What Does the Health Law Mean for Me?

Many of our NeedyMeds users have asked us to help them figure out what healthcare reform, or Obamacare, will mean for them and for their families or clients.  This is understandable because the law is complex, with both state and federal governments playing a role in implementation.

Some of the more common questions include these:

  • I am uninsured right now. The new law says I have to buy insurance. What happens if I can’t afford it? What will happen if I don’t buy it?
  • Can I keep the health insurance I already get from my work?
  • Can I get health insurance even if I already have health problems?
  • I am a senior citizen. What will happen to my health coverage with the new law?

To help answer these and other questions, and provide clear guidance, we recommend reading Kaiser Health News’ “A Consumer’s Guide To The Health Law,” which provides a clear and concise overview of the ACA.

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Some analysts argue that there could be modifications to reduce federal spending as part of a broader deficit deal; for now, this is just speculation. What is clear is that the law will have sweeping ramifications for consumers, state officials, employers and health care providers, including hospitals and doctors.

While some of the key features don’t kick in until 2014, the law has already altered the health care industry and established a number of consumer benefits. For example, the extension of coverage to adult children up to age 26, the elimination of lifetime spending caps and ability for people with pre-existing conditions to obtain coverage have help many Americans.

Kaiser Health News article primer on parts of the law already up and running, what’s to come and ways that provisions could still be altered. Now that President Barack Obama has won a second term, the Affordable Care Act is back on a fast track.

We still don’t know the full impact of this act and it may be implemented differently in different states. There’s no denying that, overall, it will result in more people having health insurance coverage.

Affordable Care Act – Here to Stay

The outcome of the November Presidential election also decided the fate of the Affordable Care Act (ACA). Ron Pollack, Executive Director, Families USA says: “The election has settled key issues about the directions our nation’s healthcare will take: It means Obamacare will be implemented, the Medicaid safety net will be strengthened, and Medicare’s guaranteed benefits will not be undermined. As a result, people across America will gain peace of mind knowing that high-quality, affordable healthcare will be there for themselves and their loved ones,”(Healthcare Finance News). This means that implementation will go forward.

This is good news for all Americans, but especially for those who are presently uninsured. But how will this work?  The ACA has two main pillars, each of which will be decided on a state-by-state basis:

1) Create a health insurance exchange

2) Expand Medicaid

Each state will have the option of setting up their own health insurance exchange (state-run), allowing the federal government to set up and operate an exchange on behalf of the state (federally-run), or create a state-federal partnership where both entities will cooperatively set up and run the exchange.

What is a health insurance exchange? It can be defined as an online insurance marketplace where consumers can choose from a number of health insurance plans. “The exchanges are supposed to make it easier and more transparent for small businesses and millions of individuals who are not covered through their employers to shop for health insurance,” according to the Washington Post (Obama’s health-care law still faces challenges…).  Consumers will be able to compare plans and choose the one that best fits their healthcare needs and income.

Regarding Medicaid expansion, the Pew Center states: “States must also decide whether they want to accept generous federal funding to expand their Medicaid programs to cover millions more people,” (Pew States – Stateline).  Federal funds will cover this initially, but states will be asked to cover 10% of the cost eventually. Again, we are awaiting the states’ individual decisions on whether to expand Medicaid, and we will keep you up-dated.

For more information, we recommend this website: HealthCare.gov, this provides the most current analysis of the Health Care Law.

 

Please post your comments and questions and we will respond. NeedyMeds wants to be YOUR health safety net resource!

 

What Is Healthcare Reform? And Why Is There So Much Controversy About It These Days?

Julie Kautz MillsWelcome to the NeedyMeds Blog! We are pleased to bring you our inaugural post, and we look forward to presenting you with timely, provocative pieces on healthcare reform, patient advocacy, medication and healthcare access, and other health-related news. Our goals are to educate, enlighten, and elucidate; together, we will try to make sense of the myriad and ongoing healthcare-related changes in the U.S. today

My name is Julie Kautz Mills and I am Director of Outreach at NeedyMeds. My academic background is in bioethics, education and psychology, and I spent 16 years working in healthcare administration in the Boston area. I’ve lived in two Canadian provinces and four European countries, and thus have had the opportunities to experience other healthcare systems.

So what IS healthcare? Is healthcare a right, to be provided for all citizens by government mandate? Or, is it a choice, to be decided by individuals? Who should decide? And who should pay? And what happens if you cannot pay? These are potentially problematic questions, however I think we can all agree that each and every one of us has needed, or will need, healthcare during our lives.

health·care

noun

1. the field concerned with the maintenance or restoration of the health  of the body or mind.

2. any of the procedures or methods employed in this field.

adjective

3. of, pertaining to, or involved in healthcare: healthcare workers; a healthcare center.

healthcare
noun
the preservation of mental and physical health by preventing or treating illness through services offered by the health profession

(WordNet® 3.0, © 2006 by Princeton University)

A number of recent studies (Kaiser Health News) have shown that the majority of Americans do not understand healthcare reform, and given the complexity, and the fact that each of the 50 states will have their own healthcare exchanges, this is not surprising news!

At present, there are approximately 50 million uninsured people in the U.S., representing approximately 17% of our population. Many consider this to be a national disgrace. We may be one of the richest nations on the globe, and we may spend the most per capita on healthcare, but overall health indicators, including mortality statistics, show us to be unhealthier as a whole than populations of other countries who spend far less. What is happening here?

Today, we will begin by defining healthcare reform and the Affordable Care Act (or ACA; also referred to as “Obamacare.”).  To begin with, the main objectives of healthcare reform are simple: to improve health and access to healthcare in the U.S. overall and to reign in spiraling healthcare costs by focusing on preventive care and ensuring that the right care is delivered at the right time in the right place.

These objectives seem reasonable, and we could likely all agree, desirable. But, it could be argued the divisive political landscape has led to confusion and probably to proposed solutions that are unnecessarily complex.

Where do we stand today? Our next post will examine how healthcare reform will be achieved looking at both federal and state developments. Stay tuned!

We welcome your feedback and we would love to hear from you! Let us know about your healthcare-related questions and issues and we will do our best to address them. Please post your comments!