Details of the Affordable Care Act, (Obamacare) - Oct. 2012

The Affordable Care Act, more commonly referred to as Obamacare, was signed into law on March 23, 2010 and remains one of the leading topics in headlines today. The law was established to improve healthcare coverage across the U.S. and to provide protection for all consumers. The new healthcare plan will affect all United States citizens from physicians, nurses, businesses and every individual regardless of income or stature.

President Obama ran his first election on the premise of health care for everyone and for change to come to the United States. Americans rallied behind the candidate in a way that had not been seen during a presidential campaign in many years. People have looked to the new president to repair our broken economy, create jobs, reform our current healthcare system, as well as to bring our troops home. This is no small feat to accomplish in a four year term. Though our economy is still off track and new jobs remain a problem, President Obama did make good on his promise of reforming healthcare. After nearly four years of vigorous and heated debates about the law's unsustainable cost and the law's constitutionality, reform has occurred, but many still remain skeptical.

The country seems to be divided in its opinion on whether the new healthcare system will bring about the positive change needed in the medical world. There is no doubt that our current system needed overhauled but some feel that the Affordable Care Act does not address our countries problems. Those that have opposed the law argue that the United States cannot afford to carry out such a plan with our deficit already at an all-time high. They feel that our economy's tenuous recovery will be jeopardized beyond repair if the plan stays intact as it was passed by Congress. Those in favor of the plan feel that the Affordable Care Act can be sustained by cutting waste within the system.

It is no secret that Democrat and Republican politicians have sat on opposite sides of the fence, each making strong cases for or against the new plan, but the question is what is it that American citizens want? According to a new poll conducted by the New York Times/CBS News Poll taken directly after the Supreme Court's decision, 82% of Americans believe that healthcare is a top issue, with 61% saying that the individual mandate needs to be repealed, if not the entire law. This poll leaves little doubt that Americans are paying attention and Obamacare is on the minds of voters across the country.

Why is there such a drop in the polls leaving a vast majority of Americans against the Affordable Care Act who were for the new law from its earlier inception? Fear for the unknown could play a large part in the decreased favor. As voters watch the tug-of-war between the parties it has left questions unanswered on how Obamacare will affect our economy, our business sector and consumers. Another major factor is the fear of excessive government control over private industry. People are apprehensive since the bailouts to save 926 different companies took place, such as the few listed below:

With a total of 603.8B dollars in bailout funds distributed to failing companies in a time when our countries monetary situation is questionable at best, people have become even more apprehensive about any additional expenditure by the government. That includes the healthcare plan.

The Elderly and Disabled

The elderly are concerned that Medicare/Medicaid benefits will be cut as a result of supplementing the new plan and those nearing retirement age are fearful that social security and medical benefits will be non-existent by the time they become eligible. Many American's retirement hinges on Social Security and Medicare benefits as their primary source of income and healthcare needs.

In a paper written for the Center for Data Analysis at the Heritage Foundation, the Affordable Care Act would most affect recipients of Medicare Advantage Plans. Their claim is that millions of seniors who use the Medicare Advantage Plan instead of Medicare will experience drastic cuts in funding. It is estimated that three fourths of the cuts will be directed at seniors whose income is less than $32,400 per year. That means that the average recipient will incur a 15 % benefit decrease.

Supporters argue that the current predictions on Medicare cuts are inaccurate. They believe that "fear mongering" techniques are being used on seniors in order to gain the opposition needed to repeal the Affordable Care Act. Those for the plan maintain that there are two sources that will receive cuts. Fraud is at the top of the list. Currently it is believed that at least 60 billion dollars a year is being fraudulently siphoned from the federal government health programs. Cracking down on fraud will help supplement the additional cost of the healthcare plan. Medicare Advantage Programs that are being offered by private insurers will also be reduced.

No one is arguing that fraud needs to be eliminated. The pre-dominate problem is with cuts to the Medicare Advantage Program, that is at the heart of the matter and has proven to be a heated topic to say the least. In order to understand why the Medicare Advantage Program has been singled out for reform you first need to understand the program.

It was believed that Medicare would be better administered by private companies vs. government and that benefactors had the right to purchase added benefits if they were willing to pay higher premiums for the additional coverage. With this belief the Medicare + Choice program also known as Part C of Medicare, was created in the Balanced Budget Act of 1997. The program had limited success but in 2003 with the implementation of The Medicare Prescription Drug, Improvement and Modernization Act the program really took off becoming a viable option for seniors. The Act increased subsidies being paid by Medicare to the Medicare+Choice program which in-turn increased member benefits and assisted seniors in order to avoid the "donut hole" for drug coverage. At this time the program was renamed Medicare Advantage.

