Affordable healthcare act
The affordable health care for America legislation was signed into law in 2010. It was first crafted by the United States House of Representatives as a bill in 2009 but was never passes into law but through the Obama administration when it was passed into law.
The key provision under the act included prohibiting insurers from charging different rates based on the patients’ medical history or gender. It prohibits insurers from refusing to cover a patient’s medical bill based on their medical history. This is due to the fact that insurers in the past have been known to find faults with a consumer’s application so that they can avoid paying for their medical bills especially for those suffering from cancer.
The act also established minimum standards for qualified health benefit plans. Qualified health benefits in this case follows similar rules stipulated in the affordable health care for America act which include a standard set of services which includes hospital and outpatient care, mental care and maternity, prevention and well child care.
The law provides that consumers should be able access information and can be able to compare insurance coverage options and pick the cover which can accommodate their needs. This will be possible in that it is required that such information should be put online where anyone can access them.
The law also prohibits denying coverage of children based on pre-existing conditions. It does this by preventing insurance companies from preventing coverage to children under the age of 19 based on previous existing conditions which were used in the past.
The law also has consumer assistance programmes. This is done through granting of grants to states which subscribe to these laws which will help them set up or expand independent offices to help consumers navigate the private health insurance system. These system helps consumers make complaints and appeals to enroll in health coverage, get educated about their insurance policies and rights either as a group or an individual.
In a bid to increase access to improved quality and cost effective care, the government will provide small businesses with insurance tax credits. This is to enable them provide insurance benefits to their workers where the 1st phase will provide a credit of up to 35% of the employer’s contribution to the employee’s health insurance while small non-profit organizations may receive 25% credit.
The law will also see to prevention of disease and illness by setting aside $15billion prevention and public health fund which will be invested to help keep the Americans healthy which include smoking cessation to dealing with issues of obesity. The law will also crack down on health care fraud as it will invest in new resources which will require new screening procedures for healthcare providers to boost efforts of reducing fraud and waste in Medicare, Medicaid and CHIP.
Americans who earn less than 133% of the poverty level as of 2014 will be eligible to enroll in Medicaid. Under the law, most individuals who can afford are required to take personal responsibility by obtaining personal insurance covers or pay a fee to help offset the costs of caring for the uninsured Americans. However, if the coverage is not available to the individual, then they will be exempted.
In 2015, it is expected that physicians will be paid according to value and nor volume. Physician’s pay will be tied to the quality of the care they provide to the patients. Their payments will be modified in that those who provide a higher value will consequently receive a higher pay. This will therefore be effective as from January 1, 2015.