Affordable Care Act
The Affordable Care Act (ACA) is made for individuals and families who had previously been not insurable due to poor health or preexisting conditions. It also made healthcare more affordable for those individuals and families living at or below 400% of the current poverty level.
There are certainly several Affordable Care Act pros and cons that must be considered by all Americans. Here are a few of the most important key points to look at:
Enrolling in the Affordable Care Act is an extensive process
Since having health insurance is required because of the Affordable Care Act, many are forced to endure a very complicated enrollment process. Public health agencies, hospitals, and other social services or medical providers set up assistance programs to guide consumers through this process, but the complication of finding the right coverage for the right need can be a somewhat tricky process to get right – that's why we are here to help.
Makes it difficult to access a doctor in some communities
In rural areas, the Affordable Care Act brought hundreds of previously uninsured families into the healthcare community. This created more appointments for doctors, which reduced physician access for everyone. Even in the first year of the law’s implementation, it was not unusual for a wait list of up to 6 months to form when accessing optional services from local doctors.
Screenings and preventative services are covered
Many preventative services, including care screenings, are included in the policies offered under the Affordable Care Act. Although these services would usually go straight to the deductible under most plans, with the Affordable Care Act, the screens and services are generally offered with either a low copay, no copay, or may be covered outside of the deductible rules.
Many families qualify for credits
Most families that are defined as being in the Middle Class, or living at or below 400% of the current poverty level, receive tax credits on their premiums. Medicaid expansion was also included in this law so that protections could be extended to households at 138% of the current Federal poverty level, which allowed more adults without children to receive coverage.
Enough options to find what fits you best
Plans have three different tiers, from lower-end bronze policies all the way up to gold policies with the best benefits. Where bronze policies are more affordable, they include higher deductibles and annual out-of-pocket costs, whereas gold policies come with the lowest deductibles and much higher premiums. Silver plans fall somewhere in between in terms of premium costs and deductibles.
Health saving account (HSA)
"HSA" stands for Health Savings Account. HSAs allow consumers to pay for qualified medical expenses with pretax dollars—meaning income-tax free—and save for retirement on a tax-deferred basis. An HSA is tax-favored savings account that is used in conjunction with a high-deductible HSA-compatible health insurance plan to make healthcare more affordable and to save for retirement.
Open enrollment is your chance to sign up for a new health insurance plan or compare your options in the market. Open enrollment begins on November 1st and continues through December 15th. Coverage under a new plan selected during the open enrollment period can begin no sooner than January 1st.
Removes the idea of pre-existing conditions
If you have a chronic medical condition or underlying pre-existing condition, you’ll likely need to apply for an ACA plan.
Raises the cost of health insurance for many Americans
The Affordable Care Act was intended to bring in more low income households to the insurance market. Low income individuals could receive government subsidies to make their insurance affordable. For higher income families, those subsidies were not made available. The law also requires a wider range of services and benefits to be covered, which means health insurance plans had to be generic instead of specifically tailored to individualized needs. This has caused premiums to rise dramatically over time.
Allows children to stay on a parent’s plan until the age of 26
For young people, obtaining health insurance can be a difficult proposition. Even in the past, employers would often require 3-12 months of consistent full-time employment before offering health care insurance as a benefit. This meant most young people would choose to remain uncovered and avoid going to the doctor as much as possible. By allowing children to stay on a parent’s plan until the age of 26, it has provided millions of young adults with the coverage they need. At the same time, covering these youth provides relatively little risk to the insurance industry.
Covers prescription drugs
If you want a comprehensive plan that covers prescription drugs, an ACA plan will likely leave you better off.
Mental health included
Because of the coverages that are offered, insured individuals through the Affordable Care Act can access needed services, including treatment for mental health needs, without being required to access a local emergency room. This reduces individual treatment costs since ER services are typically more expensive.
Removes per year and lifetime limits
The Affordable Care Act also removed the lifetime caps or specific time frames that people were given to use their insurance coverage. This means you could never get kicked off your plan for getting sick or “run out” of coverage. People can continue to access their coverage, even if their health care requires expensive treatments, because insurers can no longer exclude people due to how much their care actually costs over time.
The Affordable Care Act pros and cons should be considered before deciding on the best healthcare plan for you. There are many benefits that have been experienced, but those benefits do have a very real cost for many families. One thing is for certain: many people who didn’t or couldn’t have health insurance before can have it now.