Obamacare Items that were implemented in 2010, 2011, and 2012
Affordable Care Act 2010 Accomplishments
March 23, 2010, President Obama signed the Affordable Care Act. With the democrats control senate, house, and presidency, The bill was signed into law. The law took into account some retroactive measure effective January 1, 2010
Small Business Health Insurance Tax Credits
Starting January 1, 2010 all small businesses are eligible for health care tax credits to assist in providing health care benefits to employees. The law will provide a tax credit worth up to 35% of the employer’s contribution to the employees’ health insurance. Small business that have non-profit status may receive up to a 25% credit
Starting April 1, 2010 each state was eligible to receive fund matching for the coverage of additional low income and families within the states Medicaid, these are funds that were not available prior to the Affordable Care Act. The Medicaid Expansion helps support the cost of states insuring additional low-income individuals.
Medicare Donut Hole Coverage
Starting January 1, 2010 any Medicare recipient who reach their maximum prescription drug coverage and had to pay for drugs in the “Donut Hole” gap during the 2010 year, received a rebate check in the amount of $250 non taxable to help reimburse the cost they might of incurred. (Rebate applied for 2010 year only) To date this program has help save billions.
Affordable Care Act ERRIP, Coverage of Early Retirees.
The Affordable Care Act established the ERRP program to provide employers and other health plan sponsors 5 Billion dollars in funding to insure individuals that retired early between the ages 55 and 65 and their dependents. The health care providers who were eligible to provide such plans would receive a partial reimbursement by the federal government for benefit between June 2010 until 2014. This program was aimed as bridge funding until the Health Insurance Exchange becomes established in 2014. This program had some complications in that it ran out of money. The 5 Billion dollar was underestimated for the three and half year span.
Obamacare PCIP Program, Pre-Existing Condition Insurance plan
Obamacare provided a health insurance pool to cover individuals that were uninsurable due to any Pre-Existing Condition. The plan was set to provide coverage options to individuals who were uninsured for a minimum of six months because of a pre-existing condition. The plan was established by either the state or department of HHS. This was another program to provide bridget funding until the Health Insurance Exchange opens in 2014. The PCIP program was shut down in January 2013 for a myriad of reason, but mostly the 5 Billion dollars in funds was consumed faster than the timeline allowed, by the end of 2012 the program had already consumed 50% of its budget in medical claims alone.
Affordable Care Act Young adult Coverage
Established for all plans starting after September 2010. All young adults were eligible to stay on parents coverage up to the age of 26 as long as the young adult was not offered insurance at work.
Affordable Care Act Preventative Care Coverage
All small group employer health care plans that were not grandfathered or established after March 23, 2010 must provide preventative health care coverage to their beneficiatries. Plans subjected to the new requirements must provide the service listed below at no charge.
- Blood pressure, diabetes, and cholesterol tests
- Cancer Screening, including mammograms and colonoscopies
- Counseling to quitt smoking, lose weight, eating healthfully, treating depression, and reducing alcohol use
- well-baby and well-child visits, from birth to age 21
- Vaccinations against diseases
- Materniny Counseling, screening, and vaccines
- Flu and pneumonia shots
Prohibition of Coverage Recantation
Starting on all health care plans established after September 2010 Health Care plan providers agreed to no longer recant coverage of an individual based on application technicalities, honest mistakes, or lack of information that has no bearing on health status. Prior to this requirement that made such actions illegal, if an insurance company found an error in a insurance application, the company had the rights to cancel the policy retroactive from the date it began, and could also ask you to pay any funds spent after the policy on your health care.
Life time limit prohibition
All plans put in place after September 2010 will prohibits plan providers from putting any lifetime or annual limits on the majority of benefits provided. While the lifetime limit was effective after September 2010, the prohibition of annual limits phases out until 2014, when the limits are phased out completely.
Children under 19 must be covered by a Health Plan.
Starting on all plans put in place after September 2010 health plan providers are not able to deny or limit the amount of benefits for anyone under the age of 19 regardless of pre-existing medical conditions. This includes any pre-existing health issues that developed before the child applied to the health care plan,or at birth.
Plans must justify premium rate hikes
Starting on all plans put in place after September 2010 health plan providers must participate in a rate review program to control unreasonable insurance premium increases. Starting on September 1, 2011, health plan care plan providers and insurers must justify any premium rate increase of 10% or more prior to the rate increase taking place.
Read More about Affordable Care Act Implementations in 2011
Read More about Affordable Care Act Implementations in 2013