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28.11.2013
THIS iS A DIGEST OF THE BENEFITS OF THE AFFORDABLE CARE ACT THAT MOST DIRECTLY AFFECT INDIVIDUALS. We suggest that you initially scan through the headlines of each paragraph to gain an overview of the act.
8 On March 23, 2010, President Obama signed into law the Patient Protection and Affordable Care Act (ACA). 8 ACA REDUCES THE BUDGET DEFICIT: ACA is the largest deficit reduction bill in a generation, Landmark 59-60. 10 CHECK FOR THE TRUTH: ACA REQUIRES BOTH IMPLEMENTATION BY THE STATES AND THE VOTERS ONGOING SUPPORT. 14 2010 MEDICAID: States may opt out of the following program, but must adhere to its criteria if they opt in. 12 2009 RECOVERY ACT REIMBURSEMENT FOR COSTS TO STATE MEDICAID PROGRAMS has saved Minnesota (in a€™09 -a€™10), $1,673,476,158 thru Sept 30, 2010. 14 2010 FOR THOSE THAT CANNOT AFFORD INSURANCE; See link to a€?Find your Health Care Optionsa€? above, or click here.
2011 IF ENACTED INTO LAW, PROPOSALS TO REDUCE FEDERAL FUNDING FOR MEDICAID ARE EXPECTED TO SUBSTANTIALLY REDUCE FUNDING TO STATE MEDICAID PROGRAMS AND ARE EXPECTED TO LEAVE 44 MILLION WITHOUT FUNDING FOR HEALTH CARE. 18 2014 EXCHANGE BUYING: To lower insurance premiums from what they would become under past practices, insurers are required to include everyone in a single risk pool, S.
18 2014 PENALTIES are monthly for the non-exempt individual who fails to insure themselves and their dependents.
18 2014 WITH THE HELP OF CONSUMER ASSISTANCE OFFICES, INSURANCE EXCHANGES WILL CREATE TRANSPARENCY AND COMPETITION AND THEREFORE LOWER RATES.
18 2011 AS PART OF TRANSPARENCY, INSURANCE COMPANIES MUST ADOPT UNIFORM EXPLANATIONS OF COVERAGE AND STANDARD DEFINITIONS prior to March 24, 2011.
20 2014 SUBSIDIES FOR THOSE UNDER 400% OF THE FPL limit premiums to between 2% to 9.5% of income, S 1401 and out of pocket costs to 30% of contract costs, S 1402. 21 2014 PRICE DISCRIMINATION OF ANY KIND except age and smoking is prohibited, S 2701 (A) (1). 22 2011, UNDER A PROVISION DRAFTED BY SENATOR FRANKEN (D MN), individual and small group plans (including grandfathered plans) must spend 80% of premium dollars, 85% in large group markets, on medical services, not administration, advertising, or profits, S 1001, sub 2718 amended by S 10101 sub 2718. 22 2014 ACA PROVIDES COST CONTROLS: By Jan 1, 2014, under Ss 1302(c) and S 1201 sub 2707(b) there will be annual out of pocket cost controls, and four cost levels of a€?essentiala€? benefits. 23 2010 SMALL BUSINESS WILL RECEIVE 35% TAX CREDITS NOW AND 50% IN 2014: employers with 25 or less full-time equivalent (FTE) employees with an average compensation of $50,000 or less can receive a tax credit beginning in 2010, S 1421, modified by S 10105. 27 2010 ACA CREATED A FEDERAL HIGH RISK INSURANCE PROGRAM FOR THOSE WITH PREEXISTING CONDITIONS and without insurance for six months. 29 2010 ENDS RESCISSIONS except for fraud or intentional misrepresent the law bans self funded and insured plans from dropping people from coverage when they get sick, S 1001, subs. 29 2010 BANS DUMPING which is the practice of raising premiums on the individual and small group market to discourage insureds from continuing the policy in question.
29 2010 ENSURES QUALITY OF CARE by requiring health care systems to report benefits and reimbursements that improve outcomes, follow up, prevent readmissions, improve patient safety, reduce medical errors and implement wellness and prevention activities.
29 2010 MUST PROVIDE AN INDEPENDENT APPEALS PROCESS: new individual and group plans must provide an internal and external appeals process,50 S 1001, sub 2719, that includes ongoing benefits during the appeal, S 1001, sub.