Along with the new found popularity came some very significant issues, such as, the amount of increased cost that fell upon taxpayers shoulders. In 2003, congress was addressed by private insurance companies for the purpose of having the government subsidize the 12 to 13% increase for a few years so that the insurers could create an effective program to provide Medicare services and additional benefits. The subsidies were supposed to be slowly phased out by the year 2010 but that did not occur. Instead the insurers appealed to Congress to extend the current subsidy. Congress voted at that time to not extend the subsidy forcing the Medicare Advantage program to keep to the deal made in 2003.It was an unfortunate coincidence that the end of the program came about at the same time as the healthcare program.

Those with disabilities have had many challenges with healthcare in the past. In states like Florida those who qualify for Social Security Income (SSI) also qualify to receive Medicaid, but many find themselves limited in job opportunities. In order to benefit from SSI you must fall under a certain income bracket and that makes it impossible to advance in any career without losing your SSI benefits. If the individual makes too much money they lose their SSI but that is not the biggest problem, they also lose their medical coverage. Some people believe this is taking advantage of the system but in reality it is the only way most can maintain treatment for their illness. Most insurance companies currently refuse to cover pre-existing conditions; therefore, if they lose their Medicaid (even if their job offers health insurance) they can no longer get treatment for their ailment/disability. The current system does not provide for a way for people to get off Medicaid once they are put on it.

The Affordable Care Act offers those who are challenged by disabilities an opportunity to take advantage of private sector insurance companies added benefits without being penalized by how much they earn. This means better healthcare without being prejudiced against pre-existing conditions. Those who choose to gain insurance through the private sector can expect NO lifetime caps, higher premiums, rescission of policy and non-renewability.

Pre-Existing Condition Insurance Plan (PCIP)

Under the Pre-Existing Condition Plan outlined in the Affordable Care Act individuals are now eligible for health coverage regardless of income as long as they have been without insurance for six months or longer. Many American's have been denied coverage simply because they had the misfortune to be diagnosed with an illness before gaining medical coverage. With the new healthcare law consumers have an opportunity to gain insurance coverage if they meet certain qualifications. This offers consumers a way to hold insurance companies accountable.

PCIP Qualifications:

PCIP Disqualifications:

What the Entrepreneurs Can Expect

Those who have their own business or company, or expect to in the future, will now have to operate within the framework of the new healthcare law. This has some business owner's up-in-arms about Obamacare. For years small business owners have pushed for healthcare reform. They asked primarily for reform that lowers cost but what they found was that the bill actually adds to their business cost as well as mounds of red tape. According to numbers the Obama administration has released it is estimated that the new mandates could increase cost by 7 percent from today through the year 2014. Though not all businesses are taking the same stand on Obamacare, many are happy with the changes taking place. Those who agree with the new plan are excited about offering coverage to workers that will adequately cover their healthcare expenses without devastating their savings.

Now that the Affordable Care Act has been upheld and found constitutionally sound business owners have only one choice and that is to find a way to make the new plan work for their company or business. Familiarizing yourselves early on with the new plan could help alleviate some complications. Finding creative new ways to save cost may be crucial in having a successful implementation of the healthcare plan. Ideas such as shopping around for group health benefit plans or utilizing program exchanges all could help make up the difference of the estimated 7% increase. Whether business owners approve or disapprove is now irrelevant. It is imperative to make educated business decisions based on what is instead of what may be in the future.

Doctors, Nurses and Hospitals stand on the Affordable Care Act (ACA)

The ACA has generated a lot of buzz from the medical society. Institutions such as the American Hospital Association, the American Cancer Society, the American Nurses Association, the American Academy of Pediatrics and other organizations have supported the Affordable Care Act. There are some great provisions for nurses or nurse practitioners in the new plan allowing for education and funding for women's clinics. Many nurses feel that the most exciting and innovative grant program is one designated to the creation of nurse-managed health facilities.

Doctors who support the new plan believe that the Affordable Care Act will promote better care for all. They believe that it is more beneficial to have everyone in the insured risk pool, rather than having lower income families utilizing Emergency Rooms for general care. Those with pre-existing conditions will no longer go uninsured. The new reform could also mean that individuals could look for coverage outside of their state of residence which will make insurers become more competitive.

Those who oppose the plan argue that the AMA which the President used as the opinion of all doctors only represent about 13% of American physicians. Many doctors believe that the government has no place in their medical office. They believe that healthcare will suffer from the added burden of red tape involved. Some doctors believe that the only real reform we need in healthcare is that there is a lack of competiveness within the insurance industry. Doctors who oppose the new law believe that the law aggravates the problem by giving limited choices for insurance to the private sector, it drastically increases regulations, and affects decisions making that is centralized.

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