You have probably heard a lot about Obamacare and if you are an American citizen you must have enrolled for it too. This healthcare law has been highly debated and the bill received support as well as faced criticism before it was passed and signed into ruling. In a nutshell, the act strives to provide access for every American to quality and affordable healthcare. However, are you aware of all the facts about this act? Are you still confused even after signing up, or did you miss the deadline to enroll for it? Let’s look at some essential details and specifics on ObamaCare to give you a fair idea about what it entails.
The amount of spending on healthcare by Americans is on the rise and the health insurance industry is growing. On the one hand there are people paying hefty amounts for expensive health care. On the other hand, according to the Congressional Budget Office, there are around 32 million individuals who cannot afford even the basic health plans. Keeping this in mind, a new healthcare insurance reform plan was made law by American President Barack Obama. The Patient Protection and Affordable Care Act, also known as Obamacare, was first approved and passed into law on March 23, 2010 and it has come fully into effect from 2014. The open enrollment for this year ended on March 31, 2014 and the next enrollment period will start on November 15, 2014 for the upcoming year 2015.
Although it doesn’t replace private insurance or Medicaid or Medicare, it instead offers new benefits, improved coverage, protections and rights. Private and public health insurance is made available to all citizens through various new reforms. Here are some of the important positive changes that this act brings forth:
- 10 essential health benefits will be incorporated on all health plans that comprise of emergency care, prescription medication and hospitalization benefits. Also included will be maternity and newborn infant care.
- Overall costs for insurance will be reduced and services will be available to all individuals and families, especially those who couldn’t earlier get insurance. If you cannot afford insurance, you may be eligible to get a free or low cost plan through subsidies. Also, eligibility for Medicaid is expanded in 26 states to 15 million low-income Americans who were uninsured.
- Preventive services are another significant addition to the insurance plans. Under this, individuals can avail free annual checkups, screenings and vaccines; this in turn will prevent diseases and reduce costs of expensive treatments in the future.
- ObamaCare’s Health Insurance Marketplace has been created where you can compare and buy subsidized health insurance products according to income categories, and check if you qualify for Medicare, Medicaid or CHIP.
- All businesses (with over 50 full time or equivalent employees) will have to provide health insurance to all the employees or pay “Employer Shared Responsibility Payment” on their federal tax return every month.
- Medical insurance is guaranteed, by which you will not be denied coverage for any reason like pre-existing conditions, mistake in applications, gender status etc.
- Children can be covered with their parents plan till they are 26 years old. As for seniors, they will enjoy more benefits closing the Medicare Part D donut hole (seniors had to pay out of their pocket for prescription medication) and other issues.
If the benefits are so promising, then why has the act faced so much negative criticism? More people (in fact, everyone) paying for healthcare is expected to bring down overall costs incurred by the care providers. So what’s the harm you ask? Well there is a catch here:
- The act makes it mandatory for everyone to sign up for health insurance or pay a certain fee as tax. The penalty amount is $95 (or 1% of income, whichever is higher) in 2014. This then increases to $325 (or 2% of income) in 2015 and $695 (or 2.5% of income) in 2016.
- About 30.1 million people buy their own health insurance privately. Even though the option for exchanging plans is available, some have to cancel the plans if it doesn’t meet the essential benefits criteria and the cost of replacement insurance is too high.
- Another disadvantage is that preventive care services may end up increasing the overall health care costs as many people who do not need these services will use them. This will also require more primary care physicians.
- Taxes have also been raised on around 1 million individuals whose income is above $200,000. The amount for Medicare taxes was 2.35% in 2013 as compared to 1.45% in 2012 for above threshold income. Now families are able to deduct medical costs that have exceeded over 10 percent of income, as compared to the previous 7.5 percent of income.
- It is estimated that $84.8 billion would be paid in fees by pharma companies for closing the donut hole and providing prescription medications for seniors.
- The people who lose out after this act, will be those who are unable to cancel their plans, who will not want to limit their healthcare choices and also those who do not wish to sign up for this plan.
In short the ObamaCare act tries to fit everyone under one common scheme by making all Americans sign up for it and provide government approved health insurance. Some people are wary of this act since it seems to be government centered and bureaucratic, giving the government an ultimate right to control American Healthcare by restricting individual choices and freedom.
President Barack Obama quoted, “After a century of striving, after a year of debate, after a historic vote, health care reform is no longer an unmet promise. It is the law of the land.” This is definitely a good thought but the execution needs to be carried out in such a way that the drawbacks are limited. It remains to be seen how it is accepted all sections of society over time and how the act is affects healthcare in the long run.