23 2010 SMALL BUSINESS WILL RECEIVE 35% TAX CREDITS NOW AND 50% IN 2014: employers with 25 or less full-time equivalent (FTE) employees with an average compensation of $50,000 or lessA  can receive a tax credit beginning in 2010, S 1421, modified by S 10105. WE BELIEVE THAT IT WILL PROVIDE THE BASIC INFORMATION AND GATEWAYS TO RESOURCES YOU NEED TO UTILIZE THE BENEFITS OF THE AFFORDABLE CARE ACT. These are the numbers of the pdf slides in the slide show section of this web site that relate to the paragraph. If it doesna€™t, look at the end of the digest for the number of the associated Note and either click on the associated URL or enter it into the address bar of your internet search engine. PRESIDENT OBAMA, 280 DEMOCRAT REPRESENTATIVES AND SENATORS IN THE 111th CONGRESS PASSED ACA USING HELP FROM PRESIDENTS TRUMAN, EISENHOWER, KENNEDY, JOHNSON, NIXON, REAGAN, CLINTON, and G. The Congressional Budget Office (CBO) projects ACA to reduce the deficit by $1.5 trillion over the first 20 years8. IF IMPLEMENTED BY US, OUR GOVERNMENTS AND THE HEALTH CARE INDUSTRY AS IT WAS WRITTEN, 12 in the next four years most people will notice that it will be easier to read, understand, compare and shop for insurance. In this digest, each provisiona€™s effective year date is shown at the beginning of each entry. To start $30,000,000 was allocated in 2010 to jump start state consumer assistance offices. Until ACA came up for passage in 2009 this was endorsed by conservatives, Democrats and GOP leaders 60.
That is because seventy-five percent of health care cost is spent on chronic illnesses arising from modifiable behavior.


Authorizes Medicare coverage of personalized prevention plan services, including an annual comprehensive health risk assessment, Section 4103, as modified by S 10402; Ss 4104-4105. 1312 (c); insurance will be sold through state operated exchanges accessible by both individuals, and small businesses, Ss 1311-1324. Without it costs will be uncontrollable.20 By 2014 individuals and employers with more than 50 employees must provide health care insurance, Ss. These are payable with the tax return with maximums of $2,085 per family or 2.5 percent of household income (whichever is higher).
The Federal government does not have the authority to limit premiums, but the subsidies mention immediately above limit premium cost. Medical services will be defined by the HHS in consultation with the state insurance commissioners, S 1001, sub 2715, 2718. Coverage denial for pre-existing conditions is banned if less than age 19, and for everyone on Jan 1, 2014,44 , S.
Denial is common in the commercial market.61 This program will operate until the insurance exchange takes effect in 2014 when everyone must be accepted. The provision, which is in S 1001, sub 2717 is effective immediately and is to be implemented within two years. They can also be typed in to the address line of an internet explorer, perhaps at the library. PRESIDENT OBAMA, 280 DEMOCRAT REPRESENTATIVES AND SENATORS IN THE 111th CONGRESS PASSED ACA USING HELP FROM PRESIDENTS TRUMAN, EISENHOWER,A  KENNEDY,A  JOHNSON, NIXON, REAGAN, CLINTON, and G. 1312 (c); insurance will be sold through state operated exchanges accessible by bothA  individuals,A  and small businesses, Ss 1311-1324. Without itA  costs will be uncontrollable.20 By 2014 individuals and employers with more than 50 employees must provide health care insurance, Ss.
The Federal government does not have the authority to limit premiums, but the subsidies mention immediately above limit premium cost.A  Also, an employer must offer a free choice, tax deductible, and non-taxable voucher in the amount of the employer contribution for purchase of insurance on an exchange if the employee earns less than 400% of the federal poverty income level.
Then read the text, verify it, if you wish, by referencing the sections of the act that are cited and expand the information by clicking on the web site links provided. According to the politically neutral Congressional Budget Office (CBO), repealing ACA would increase the deficit by $230b over the next ten years67 and by one-half of one percent of the GDP hereafter. They will no longer have to worry about losing coverage for any reason and their insurance costs will become more affordable than they would be without ACA. The provision becomes effective for plan years beginning on or after the day date given in the entry.
By 2014, these offices will be points of entry for all programs, simplified insurance applications and appeals.
They are authorized to credit us up to 20% of total premiums to encourage healthy behavior. Increased physical activity, healthy nutrition, cessation of tobacco use, and moderate use of alcohol bring major reductions in suffering, early death and cost. Jan 1, 2011 the ACA started a 50% discount off the Pharmaceutical company retail prices of brand name drugs and biologics in the donut hole and other discounts on generic drugs.
By opting into the ACA Medicaid program, the ACA gives states with very low MEDICAID qualifying income levels the option to EXPAND MEDICAID COVERAGE by increasing qualifying income levels to 1.33 times the Federal Poverty Level or less.
This is part of the right to keep what you have, but much can depend upon whether your plan is a€?newa€? or a€?grandfathereda€?.
There will also be a low cost catastrophe coverage policy for those under age 30 (S 1302 (e)) and a special program for those under age 21, (S. The HHS Secretary has directed the states to have the legislation and regulations needed to approve or disapprove rates and has granted $51 million to 45 states to assist this process. 28 ACA reimburses employers for 80 percent of claims between $15,000 and $90,000 solely to lower costs for employer based plans for retirees between the ages of 55-64. Insurers may offer a low cost catastrophic plan for those under 30 and four plans varying coverage at 60%, 70%, 80% and 90% of the cost of benefits. 113-127, 133, and Index a€?Medicarea€? for comprehensive digests of the issues and provisions or call-1-800-MEDICARE.
