Patient Protection and Affordable Care Act of 2010


Description: The Patient Protection and Affordable Care Act also known as the Health Care Reform Law, or Obamacare was intended to provide widespread insurance coverage for American citizens while also placing limitations and regulations on the health care insurance industries. Also in the health care Law are provisions to create further opportunities to educate health care professionals and expand the depleted health care workforce.

Passed by Congress: Dec. 24, 2009
Signed into Law by President Barack Obama" March 23, 2010
Open Enrollment Began October 1, 2013
Coverage Begins: January 1, 2014
Open Enrollment Ends: March 31, 2014

Health Care Bill Literature




Bill Sponsors:
Representative Charlie Rangle of New York and 39 other Representatives (37 Democrats 3 Republicans)

Previous Attempts at Health Care Reform:
Nixon '74
Clinton '93


Key Provisions:
  • Health Care benefits for children extended to age 26
  • Grandfathers all healthcare plans from before 2010
  • All citizens (guardian of dependents is responsible for them) are required to have health insurance
    • Also know as an individual mandate or minimum coverage provision
      • Minimum coverage needed to avoid penalty (according to the IRS)
        • "Minimum essential coverage includes the following:
          • Employer-sponsored coverage (including COBRA coverage and retiree coverage)
          • Coverage purchased in the individual market, including a qualified health plan offered by the Health Insurance Marketplace (also known as an Affordable Insurance Exchange)
          • Medicare Part A coverage and Medicare Advantage plans
          • Most Medicaid coverage
          • Children's Health Insurance Program (CHIP) coverage
          • Certain types of veterans health coverage administered by the Veterans Administration
          • TRICARE
          • Coverage provided to Peace Corps volunteers
          • Coverage under the Nonappropriated Fund Health Benefit Program
          • Refugee Medical Assistance supported by the Administration for Children and Families
          • Self-funded health coverage offered to students by universities for plan or policy years that begin on or before Dec. 31, 2014 (for later plan or policy years, sponsors of these programs may apply to HHS to be recognized as minimum essential coverage)
          • State high risk pools for plan or policy years that begin on or before Dec. 31, 2014 (for later plan or policy years, sponsors of these program may apply to HHS to be recognized as minimum essential coverage)
          Minimum essential coverage does not include coverage providing only limited benefits, such as coverage only for vision care or dental care, and Medicaid covering only certain benefits such as family planning, workers' compensation, or disability policies."
    • Exemptions (IRS Quote)
        1. Religious conscience. You are a member of a religious sect that is recognized as conscientiously opposed to accepting any insurance benefits. The Social Security Administration administers the process for recognizing these sects according to the criteria in the law.
        2. Health care sharing ministry. You are a member of a recognized health care sharing ministry.
        3. Indian tribes. You are a member of a federally recognized Indian tribe.
        4. No filing requirement. Your income is below the minimum threshold for filing a tax return. The requirement to file a federal tax return depends on your filing status, age and types and amounts of income. To find out if you are required to file a federal tax return, use the IRS Interactive Tax Assistant (ITA).
        5. Short coverage gap. You went without coverage for less than three consecutive months during the year. For more information
        6. Hardship. The Health Insurance Marketplace, also known as the Affordable Insurance Exchange, has certified that you have suffered a hardship that makes you unable to obtain coverage.
        7. Unaffordable coverage options. You can’t afford coverage because the minimum amount you must pay for the premiums is more than eight percent of your household income.
        8. Incarceration. You are in a jail, prison, or similar penal institution or correctional facility after the disposition of charges against you.
        9. Not lawfully present. You are not a U.S. citizen, a U.S. national or an alien lawfully present in the U.S.
    • Goes into effect January 1, 2014
    • a penalty amounts
      • Calculated in two seperate formulas
        • 1% of annual household income (cannot exceed bronze plan average premium)
        • $95 per person ($47.50 for children) max is $285 annually
  • Disallows coverage denial based on pre-existing conditions
    • Required to offer same pricing structure based on age and geographic location
    • Exempt from this is tobacco users
  • Reduces out of pocket payments for seniors who have reached the "Donut Hole" in paying for prescription drugs.
    • *Donut Hole- the name given to the gap in coverage when prescription drugs reach a certain cost. Previously, once this certain cost for prescription drugs is reached then insurance companies were not longer responsible for paying for drugs until they reached another benchmark (often times thousands of dollars of prescription drugs are paid for out of pocket in this "Donut Hole"
  • Nationwide insurance
    • Parent Site will be HealthCare.gov
    • Dates annouced
      • Coverage begins January 1, 2014
      • Open enrollment ends March 31, 2014
    • Different Application methods
      • Mail
      • Online
      • Phone
    • Savings Tools
      • Preview plans
      • Cost and Saving calculator
    • Separates plans
      • Based by state
      • Based by type of coverage
  • Lower Premiums
    • Poverty Subsidy
      • incomes between 100-400% of poverty will receive subsidies
      • subsidies continue based on income
    • Medicare is expanded
      • includes families and individuals up to 133% of federal poverty level
        • 5% income disregard


Ammendments
Health Care and Education Reconciliation Act of 2010

Recent Controversy:
Florida Attorney General Bill McCollumn Successfully convinced a Pensacola Judge to hear a trial on the constitutionality of a health coverage mandate. Click Here for More Info

Government shutdown
Opposition to Obamacare by congress created a government shutdown lasting 16 days in an attempt to defund this program
More information
This shutdown ended on October 16, 2013


Related Terminology/People:
Max Baucus
Health Care Reform
Blue Dog Democrats
Public Option
Medicare Donut Hole
ObamaCare

Web Resources:
http://www.opencongress.org/bill/111-h3590/show
http://www.huffingtonpost.com/jill-schlesinger/baucus-health-care-plan-b_b_288938.html
http://www.healthcare.gov/
http://www.ncsl.org/documents/health/grandfathered.pdf
http://www.lifehealthpro.com/2010/10/07/after-ppaca-the-future-of-the-health-insurance-und
http://www.apha.org/advocacy/Health+Reform/ACAbasics/MC_provision.htm
http://www.irs.gov/uac/Questions-and-Answers-on-the-Individual-Shared-Responsibility-Provision
https://www.healthcare.gov/what-if-someone-doesnt-have-health-coverage-in-2014/
https://www.healthcare.gov/marketplace/individual/
https://www.healthcare.gov/what-is-the-health-insurance-marketplace/#state=florida
http://www.npr.org/blogs/health/2013/08/27/216089762/health-insurance-exchanges-prompt-consumers-questions?ft=1&f=1001
http://kff.org/medicaid/fact-sheet/where-are-states-today-medicaid-and-chip/

Images of the Health Care Reform Debate:

Protesters-rally-against-Democrats-health-care-reform-bill-in-Washington_1.jpgBO_Health_Care.jpeghealth_protest_110509_monster_397x224.jpg