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accident should lead to any family’s financial ruin.”
Local physician Dr. Arnold Villafuerte says the court’s ruling is a “major achievement for communities of color and other underserved populations.”
“Millions of Americans now have the medical coverage they need to get healthy and stay healthy,” he says. “I look forward to the day in 2014 when nearly all citizens will have access to affordable health insurance and be protected from insurance company practices that unfairly deny and limit coverage.
The ACA’s four main points are: (1) ensuring people get the care they pay premiums for; (2) increasing access; (3) improving affordability; and (4) supporting these changes. According to a CNN article, more than 60 percent of bankruptcies are due to overwhelming medical bills. Because medical care is essential, President Obama says that the law helps families get the assurance they deserve and protects them against abuses by insurance companies.
The ACA also keeps insurance companies accountable to those who pay premiums. One goal was to ensure that premiums paid each month were actually spent on health services. Starting in 2011, insurance companies were required to spend at least 80 percent of the premiums they collected directly on medical care and quality improvement. If not, the companies have to return the extra money to its members. This summer, almost 13 million Americans will get rebates because their insurance companies spent too much of premiums on advertising or CEO bonuses.
Second, health plans are now banned from dropping patients from coverage when they get sick and need medical services. Third, starting in 2014, the law will ban annual and lifetime coverage caps so that people don’t lose access to treatments they need. Fourth, insurance companies no longer have unchecked power to charge women more than men.
Fifth, premium rate increases of 10 percent or more must be reviewed or approved by the state to prevent the hardship created by it. Only 20 states currently review rate increases. Sixth, insurance plans must now cover ambulance and emergency services; hospitalization; maternity and newborn care; mental health and substance abuse treatment; prescription drugs; rehabilitation and self-help services and devices; laboratory tests; preventive wellness services and chronic disease management; and pediatric care including dental and vision.
Seventh, because staying healthy is cheaper than being sick, preventive care for many Americans is now free. Over 54 million Americans have benefited from coverage of free preventive care, such as mammograms for women and wellness visits for seniors. Eighth, insurance companies cannot deny coverage to children with pre-existing conditions and as of 2014, the ban on denial will also extend to adults.
Access to medical services increased during the ACA’s two years. Before November 30, 2011, health plans often denied coverage to those with pre-existing conditions. President Obama’s reforms changed that, giving insurance to more than 44,852 individuals through high-risk pools. Young adults once fell into a “gap group.” They were too old to be their parents’ dependents but unable to afford their own insurance. Under the ACA, 6.6 million persons under age 26 are covered under their parents’ health plans.
Affordability is also key. Already, 5.3 million seniors and disabled persons have saved an average of over $600 on prescription medications. In 2011, 24.2 million Medicare patients (the elderly) received preventive health screenings, including a wellness exam, without any co-payments.
Businesses benefit as well. Offering health insurance as a benefit helps employers retain good workers. Companies get tax credits for the health insurance they provide to employees. So far under the ACA, 360,000 businesses that employ 2 million workers have already gained from tax cuts. After the ACA takes full effect, about 18 million individuals and families will get tax credits for health insurance coverage, averaging about $4,000 each.
Finally, the ACA adds medical residency slots nationwide to train 500 more primary care physicians by 2015. Preparing more doctors for primary care and temporary increases in Medicaid payments to doctors will support the increase in demand for medical services due to millions more Americans being able to get care.
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