Back in 2012, Obamacare went before the U.S. Supreme Court over the constitutional aspect of the individual mandate. Now, there is a new constitutional challenge to the law and it is related to birth control.
A provision of the ACA requires for-profit employers of certain size to offer insurance benefits for birth control and other reproductive health services without a co-pay. At issue is where certain companies can opt off of this mandate based on the claim that it would violate their owners’ long-established personal beliefs. The provision is being appealed in two cases that are being heard together.
For people with pre-existing conditions and terminal illnesses, the Affordable Care Act, aka Obamacare, has been viewed as a positive. With a firm stand against long standing discrimination in the health insurance industry, Obamacare strived to bring in equality for all, irrespective of their medical condition. However if Obamacare left any gap to make health insurance equal for all, it is the access and cost of drugs needed to cure chronic medical problems. Currently, these ‘specialty’ drugs are adding financial burden on people with chronic illnesses.
According to available data, these specialty drugs cost somewhere around $8,000 a month, and people who have purchased health insurance off the health insurance marketplaces could be responsible for up to 50 percent of those costs. Insurers cite increasing drug prices for this sharing of costs, stating that these drugs can cost roughly $100,000 per year, per patient, and thus require some support from patients. Although this replacement trend of fixed dollar co-payments with co-insurance cost sharing model stands since before the implementation of PPACA, it has gathered more force in the last few months, particularly because of the increasing drug prices.
If anything grabbed more attention, anguish, and aversion than the failures of the federal online marketplace last year, it was the cancellation of policies that did not meet the requirements of Affordable Care Act. The cancellations, a thorn in the side of the administration, came at the most inopportune time – when the officials were struggling with a marketplace that was marred by technical glitches, lack of interest, and opposition’s constant badgering into acquiescence. Unfortunately, the impact of these cancellations was nothing less than debilitating, with nearly 4.7 million people losing health insurance and coming under the uninsured domain.
Back in 2010, when Obamacare was unfolding its propositions and plans for the implementation, a crucial aspect of the law was coverage to people below the federal poverty line, up to 138 percent of the federal poverty line through a proposed Medicaid expansion. However, in 2012, the proposal to expand Medicare coverage was shot down by Supreme Court. Twenty-four states are currently refusing to align with the expansion (six of those are currently having an open debate on this issue but for the purpose of this post, I am counting them as a “not expand”), and have triggered a health law coverage gap for individuals who need subsidized health insurance coverage. The main, collective concern of these states was the financial liability that Medicaid expansion will add to the already struggling economy of the U.S.
From a proposal to a law, the Affordable Care Act, was written with the intent that the states and federal would be a partnership. However, reality has been a bit different – some states refused to stand up their own exchange and some have refused to expand Medicaid.
Effectively, a state-federal partnership is crucial to ACA, and one example that can be learned from is CHIP (Children’s Health Insurance Program). When CHIP was rolled out, state actions were extremely critical to implementation of the program.
Continuing from the first part of our series, which showed the most important facts to know before the March 31 open enrollments deadline, such as penalties, subsidies, and Medicare coverage. This second part of the series is going to take a dive into the remaining 4 aspects you need to consider in the wake of the approaching deadline. These 4 points will help you see why now is the right time to enroll for better health insurance through Obamacare exchanges, and how you can reach out for support to get health insurance through subsidized exchanges. Let’s take a look.
The launch of the ACA, aka Obamacare, has been a bit of a rollercoaster — technical issues, canceled policies, etc. However, most of these issues have been sorted and we are just a few days away from the end of open enrollment. Of course to ensure confusion continues, the administration announced recently announced an extension for people who have started the enrollment process but not completed it. If you want coverage but have not shopped for health insurance yet, these last few days are crucial for you. In a two part series, we have covered the 7 most important things that you need to know before the enrollment window ends. So, let’s get started.
Software issues, debate over young invincibles, delays, extensions, sticker shock are just a few of the myriad issues surrounding Obamacare. Ideally, Obamacare has been seen as a harbinger of major change in the way individuals purchase health insurance. However, Obamacare has something to offer to small businesses too. While small business have until October 2016 to confirm their health insurance plans to new federal rules, the below are a few things that small businesses should keep in mind.
Although most of the major Obamacare provisions apply to large organizations, with 50 or more employees, several incentives are in place for small businesses with 50 or lesser employees. Here, we round up four incentives Obamacare has in store for small businesses.
When Obamacare was designed, it had aspirations that all Americans would have health insurance coverage, regardless of age, income level or health. As we know, the act has been hotly contested and challenged all the way to the U.S. Supreme Court. But there have been some casualties. The health-law coverage gap, an unfortunate consequence of amends to PPACA, is one such casualty.
Before we move into how and why, let’s first understand what we mean by the health-law coverage gap. Rewinding back to 2010, Obamacare was designed to provide health insurance to the underprivileged through a two-pronged approach – new federal subsidies and expanded Medicaid program. For people earning up to 138 percent of the federal poverty line, Medicaid was to be expanded for covering their health insurance requirements. For people in 138 – 400 percent of the poverty line, the law proposed federal subsidies that could be attained while enrolling through federally facilitated marketplaces.
Young adults, or as Obamacare likes to call them – “young invincibles”, have been the talk of the nation since the day Obamacare was implemented. As an industry basic, young, healthy individuals are required to balance the risk pool and reduce the liability of health insurance coverage on the insurance carriers. These healthy individuals, generally classified in the age group of 18 to 35, do not utilize the services of emergency rooms and hospitals as much as their older, unhealthier counterparts. In essence, the onus of balancing out the equation is heavily dependent on these healthy individuals.
Enrollment of young invincibles has been in the crosshair of industry experts since the beginning of the ACA. The center of many discussions has centered on how to engage this demographic. Several reasons have been cited for the lack of interest from this demographic toward federal health insurance marketplaces.