The Affordable Care Act has been in place since March 23, 2010. The ACA is America’s health plan and has been for over 10 years. Many people think ACA can only be access through exchanges. ACA is the road map to what all companies use that provide health plans must follow.
The Primary Goals of ACA are as follows:
- Affordable Health Insurance for more people (subsidies and tax credits) 100% to 400% of federal poverty level.
- Expand the Medicaid program to cover all adults with income below 138% of the federal poverty level.
- Support innovative medical care delivery methods design to lower the cost of health care.
What is ACA Health Plan?
The ACA is designed to make guaranteed issue health insurance plans available to everyone. These plans cover pre-existing conditions, along with a list of essential health benefits that do not change from plan to plan. Presently, there are over 20 million people on ACA plan.
The second part of ACA Plan is the Health Care and Education Reconciliation Act. This helps to ensure that consumers get value for their money, immediate access to insurance for uninsured with pre-existing conditions, affordable coverage options, essential health benefits required, basic health plans for low income not eligible for Medicaid.
Did you know there is an initial premium review process in ACA plan? This is an annual review for the purpose of managing unreasonable increases by health insurance companies? This is done by monitoring trends in the area to help determine what costs are reasonable.
A few other benefits with ACA for all Americans are no lifetime or annual limits for medical coverage, preventative health services, dependent care, uniform explanation of coverage, high quality of care and prohibit discrimination based on salary no medical coverage.
The list of essential health benefits defined by ACA are the same today as they were on March 23, 2020.
- Ambulatory Patient Services
- Emergency Services
- Laboratory Services
- Pregnancy, Maternity and Newborn Care
- Breastfeeding
- Hospitalization
- Mental Health & Substance use disorder
- Prescription Medication
- Pediatric Services
- Rehabilitative Services
- Preventative & Wellness Services and Chronic Disease Management
The commitment of the authors of ACA was for a long-lasting solution to health care. For example, requiring the health insurance companies to spend 80 cents to 85 cents of every dollar of premium on medical care and improvements. What other industry is required to do the same?
The future with ACA is bright, but it will take a joint effort by pharmaceutical companies, hospitals, doctors, and health carriers. Will they all commit to 80 cents to 85 cents per dollar toward medical care and improvements limiting their profit return? It will take all four to work together to keep medical cost affordable.
Please share your thoughts!