Affordable Care Act: What does it mean for you?

On October 1, 2013, the Affordable Care Act, otherwise known as Obamacare, became the law of the land. Even though certain political parties were hoping to delay or slow down the implementation of the Affordable Care Act, it now is in effect and will have dramatic affects on all of us under the law.

Under the law, millions of low to moderate income Americans will be eligible for discounts towards healthcare in the form of tax credits and other subsidies. The newly created marketplaces allow individuals and families to purchase healthcare and may steer people into Medicaid, if they qualify. The marketplaces are a new location where individuals can shop, compare and buy health insurance in a way which was not available before the Affordable Care Act.
New safeguards will come with the marketplaces when the plans go into effect on January 1, 2014. Medical health insurers can no longer deny coverage of pre-existing medical conditions. All of the plans currently in existence must cover a central benefits such as hospitalizations, maternity care and mental health services. The strikingly different factor within the Affordable Care Act is that insurance companies cannot drop coverage of an individual or family member just because they become sick. Small businesses will have options for insuring workers and will receive tax credits to pay for it.

The interesting thing is that the law will have very large effects on certain groups, such as those with mental illnesses and immigrants. All new marketplace plans must offer ten (10) different essential health benefits and mental health coverage is one such core area. Future coverage will include services such as counseling and psychotherapy. Insurers must cover those individuals at levels similar to general medical and surgical care.

In terms of coverage for immigrants, the law will have its biggest effect on current citizens. Legal immigrants or individuals who have legal permanent residence will face the individual mandate. They must buy health insurance or pay a penalty. Both permanent residents and legal immigrants will be eligible for tax credits and cost sharing reductions to ease the burden of buying coverage. Medicaid may also be another option for residents in Pennsylvania. However, adults must be legal residents for five (5) years in order to be eligible.

Unfortunately, undocumented immigrants will receive no new assistance or health insurance under the Affordable Care Act. Individuals who are undocumented will not be allowed to buy insurance in the marketplace. They will not be eligible for tax credits and they must continue to rely on public health centers and emergency rooms for critical medical care. Undocumented immigrants could also potentially try to find insurance outside the new healthcare exchanges. The problem rests not only in the failure of the Act to provide health insurance for undocumented individuals, but also raises potential future problems where there is a mixed immigrant family. Currently, according to the Pew Research Center, there are 8.8 million people living in America with mixed status families.
While the Affordable Care Act provides a welcomed relief to individuals who are in need of health insurance who fit within the criteria of being able to sign up, it does continue to raise concerns in the ability to implement affordable health care under the law. As the United States Supreme Court has determined that the Affordable Care Act is constitutional, unless there is a dramatic change in the leadership of this country, the law will remain in effect. Individuals who are capable of getting health insurance under the Act should continue to support the Act and to vote for legislators who believe that access to health insurance is important. If you have any additional questions in relation to the Affordable Care Act, I would direct you to the website, healthcare.gov or the 24/7 Helpline at (800) 318-2596.

 

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