Decoding ACA Advantages: Ensuring Health Insurance for Everybody

Mar 4 08:36 2013 sammy smith Print This Article

The Affordable Care Act had just one roadblock in its path and with the re-election of Obama, these last, few hiccups to have been removed and now, healthcare reforms are poised to be unleashed in their wholesome format.

There has been a lot of negative sentiments about the ACA,Guest Posting particularly from the politically-inclined individuals and corporates who aren’t such big fans of the universal health policy view. However, Obamacare is set to challenge this outlook and ensure that people across the United States have access to affordable and easily-available health insurance. 
For years, Americans who were in the phase of switching or changing jobs or had just lost their jobs had to bear the brunt of having no health insurance. This was mainly because of prejudiced health insurance policies that did not provide coverage once the individual did not have a steady source of employment. This is despite the coverage provided as a part of COBRA. However, since the onset of the healthcare reforms, more and more individuals are getting access to health insurance even if they lose their jobs. Yes, there might be some window period before their health coverage is renewed or reactivated, but this waiting period has been reduced drastically and is poised to be reduced further in 2013.
The ACA is very stringent about the denial of health coverage on the basis of pre-existing conditions. This has been a topic of much controversy in recent years where many documentaries and international films have projected the suffering of millions of Americans who have had to pay for exorbitant healthcare costs simply because they suffered from some small ailment. In many cases, the condition for which the treatment was being sought and the pre-existing condition didn’t even have a properly-diagnosed connection.
It was just an excuse for insurance companies to further reduce their risk, deny insurance or charge severely inflated premiums. However, pre-existing conditions can no longer be used as a reason to deny health care enrollment. The healthcare reforms have already kicked in and this refers to the changes that have been made even before the private exchanges are established or state and federal health insurance marketplaces are created.
With the creation of PCIP or the Pre-Existing Coverage Insurance Plan, thousands of Americans have already gained coverage and many more will get insurance, including those who had been denied earlier and children who are very often refused health insurance because of pre-existing health conditions.
The ACA is rather concerned about how healthcare insurance can be discounted or made cheaper to ensure that it is accessible at the very lower end of the premium paying pyramid. For this reason, the setting up of state and federal health exchanges has been proposed and already, 13 states are in the process of creating their health insurance marketplaces. In fact, all states are mandated to create either their own, regional or hybrid health insurance exchanges or default to a federal health insurance marketplace by October 2013.
The biggest advantage of the creation of healthcare exchanges will surface in the form of cheaper insurance since premium caps will be created by the regulatory bodies. This means that insurers will not be able to charge beyond a certain value for each health plan they enlist on the exchange. This will be a part of the exchange enrollment for payers. Further, they would need to provide and explanation every time they seek a premium hike. Their functioning will also become more transparent, regulated via periodic audits and a systematic submission of reports.
People who are subscribing to health insurance via the exchanges would have to submit their details only once from which important information like their Medicare eligibility enrollment or the same for CHIP and Medicaid would be calculated and the cost-sharing will be processed accordingly.

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sammy smith
sammy smith

Author is a well known authority on health insurance software in the US. He is currently looking to expand his expertise in medicare eligibility enrollment and health care enrollment available.

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