Affordable Care Act Basics, Part Two

By |2020-08-14T05:42:31+00:00August 28th, 2020|Categories: Blog and News, NHIA Blog|Tags: , |

The Affordable Care Act, which people also refer to as ACA, PPACA, or Obamacare, is a federal law concerning health care coverage. The act stems from the Obama Administration’s desire to expand healthcare coverage and Medicaid, as well as encourage innovation. Obama’s signature goes on the ACA in 2010, and the states implement changes by 2014. Last week, we reviewed key Affordable Care Act basics, such as what the Federal Poverty Level is as well as the main purposes of the ACA. This week, we are looking at more Affordable Care Act basics key protections the ACA affords as well as federal provisions that help achieve the ACA’s goals.

Rights & Protections

The ACA affords Americans some very specific rights and privileges. If you get a new insurance plan, these things should be on there. But there are a handful of plans that insurance companies grandfather in, so check your plan for coverage today. So here are some things that plans must do.

  • Cover individuals with pre-existing conditions, as well as not charging more for it.
  • Offer free preventative care.
  • Provide young adults with more options.
  • Abolish lifetime and annual limits on coverage of essential health benefits.
  • Assist customers understand what type of coverage they get.
  • Protect your choice of healthcare provider as well as protect you from retaliation from your employer.
  • Give mothers breastfeeding support and equipment.
  • Birth control counseling and cost coverage.
  • Include mental health and substance abuse services in the category of essential health benefits.
  • Allow people to appeal health plan decisions and have an outside party review them.

The ACA also holds insurance companies accountable for rate increases and prohibits them from dropping a client when that client gets sick.

Federal Provisions

The three main purposes of the ACA are to improve the availability of coverage, expand Medicaid, and support cost saving innovations in health care delivery. There are quite a few steps the federal government takes to achieve those goals. We only have space for some of the provisions on this page, for a full list, check out the National Conference of State Legislatures website. In addition, there are exceptions to a few of these provisions, consult with your local health insurance company to find out further details.

Availability Of Coverage

  • Make employers help their workers get coverage. However, some small businesses are exempt.
  • Give small businesses that help cover employee health insurance costs with tax credits.
  • Insurance plans must cover young adults on parents’ plans.

Medicaid Expansion

  • Give Medicaid coverage to people with incomes below 133% FPL.
  • Improve care coordination between Medicare and Medicaid.
  • Medicaid must cover services to help pregnant individuals on Medicaid stop smoking.

Innovation

  • Comparative studies to research the difference in effectiveness of different treatments. Then, implement that research.
  • Collect and report data to analyze health disparities between populations of different demographics.
  • Invest in health information technology.

Affordable Care Act Basics: An Introduction

By |2020-08-14T05:30:10+00:00August 21st, 2020|Categories: Blog and News, NHIA Blog|Tags: , |

The Affordable Care Act, also known as ACA or Obamacare, is a health care coverage act from the Obama Administration. President Barack Obama signed the act in March of 2010. Since then, the ACA is a hotly debated topic in homes and on news stations. However few people understand the purpose and the full extent of the bill. This week and next week we are breaking down Affordable Care Act basics. Read on to learn what the federal poverty level is, the purpose of the Affordable Care Act, and other basics.

Federal Poverty Level

When it comes to the Affordable Care Act, there are many references to the “federal poverty level” (FPL). But what is that really? The FPL is an exact dollar amount that the Department of Health and Human Services calculates every year. FPL represents the minimum amount of income that an individual or family needs to cover the necessities of life, including shelter, food, clothing, and transportation.

The government uses FPL to determine your eligibility for government benefits. For example, take Tom. Tom is a single man who lives alone, and his annual income is only $17,000.  For a single person, 138% FPL is $17,609. Tom makes below 138% FPL so he qualifies for Medicaid if his state has wider Medicaid coverage.

Income Under 100% FPL

You likely do not qualify for Medicaid from income, nor do you qualify for a Marketplace insurance plan.

Income Under 138% FPL

If your state expands Medicare coverage, you qualify for Medicaid from your income.

Income 100% to 400% FPL

You qualify for government subsidies that lower your monthly premium so you can access a Marketplace insurance plan.

The Big Picture

The Affordable Care Act has three primary purposes that the entire act revolves around. All of the provisions and the design of the act exist to meet those purposes. If you want to understand the ACA, it is essential to understand these big picture goals.

Availability

Firstly, the ACA addresses an issue that gives much cause for concern in America – how many people have no health insurance coverage. At the time of the signing, over 46 million Americans are without health insurance.

The focus is especially heavy on families who are at or just above the poverty level. The government provides subsidies that keep costs as low as possible.

Expand Medicaid

Medicaid provides health insurance coverage for low income people, including families. Both the state and federal government fund Medicaid, which causes some issues when the federal government tries to expand it.

Nevertheless, expanding Medicaid is one of the big goals of the ACA. Ultimately, they want Medicaid to cover all adults with income under 138% of the federal poverty level. Find out more about those exact numbers here.

Support Innovation

Finally, the ACA strive to support innovative ways to deliver medical care. Especially those innovations that lower the cost of health care.

Come Back

Come back next week to learn more about the ACA, including key federal provisions as well as how the law protects you.

Boosting Insurance Enrollment In Florida

By |2019-09-14T18:57:08+00:00October 2nd, 2019|Categories: Blog and News, NHIA Blog|Tags: , , , |

Floridians are the largest population signed up for coverage under the Affordable Care Act, and that number is likely to increase. Read on to learn about the grant that a USF-based group earned, and the work that they are doing to help Floridians with insurance enrollment.

What Is The Affordable Care Act?

