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On September 30, the Affordable Care Act—commonly known as “Obamacare”—officially went into effect as the law of the land, after having been initially signed by the President in March of 2010. Now that it’s here, there has been some confusion as to what it will accomplish, and what it means for the average American. There are understandably many questions, and we’ll try to sort some of them out here by providing some basic info on what the ACA is, in a nutshell. Think of it as “Obamacare for Dummies”…

  • Those who benefit the most from the ACA are those who do not currently have health insurance, as well as those who have difficulty paying their premiums. For uninsured families, the ACA expands options for affordable health care.
  • The ACA helps families that may have health insurance, but have difficulty paying the premiums. Financial assistance is administered as follows: families are given the opportunity to shop for plans using exchanges that operate as state insurance marketplaces. A refundable tax credit allows for discounts on their premiums.
  • There are also benefits for those who are insured but have unmanageable copayments, deductibles, or sudden gaps in coverage. Certain limits on what an insurance plan will pay for will be eliminated, providing crucial help with out-of-pocket costs.
  • Those covered by their employers also can benefit from the ACA. As of 2014, a $5 billion program will be put into effect to assist employer-based plans in providing coverage to retirees between the ages of 55 and 65 (including spouses and dependents).
  • Pre-existing conditions can be a major issue for some, and the ACA has provisions for them, as well. By 2014, all discrimination against pre-existing conditions will be prohibited. Those uninsured for more than six months due to a pre-existing condition now qualify for greater access to insurance, under the Pre-Existing Condition Insurance Plan (PCIP), run on a state-by-state basis. If a state chooses not to elect, a plan will be established by the Dept. of Health and Human Services.
  • Families that couldn’t afford coverage in the past will now benefit from premium tax credits and an expansion of Medicaid.
  • States will receive an additional two years of funding from the federal government to provide for coverage for children who are ineligible to receive Medicaid.
  • Under the ACA, young adults are permitted to remain under a parent’s coverage until their 26th birthday.

US Census statistics from 2010 indicate more than 16% of Americans do not currently have insurance. Those without insurance tend to receive less timely care and have worse eventual outcomes. Health insurance is an issue of grave importance in America, and the ACA is intended to alleviate the difficulties faced by some who need it most. A little information can go a long way toward clearing up any confusion arising from this new, important legislation.

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