Curious about how the Affordable Care Act (ACA) will affect you and your family? Signed into law in 2010, this multi-year plan is designed to change the current health insurance system and make it more accessible to a larger number of Americans, according to Arthur Tacchino, JD, assistant professor of health insurance at The American College of Financial Services in Bryn Mawr, Pennsylvania. The specifics of the ACA can be quite complicated, he says, but there are some basics you should know.

Key Affordable Care Act Provisions

Here are seven important aspects of the Affordable Care Act, some of which have already gone into affect, and others that will be implemented over the next few years:

  1. The ACA mandates health insurance coverage for all Americans and imposes penalties—starting in 2014—on those who don't comply. Tacchino explains that the goal of this Affordable Care Act provision is to encourage people in good health to purchase insurance. Since there are some exclusions, it's worth finding out if your particular situation qualifies to avoid the penalty. Over time, it's hoped that having more healthy people enrolled in the health care system will help to control rising health care costs.

  2. Insurers will be prohibited from withholding coverage from people with preexisting conditions. This part of the Affordable Care Act is important in order to make insurance accessible for people living with chronic conditions or other diseases and will ensure they have access to the medical care they need.

  3. Medical underwriting will be eliminated. This means that health insurers will no longer be able to charge higher premiums for people in high-risk categories or who are predisposed to various health issues. This makes more of a level playing field for everyone.

  4. Health exchanges are being created that will make it possible for small businesses and individuals to come together to access health care coverage as part of a larger group. The exchanges are intended to serve as a marketplace where a variety of different carriers can offer uniform plans, making it easy and convenient for consumers to compare their options. Tacchino says that beginning in 2017, larger employers will be able to access the exchanges. In addition to these exchanges, subsidies to help pay for a portion of the premiums will also be available for individuals and families who meet certain criteria. Checking to find out if you qualify for financial assistance is a smart idea. For more information that is updated regularly, visit www.healthcare.gov.

  5. The Affordable Care Act also creates more transparency in health care so consumers will better understand their insurance plans and know what to expect, and insurers will also be held more accountable for their actions.

  6. Another important element of the Affordable Care Act is providing consumers with improved access to preventative care (such as annual checkups, mammograms, and other recommended health screenings) without any co-pays or other out-of-pocket expenses. "The push is to offer wellness and preventative care in order to help people stay healthier and incur fewer health care costs," Tacchino says.

  7. With regards to Medicaid, the affordable care act also encourages expansion of the program, but each state can decide if it wants to enact this provision and how, Tacchino says, adding that at this time there are no penalties for states that don't want to follow this recommendation.

A Final Note

While over the short-term the ACA may result in the cost of health insurance coverage going up slightly, Tacchino says that over the next few years, the hope is the provisions will keep premiums level (or encourage them to drop) as more healthy people buy into the system, eventually lowering overall healthcare costs. To learn more about health care reform efforts in your state and to find out specifics, Tacchino suggests visiting the Kaiser Family Foundation's website.

Arthur B. Tacchino, JD, reviewed this article.

 

Sources:

The Henry J. Kaiser Family Foundation. "Health Reform Source" N.d. Web. 27 April 2013.
http://healthreform.kff.org/

"The Affordable Care Act: Three Years Post-Enactment" 22 March 2013.
http://www.kff.org/healthreform/8429.cfm