Patient Protection and Affordable Care Act

From WikiMD's Wellness Encyclopedia

The Patient Protection and Affordable Care Act (PPACA), commonly known as the Affordable Care Act (ACA) or Obamacare, was a landmark piece of legislation in the United States. It was signed into law by President Barack Obama on March 23, 2010, aiming to increase access to healthcare, improve the quality of care, and reduce overall costs.

Overview of the act[edit | edit source]

The ACA includes numerous provisions designed to improve access to healthcare and ensure that insurance companies provide fair coverage.

General provisions[edit | edit source]

Under the ACA, there are no limits on how long an individual can receive healthcare from an insurance company. If insurers wish to increase the cost of their coverage, they must provide a public explanation for their decision. Insurance premiums must now be spent solely on healthcare, not on administrative costs or employee salaries.[1]

Preventive care, which focuses on preventing illnesses, is now available free of charge to many individuals. Healthcare plans also offer increased choice in selecting doctors, and individuals can access emergency care at hospitals not covered by their insurance.[1]

Coverage for children[edit | edit source]

The ACA enables young adults to remain on their parents' health insurance until the age of 26. Furthermore, insurers must provide coverage to children under 19, even if they have pre-existing conditions. This prevents insurance companies from limiting coverage to only healthy children.[1]

Individual mandate[edit | edit source]

The ACA's individual mandate requires individuals without health insurance to pay a tax penalty until they obtain coverage. The Supreme Court of the United States ruled that this penalty is constitutional. The penalty increases each year until 2016, though some exceptions apply for low-income individuals who cannot obtain insurance for free.[2]

Employer responsibilities[edit | edit source]

Starting in 2015, companies with more than 50 full-time employees must provide health insurance to their workers. Companies with fewer than 50 employees are exempt from this requirement. A full-time employee is defined as someone who works more than 30 hours per week at a single job.[3]

Health insurance marketplace[edit | edit source]

Individuals without health insurance, or those unhappy with their current coverage, can purchase insurance through the Health Insurance Marketplace. The Marketplace is accessible via the Healthcare.gov website. To receive coverage by January 1, 2014, individuals must register for insurance by December 15, 2013. Those who fail to obtain coverage by January 1 may face a tax penalty under the individual mandate. The Marketplace offers support for those experiencing difficulties during the registration process.[4]

All health insurance plans available on the Marketplace must cover prescription medications, emergency care, maternity care, mental health care, rehabilitation services, and more. Maternity care focuses on providing support to pregnant women and their newborns.[4]

Medicaid expansion[edit | edit source]

Medicaid is a government-funded health insurance program for low-income individuals, jointly financed by the states and the federal government. The ACA expands Medicaid eligibility, though states can choose whether to participate in the expansion. If a state opts in, the federal government covers the majority of the associated costs.

Opposition to the act[edit | edit source]

Error creating thumbnail:
Death Panel protest

Impact on businesses[edit | edit source]

Some critics expressed concerns that companies would avoid hiring new employees or reduce workers' hours to avoid providing health insurance. While there have been isolated cases of this happening, no statistical evidence supports a widespread trend.[3]

Medicaid expansion[edit | edit source]

Twenty-seven states have objected to the Medicaid expansion. The Supreme Court of the United States ruled that these states are not obligated to participate in the expansion, despite the federal government's wishes.[5]

Government shutdown[edit | edit source]

In October 2013, the government shut down for 16 days when Republicans refused to raise the debt ceiling unless President Obama agreed to repeal the ACA. This led to a temporary halt in government operations.[6] Over 800,000 government employees were furloughed during this time and later received back pay.

Death panels[edit | edit source]

In August 2009, former vice-presidential candidate Sarah Palin claimed that the ACA would create death panels responsible for deciding whether elderly individuals should receive healthcare or be left to die. Numerous news outlets and researchers have debunked this claim.[7]

2017 repeal effort[edit | edit source]

On May 4, 2017, the American Health Care Act of 2017 (AHCA) was narrowly passed by the United States House of Representatives with a vote of 217 to 213, sending the bill to the Senate for consideration[8] This marked the second time the AHCA was voted on in the House, as the first version failed to pass in March 2017.[9] President Donald Trump supported the passage of the AHCA and advocated for the repeal and replacement of the ACA.[10]

However, the Senate ultimately did not pass the AHCA, and the effort to repeal and replace the ACA stalled. The ACA remains in effect, though there have been subsequent attempts to modify or repeal it.

Related pages[edit | edit source]

References[edit | edit source]

  1. 1.0 1.1 1.2 U.S. Department of Health and Human Services. Retrieved November 21, 2013.
  2. NPR FAQ: Understanding The Health Insurance Mandate And Penalties For Going Uninsured. Retrieved November 21, 2013.
  3. 3.0 3.1 NPR FAQ: How Obamacare Affects Employers And How They're Responding. Retrieved November 21, 2013.
  4. 4.0 4.1 NPR FAQ: All About Health Insurance Exchanges And How To Shop For Coverage. Retrieved November 21, 2013.
  5. Forbes: About Half U.S. States Will Expand Medicaid Under Obamacare. Retrieved November 21, 2013.
  6. CNN: Government shutdown: Get up to speed in 20 questions. Retrieved November 21, 2013.
  7. The Hill Rehabs Palin's "Death Panels". Retrieved November 21, 2013.
  8. "FINAL VOTE RESULTS FOR ROLL CALL 256". house.gov. May 4, 2017. {{cite web}}: Cite has empty unknown parameter: |dead-url= (help)

Other websites[edit | edit source]

This article is a stub.

You can help WikiMD by registering to expand it.
Editing is available only to registered and verified users.
WikiMD is a comprehensive, free health & wellness encyclopedia.

Contributors: Prab R. Tumpati, MD