• No person can be denied insurance coverage due to a pre-existing condition.
• Children can remain on their parents’ health insurance coverage up to age 26.
• No copay can be charged by medical providers for preventive services.
• The 80/20 medical ratio rule ensures that at least 80 percent of the premium dollar will be spent on providing health services.
• $11 billion will be provided over a five-year period for the operation, expansion and construction of community health centers nationwide.
• For fiscal year 2012, $750 million in grants have been awarded to states for new construction and expansion of health centers. Locally, the Belle Terrace Wellness Center received a $4.9 million grant to build a new facility that will double the services offered (“Health service expanding to meet patients needs,” Augusta Chronicle, Nov. 4, 2012).
Although the U.S. Supreme Court upheld the constitutionality of the act on June 28, 2012, it ruled out the provision requiring states to expand their Medicaid programs under penalty of losing their current funding.
As of Sept. 1, 17 states, including Georgia, had opted not to expand Medicaid coverage to low-income workers. However, states may opt in at any time. The 33 states that will expand their programs will provide health insurance for a single person earning up to $14,856 and a family of four with an income of $30,656. The federal government will reimburse these states 100 percent during the first three years of coverage and 90 percent each year thereafter.
People who aren’t eligible under Medicaid expansion may qualify for tax credits. Also, small businesses with fewer than 50 employees, providing health coverage, will receive tax credits.
Open enrollment for the act will begin Oct. 1. Uninsured people are encouraged to check the online insurance exchanges (marketplaces) for affordable premiums. Assistance and counselors (“navigators”) will be provided at community health centers and at some public libraries and churches.
The mandate that all people must have some type of health insurance or be penalized is very controversial. The purpose, however, is simply to increase the number of people covered to keep premiums low. Most people would be exempt, except uninsured people and self-employed people with good incomes.
There has been so much misinformation spread by fearmongers and money-making propagandists that most polls show that 50 percent or more of Americans – especially those who already have health insurance – fear the worst: that their premiums will increase and medical service will be decreased. But when the act is explained in detail, some people change their opinion.
Like most laws in the beginning, there will be obstacles to overcome as the act is implemented. Some provisions may be repealed, and some amendments and adjustments will have to made later. The same happened to Social Security, Medicare and Medicaid years ago.
Republicans in the House of Representatives voted Friday to defund the Affordable Care Act. The intent and purpose of the act, however, is simply to provide affordable quality health care to all Americans regardless of income or status in life.
Isn’t that what our country – a haven of democracy – is all about?
Tracy E. Williams Jr.