 The Affordable Care Act, more commonly known as Obamacare, is an insurance program that was passed in March of 2010. The legislation has three main goals. The primary mission is to make health insurance available to more people. It subsidizes healthcare for those living far below the poverty level. It also aims to help expand Medicaid and supports “medical care delivery programs”.

Why Do Groups Need Grants?

Non-profit groups aid under-served communities by connecting people to medical insurance, which can help them immensely. These groups, such as the Florida Covering Kids & Families, are designed to help simplify the insurance process. Their goal is to help the uninsured population of Florida (2.5 million people) understand insurance enrollment. They especially aim to help children and families.

Florida Covering Kids & Families does not charge people to use their services. Not only do they connect people with insurance options, they conduct research on insurance trends across the state of Florida. The catch is that Florida Covering Kids & Families is a non-profit. So how do they pay for knowledgeable insurance experts and support research across the state? With grants such as these.

How Much Will The Program Receive?

Florida Covering Kids & Families will receive 1.3 million dollars each year for the next two years. The money will go to Florida Covering Kids & Families, who will in turn work with medical and insurance organizations across the state.

The programs help enroll over 60 thousand people per year in Florida. WUSF reports that the program is grateful for the money, but frustrated at the recent budget cuts. Their budget has been slashed 85% in the past two years, from 6 million at its peak to 1.25 million last year. This grant represents a trend in the other direction though, which has inspired hope.

The director of Florida Covering Kids & Families hopes that the government will provide more opportunities for funding. “Obviously, it doesn’t give us the ability to provide the level of services that are needed across the state of Florida, but it will allow us to continue to serve Floridians through open enrollment and the special enrollment periods.”

Why the Affordable Care Act May Not Go Away

By |2017-06-01T10:06:05+00:00June 1st, 2017|Categories: Blog and News|Tags: |

Though many consider it inherently flawed, the Patient Protection and Affordable Care Act, also known simply as the Affordable Care Act (ACA), a bill President Barak Obama signed into law March 23, 2010 (hence the moniker Obamacare), has held its own despite numerous attempts by Republicans to repeal it. A CNN Poll conducted in March, 2010 showed that only 39 percent of Americans favored the ACA, while a whopping 59 percent disapproved.

The ACA’s Two Mandates

The controversy stems in part from two much-maligned provisions: the individual and employer mandates. The first compels people to buy health insurance or pay a fine.  The second, also under threat of a fine, requires a business with at least fifty people on its payroll to provide health insurance to its employees. While the ACA adds millions of people to the health insurance rolls, expands Medicaid, the insurance plan that provides free medical services to low-income Americans, bans denial of coverage because of a pre-existing condition, premiums for some have apparently skyrocketed.

Latest Attempt to Repeal the ACA

The GOP has made valiant attempts to overturn the bill, including the latest attempt, President Donald Trump’s glowing debacle in March, 2017, which cast an embarrassing light on the president and Republican House Speaker Paul Ryan. Now the ACA appears to have become baked in the system, with no sign that it will go away.

Why?

Public Opinion Changes Course

For one thing, public approval for the ACA soared to an all-time high this year, a signal that repealing it could be disastrous for the Republicans during the mid-term elections. The fog of complexity that envelopes this divisive issue may serve as an omen for those who wish to reverse it.

“Repeal and Replace”

In response to Trump’s promise to “repeal and replace” the ACA, Ryan introduced a healthcare plan that, according to the Congressional Budget Office (CBO), would have left 14 million Americans without health insurance by 2018, and 24 million by 2026.

Clash Within the GOP

Consequently, moderate Republicans, especially those whose constituents have benefited from the ACA, voted against the GOP’s newest repeal effort. Republicans in the far right wing of the party, however, didn’t think it went far enough. They wanted to slash more benefits. Consequently, they too voted no. This clash revealed intractably deep divisions in the Republican Party over healthcare. That and the wave of public sentiment supporting the ACA will likely present a hurdle in future repeal efforts.

For more information on the Affordable Care Act, please contact us. Thank you.

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More In-Depth Financial Literacy is Crucial to Getting the Most out of the Affordable Care Act (ACA)

By |2016-05-18T12:38:06+00:00May 18th, 2016|Categories: Blog and News|Tags: , |

The Affordable Care Act was designed and passed into law to ensure that every single American had health insurance. This law has brought about a lot of big changes to healthcare. The main aim was to provide affordable health care options to every single American. However, without a solid understanding of all of the financial options most people do not fully benefit from this comprehensive new law.

Coverage through the ACA has been expanded including state insurance exchanges, the expansion of Medicaid, and inclusion of the individual mandate. While more Americans than ever can now afford health insurance, the ACA has also created a complex set of new choices for the consumer that includes a number of new penalties, subsidies, and plans to choose from. Research into financial literacy when it comes to health insurance is very limited at best, but researchers have found that when it comes to retirement, debt, and financial planning the average consumer is often lacks the basic understanding, confidence, and ability to make financial decisions that are in their best interests.

Applied to the ACA financial literacy should be a paramount concern for consumers. The more effectively you can navigate the myriad of options laid out by the ACA the more you will be able to benefit from all it has to offer. This is very important especially to consumers who are considered low-income. There are a number of subsidies and tax credits available that are all designed to ensure that healthcare is affordable to everyone, but if you lack the skills necessary to make the best decisions in these regards you may not only find yourself not getting as much in subsidies and tax credits but you can also be penalized financially.

It is important to understand all of the facets of the Affordable Care Act before you make a decision regarding your healthcare. Contact us to learn more about the ACA and the options it offers.

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This Sliding Bar can be switched on or off in theme options, and can take any widget you throw at it or even fill it with your custom HTML Code. Its perfect for grabbing the attention of your viewers. Choose between 1, 2, 3 or 4 columns, set the background color, widget divider color, activate transparency, a top border or fully disable it on desktop and mobile.
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