According to the Bureau of Labor Statistics this is more than any other industry 7.A  The Recovery Act and ACA together provide $2 billion to help this happen. Government Accountability Office put out a report on Nov 15, 2010 that shows the national debt is in an increasingly dire crisis. Jan 1, 2011 the ACA started a 50% discount off the Pharmaceutical company retailA  prices of brand name drugs and biologics in the donut hole and other discounts on generic drugs. States may later add large groups, S 1312(f)(2)(B).A  Policies must be easy to understand and compare,41 S1001 sub 2715,A  QUESTIONS ABOUT THE MINNESOTA HEALTH CARE EXCHANGE ARE ANSWERED HERE. As the graphic below shows, like eight presidents before him, President Obama was driven to make health care reform one of his highest priorities by the simple fact that the cost of health care is pushing the country and its people rapidly toward bankruptcy.


BUSH WHO ALL SPONSORED REFORM PROGRAMS THAT ARE PART OF ACA.11 These ideas were also included in the Massachusetts Health Care reform law passed under Governor Romney.
Click here to see a CDC report of Minnesota, or here to find your state.66 Reducing this is something most of us can do. Depending upon this, CBO and CMS estimate that this law extends the life 13 of the Medicare until 2029, if we prevent Congress from using the savings inherent in this law for other purposes. All left uninsured may use one of the 8,500 Community Health Clinic offices (see below) or they may use emergency Rooms.
Employees must purchase qualified job based insurance or lose the employer tax free contribution, if it meets minimum standards and is not excessively expensive, Ss 1511-1515. The States shall establish an annual review of unreasonable increases in premiums, inform HHS about trends in increases and make recommendations for exclusion from the exchanges Ss.1003, 2794. The program expires when the money runs out or on Jan 1, 2014 because the insurance exchanges open, S 1102. Individuals can apply for insurance from the back up federal high-risk pool38 Application requires only a letter from physician verifying pre-existing condition55 and no insurance for six months. This is the Affordable (Health) Care Act reform law and is referred to here as ACA.A  For instance, to find the law sections cited click on the underlined citation above. The report shows that the ACA enacted in March 2010 has the potential to reduce the growth of the debt by two thirds. Above incomes of 400% of FPL the insured is responsible within the out of pocket limits mentioned above.
The President knew that health care reform would be a major step toward improving the economy, creating jobs, balancing the budget and making other necessary programs possible. The ACA Act preserves private insurance and the right of individuals, employers and the states to freely continue existing health care plans and to make choices going forward so long as they meet minimum standards of benefits and coverage as outlined below, S 1312(d).
Section 9007 of the ACA now required that private not for profit hospitals develop written financial assistance policies,63 limit what they charge for services, observe fair billing and debt collection practices, and conduct regular community needs assessments.
Employers must offer vouchers to employees earning less than 400% of the poverty level income if the employera€™s plan would cost the employee between 8 and 9.8% of income, S 10108. Contact your statea€™s health department18 and ask if they have applied.A  In all cases state benefits and insurance requirements may exceed ACA. No one who offers health insurance is required to participate in any federal health insurance program created under ACA, S 1555.
Low income persons who believe that they will be dependent upon this service should seek out the private not for profit hospitals in their area and ask to see the hospitals published material.
The truth can be found at independent research sites like Snopes14, Politico15, or Fact Check16.
Exchanges may limit business access to those with 50 employees or less until 2016 and in 2017 may open the exchanges to employers of more than 100. Medicare premium dollars can presently be used to purchase a commercial, non governmental policy in place of Medicare. In May 2011, HHS announced availability of more than $100 million in first year funding for Community Task Groups (CTGs), aimed at improving health and lowering health costs and ask your congress person what happened in 2012. The federal contribution to expansion states under the optional program will be 100% in 2014 and to all states 90% after 2019, Ss. Today, 68% of medically underserved communities across the nation are in rural areas, and these communities often have trouble attracting and retaining medical professionals. In May 2011, HHS announced availability of more than $100 million in first year funding for Community Task Groups (CTGs), aimed at improving health and lowering health costsA  and ask your congress person what happened in 2012. Tim Johnson, Hyperion Press (2010), or LANDMARK, the Inside Story of Americaa€™s New Health Care Law and What It Means for Us All, The Staff of The Washington Post, ISBN 978-1-58648-934-2, pp. The law provides increased payment to rural health care providers to help them continue to serve their communities.
Qualified private plans, Tricare, VA and all government programs satisfy the mandate, S 1501(f)(1). Members of Congress and staff are required to purchase their health care plans on the state exchanges, S 1312.
There are many inter section referrals within the statute so click on a€?Find next in current PDFa€? repeatedly until it takes you to the text of the section. When the pdf of the statute opens, the a€?finda€? window may be at the top center of the web site that appears. The difference according to the Congressional Budget Office depends on whether or not the bill is implemented as written, is starved, is repealed or drained of its tax savings by extravagant spending elsewhere.17 History indicates that it will be implemented.



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