The United States famously ranks as the most expensive health care system in the world. Germany, Sweden, Canada, and France have their places below, but to match up with the U.S, Germany would have to increase its per capita expenditure by over 4,500 USD.
One of Congress’s major initiatives to ensure better health care was the Affordable Care Act (ACA), that was passed under the Obama administration. The ACA is often used interchangeably with “Obamacare”, but both essentially refer to the same act.
While the discussions for an effective healthcare plan began all the way back in 2009, it was officially signed into law in March 2010, and Americans were able to sign up in 2013. The act has always been a subject of controversy with both sides arguing over its effectiveness, in typical administrative fashion. The aims of the act were sound and the benefits it presented changed the fundamentals of even commercial insurance plans, as we know them.
So let’s look into some of the ways it helps the people of America.
1. Better Prevention = Better Health
The ACA emphasizes the need for prevention by making it mandatory for most insurance plans to cover preventive health care. The premise behind this is that diseases are easier and less expensive to deal with at their earlier stages.
A screening or routine test, vaccines, and even contraceptives can go a long way in preventing expensive emergencies in the future. The ACA itself allows for no-cost procedures that make access to colonoscopies and mammograms easier for citizens. It goes so far as to cover all 50 procedures as prescribed by the U.S Preventive Services Task Force.
2. It Encourages Affordable Insurance Plans
By presenting itself as an extremely affordable alternative to the mainstream and commercial insurance plans, it hoped to push agencies to introduce their own competitive prices and policies. That goal would have reduced the exploitative practices of private insurances and encourages them to create simpler terms that their consumers can understand.
In reality, Obamacare caused many carriers to abandon the individual market, and because it covered so many expensive add-ons, it failed to meet the core objective of being affordable for anyone who did not qualify for a government subsidy.
Another element to Obamacare is the enabling of parents to add children up to the age of 26 to their insurance plans. In the state of Florida, the Affordable Care Act Plans actually allow children (who are students) to stay on their parents plan. Given that most young people are less prone to illnesses, it allows for larger premiums to make up for company revenues.
3. It Covers Pre-Existing Ailments
Pre-existing ailments make patients more vulnerable to diseases, making it increasingly difficult for them to access affordable health care. One of the major benefits to the act is its strict policies for discrimination against patients with pre-existing ailments. These include the likes of diabetes, cancer, hypertension and more.
While the principle behind this provision may have been sound, it also temporarily raised the overall cost of health care, due to plenty of first-time patients getting tested.
4. A Variety of Health Benefits
Obamacare makes it imperative for all health insurance plans to cover ten essential health benefits within their policies. One of these includes its emphasis on Preventive Health Care and the others are as follows:
- No-cost maternity and newborn care
- Treatment for mental or behavioral health
- Equipment to treat chronic illness
- Dental and vision care for children under 14
- Coverage of prescription drugs
- Outpatient care
- Emergency room services
- Lab tests (if used to diagnose an illness)
These health benefits were mandatorily required in all health care plans post, March 2010. In addition to this, it also requires states to create their own unique “benchmark plans” to set the standard to be followed for all private insurance companies.
Unfortunately, this may have had a downside to it. Over thirty million people had their private insurance plans canceled because they did not meet the 10 benefit provision in the ACA. While no-cost maternity care might be a necessity for some, a lot of people have no use for it, and technicalities such as these got in the way of pre-existing plans.
5. Health Care for Employees
Obamacare offers several tax credits and incentives for businesses to cover health care plans for their employees. Businesses with less than 25 employees can claim a tax credit of up to 50% on the cost spent on healthcare, whereas non-profits can claim up to 35% if these are purchased on the Small Business Health Options Programs Marketplace.
Businesses with between 30-50 or over 50 employees are subjected to different regulations. However, millions of employees also lost their employee health insurance when businesses found it easier to pay their penalties, rather than provide health insurance, so the effectiveness of this provision is subject to argument.
6. Covering the Mental Health Spectrum
Before the introduction of Obamacare, mental health was not a requirement among health policies. However, ACA mandates that all health insurance in the private sector account for the importance of mental as well as behavioral health concerns, including substance abuse disorders within its patients.
Prior to this, there were no regulations that specified this as a requirement and patients did not have access to affordable mental health care. Obamacare works to ensure that mental health is treated at the same level of importance as physical well-being.
7. Obamacare’s Elimination of Coverage Limits
In order to assist those who suffer from chronic or lifetime illnesses. The ACA eliminates the need for coverage limits in the form of a lifetime or annual limits. This was an enormous barrier for patients that incurred higher expenses due to the prolonged nature of their illness, particularly those that can only be treated and not cured.
ACA ensures that they get continuous, quality treatment throughout the course of the year and their lifetimes.
The Focus of the Affordable Care Act (ACA)
Obamacare is essentially a two-part act that consists of the Patient Protection and the Affordable Care Act (ACA) and the Health Care Education Reconciliation Act. The central focus of these acts is to increase the number of Americans with access to health care insurance as well as the reduction of health care costs, in general.
It also emphasizes a systematic change within the way hospitals and medical professionals are paid. The focus is on how well you get after treatment more than the treatment itself. This encourages professionals to be accountable for their practices and encourages efficiency within the health care system.
However, it is not without its flaws. Those who did not purchase insurance were subjected to taxes, where some sought exemptions, and others preferred the taxes over Obamacare. Higher premiums, technical difficulties, and employee cuts call into light the need for objective analysis of the health care system in place. These taxes have since been eliminated by congress.
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