It seems like only yesterday that US President Barack Obama signed the Patient Protection and Affordable Care Act (PPACA) right along with the Health Care and Education Reconciliation Act of 2010. All the hullabaloo that surrounded the proceedings before, during and after that historic day now just seem like useless semantics. However the outcome was something quite extraordinary. The acts signed in by President Obama basically constitute the United States’ first step towards universal medicare.
The PPACA incorporates many provisions that began to come into effect in 2010, but will continue to fully emerge over the following four years. Here is a basic rundown of the main components:
Policies issued before the PPACA came into effect are not affected by the new rules, but they are still valid.
Medical insurers are bound to abide by the rules set out in ‘Guaranteed Issue’, which state that every applicant regardless of age, sex, pre-existing condition and community placement shall be offered the same premiums.
The rules for being eligible for Medicaid have expanded to include those whose income appears as 133% of the poverty level.
The Health Insurance Exchange will operate in each state, allowing residents to compare and purchase medical insurance plans at fair rates and apply for government subsidy.
Companies (with 50 or more workers) who choose not to offer health insurance to their employees will be required to pay a fine if the government has had to subsidize an employee’s health care.
People who do not have health insurance will be required to pay a fine (called a shared responsibility payment). This mandate is designed to encourage people to have and maintain health insurance all the time, not just when they become ill.
Medicare prescription drugs will have more subsidization
Low income families and individuals who do not qualify for Medicaid will receive help through a sliding scale subsidy when they purchase through a Health Insurance Exchange.
All annual and lifetime coverage caps on insurance policies will be removed.
Minimum standards for insurance policies will be put in place.
Some insurance benefits will be deemed essential and therefore fully covered.
The Health Care and Education Reconciliation Act of 2010 makes amendments and additions to the PPACA, including dealing with student loan reform:
Kickbacks and special deals for senators in relation to health care are eliminated.
More tax credits when purchasing insurance
Doctors who treat patients under Medicare will be reimbursed at the full rate of pay
The subsidies to low income individuals and families moved from a broad scale to a much more generous level. Under the new act, low income groups will pay only 2-4% of their income on premiums.
Penalties paid by companies not offering health insurance to their employees are increased.
Medicare patients receive 50% discount on brand name drugs, and increasingly so as the years progressed.
Regarding student loan reform, loans will now be administered by the Department of Education and not through independent banks.
The repayment cap for new borrowers is lowered to 10% of their income, and loans will now be forgiven if regular monthly payments are made for 20 years.
Funding for historically poor schools and community colleges will increase by several billion dollars.
With so many politicians losing out on the changes, it is understandable that several lawsuits were filed challenging the provisions introduced by the new laws. However, according to Wikipedia as of January 2011 those challenges were turned down. Therefore the United States has finally joined the other 33 developed nations of the world (as determined by the United Nations Human Development Index) in offering universal health care to the public.
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