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So, What’s the Deal With That Health Care Law?

Health Care
(Photo by David McNew/Getty Images)

In March of 2010 the President signed the Affordable Care Act (ACA) into law. Some parts of the law are already in effect and other aspects of the law are will come into effect soon. I want to know what’s happening. But it has been hard to find information that is just information, not opinion. Bullet points not politics is what I am looking for. So I set out to find out. And I figured that if I wanted to know, you might too. So, here is what I found and some links if want to know more.

A note here about the politics around the ACA:  The ACA is law. Agree or disagree with the merits or morality of the law fine, but that’s not what this post is about. If someone wants to have a discussion about public policy and government, I might enjoy that somewhere else. If someone wants to yell talking points thanks, but no thanks. Here I just want to know what going on, not argue policy.

I got this information from United States government websites, which are full of info especially if you want to know specific stuff. HealthCare.Gov is a great place to start. I also found a lot of good summaries from AARP, this FAQ from the Centers for Medicare and Medicaid Services and other news sources.

The basics: The ACA creates some protections for people in regards to health care coverage and it requires everybody to have health coverage starting in 2014, for that to happen it creates Health Exchanges. Open enrollment for the exchanges begins October 1st. One of my big question is what does that mean for me? This is the best answer I found:

What do I have to do? If you’re one of the roughly 80 percent of Americans who already has health insurance through an employer or is enrolled in a government program like Medicare, the answer is: probably nothing.

On Oct. 1, new health insurance websites will debut in each state. Some will be run by the state, and others will be run by the federal government. These sites, called health insurance exchanges or marketplaces, are designed to serve those without insurance and those who buy insurance on their own. -Jeffery Young

OK good. So, for me personally, I’ll probably have to do nothing then. But, if I didn’t have insurance or I wanted to change what I have, then starting October 1st I could look into other options with the Health Exchanges.

But, before we get in more about the Health Exchanges, here are some parts of the ACA that are in effect now.

  • People up to age 26 can remain on their family’s health insurance plan.
  • Insurance companies can no longer drop your coverage if you get sick and they can’t place lifetime dollar limits on health coverage.

.Starting in 2014.

  • Coverage cannot be denied to people with preexisting conditions such as asthma, diabetes, high blood pressure or cancer. And if you or a family member gets sick or injured, coverage cannot be cut off or your plan canceled.
  • Everybody must have some sort of health coverage.
  • Health insurance Marketplaces go live.

Click here to see an info graphic about the basics of the ACA.

Now, back to the  part of the ACA that I really wanted to know more about, the Marketplace or Exchanges. Starting in 2014, everyone is required to have health coverage. That coverage can be through your employer, Medicare, state health programs or through the Marketplace. If you don’t have health coverage, you may have to pay a penalty. There are some exceptions, including people with a very low income. Marketplace enrollment starts October 1st, 2013 and ends in March 2014.

What is the Health Insurance Marketplace?

  • It is described as a one-stop shopping place where people can purchase health insurance coverage.
  • The idea is that someone can compare plans and find one that fits their life and budget.
  • Every plan is required to cover things like doctor visits, hospital care, emergency care, prescriptions, preventive care and more.
  • The price of the plan is determined by household income.

Here’s a video about it:

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The Marketplace isn’t available until October. You can go here or here for South Dakota based information about the Marketplace. To find more help start here.

What about me and my family? What do we need to do?

If you like the health insurance you get at work, you can keep it. You don’t have to do anything. You’re considered covered. You may be able to change to Marketplace coverage if you want to.

Here are two question and answer forms that I found helpful. They are similar and will give you an idea of what you can expect, are eligible for and can do. You enter your state, family size and income to find out what you need.

There will be more specific info available starting in October (South Dakotan info hehe).

Fact Sheets from HHS.

I think I have a better understanding of what’s going on and what will affect my family. Hopefully the info will help you too.

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