The Affordable Care Act (ACA) formed under the guidance of President Obama has largely expanded health care benefits to nearly fifty five million Americans who did not have any kind of health coverage, and even other citizens who were underinsured. This paper identifies and describes few important components of the Affordable Care Act that are categorized into Insurance Reform, Quality Improvement, Payment Deductions, and Healthcare Reform.
Establishing State Health Exchanges: Through the establishing state health exchange component the individuals, and people owning small office home office businesses have the liberty to buy health insurance with proper and transparent documentation. These insurances can be purchased at an economic price by comparing with other insurance providers.
Pre-existing Condition Insurance Plan: Individuals who had a pre-existing health condition were not allowed to buy any insurance plans before 2010. Since July 2010, people who had been denied insurance because of a preexisting condition and have been without insurance for the past six months could receive insurance through the PCIP program .
Rehabilitative and Habilitative Services: Many insurance plans cover rehabilitation treatments in case the individual is unable to perform any daily activities such as speak, work or walk. The insurance plan covers surgical equipment including wheelchairs, walkers and knee braces. Even habilitative services such as long-term disabilities is also covered in the plan.
Maternity and Newborn Care: According to ACA preventive service in prenatal care must not be charged by any insurer. The insurance plan covers the cost of the childbirth and new born baby care from its birth. These benefits are a boon for people who cannot afford the pregnancy costs, because many insurers do not cover pregnancy in their clauses. After the ACA many insurers have started providing maternity care and new born care.
Patient-centered medical homes (PCMHs): ACA provides more horizontally combined primary care by employing nurse navigators, patient registries, home health services and tele-monitoring methods to decrease unnecessary readmissions and total costs .
Young Adults Coverage: There are many uninsured youths in U.S. Earlier the children were dependent on their parent’s health coverage. ACA requires that the insurance plan provides dependent coverage for children and make that coverage available till the youth turns 26.
Insurance for early retirement: People retiring early before the age of 64 lose their health insurance from employers, and later end up paying high premiums if they buy insurance plans after retirement. ACA provided $5 billion to help employers in state and local governments, cover the cost of health insurance to early retirees and bring down premiums .
Expanded Medicaid: ACA funds states and local governments to expand the Medicaid programs that covers numerous low-income families and individuals, and offers coverage to maximum people. If the state has not expanded the Medicaid program, the individual can still apply for Medicaid and get qualification for tax credits to help in paying the health coverage.
Bundled-payment program: ACA boosts the innovative models through the creation of “shared savings” programs that reward societies that achieve pre-defined quality metrics at lower costs . Bundled-payment programs are created to generate incentives and offer capitated settlement cost for a bundled service, for example, orthopedics and cardiology.
References
Brown, K. (2013, April 25). Affordable Care Act at 3: Key components implemented so far provide bridges to coverage. Justice and Economic Security for all Coloradans, 1-3. Retrieved from http://cclponline.org/wp-content/uploads/2013/10/Affordable-Care-Act-at-3-PART-2.pdf
Burroughs, J. H. (2012, November 27). Revisiting the key components of the Affordable Care Act. Retrieved from Hospital Impact: http://www.hospitalimpact.org/index.php/2012/11/27/revisiting_the_key_components_of_the_aff
