In the two years since it was signed into law, the Patient Protection and Affordable Care Act has generated hundreds of thousands of news reports.
A Google search for “ObamaCare” turns up 25.7 million hits.
Yet, after all this time — and all those words — many Americans are still wondering: What’s in it for me and how will it change my healthcare?
Now that President Obama has won a second term, the answer to that question is more important than ever.
The ObamaCare Survival Guide is the first book offering consumers, business people, seniors, medical professionals, and others a practical understanding of the massive new law.
There are five major ways that ObamaCare will alter healthcare for millions of Americans.
1. The Individual Mandate
This is the key provision that was upheld by the Supreme Court. Once the justices ruled that this section is constitutional, it set the stage for the rollout of ObamaCare.
Simply put, the individual mandate requires all Americans get to health insurance and imposes a fine on those who don’t. The Supreme Court called it a tax and ruled it was legal for the government to levy this tax on those without health insurance.
As part of this mandate, ObamaCare includes a provision that no one can be rejected for a pre-existing health condition.
There is assistance for low-income Americans, and small businesses will also receive support in the form of tax credits.
But what happens if you don’t get insurance? Well, that’s when the Internal Revenue Service will get involved. The IRS will be the enforcer.
: Individual Mandate Explained in Chapter 5 — Go Here Now.
2. Health Insurance Exchanges
These exchanges are the heart of ObamaCare.
They will be state-run. If you don’t have health insurance, this is where you’ll shop for it.
ObamaCare requires each state to set up an exchange by 2014. And if they don’t, the federal government will create and manage it.
Compared to other parts of the law, there isn’t as much political controversy around exchanges. Conservatives like that they are competitive marketplaces, while liberals like the way they protect consumers. The exchanges are expected to improve the system in several areas including increased choice, providing some level of insurance standardization, increased consumer protection, and lowering the cost of insurance.
Each state is required to provide four plans. By 2014 Americans should be able to shop online for insurance, looking for the best deal from any of the many state-based exchanges that will be set up. The idea is that the uninsured will have the ability to choose an affordable insurance plan with guaranteed “essential health benefits.”
: Who Is Eligible to Use the Exchange? It's covered in Chapter 7.
3. Doctor Shortages
One unanswered question is: Will the law cause doctors to quit the profession?
Polls of doctors suggest the answer may be yes.
A survey of 2,400 physicians conducted in 2010 for the Physicians Foundation found 40 percent would “retire, seek a non-clinical job in healthcare or seek a job unrelated to healthcare” during the next three years.
Affordable Care Act supporters argue the survey is not a true measurement of physician sentiment, since it came at the height of national debate over ObamaCare.
But the truth is no one can predict how the medical profession may respond to the coming changes.
One thing is clear, however: The nation is already experiencing a doctor shortage, with the Association of American Medical Colleges estimating that by 2015 the nation will need 60,000 more doctors than the U.S. is expected to have. Adding another 37 million uninsured Americans to insurance rolls and Medicaid, as ObamaCare aims to do, is likely to add to the problems caused by existing doctor shortages.
: Get Critical Advice on the Best Way to Handle Your Healthcare — Click Here Now.
4. Medicare Changes
Under ObamaCare, Medicare reductions would add up to $716 billion in 10 years, according to the nonpartisan Congressional Budget Office.
Healthcare experts believe Medicare will remain largely unchanged for Americans 55 and older. However, significant changes come in 2022.
That’s when reductions in reimbursement to hospitals, insurers, and the Medicare Advantage program (by about $68 less per month, according to the Congressional Budget Office) are scheduled to begin. They could lead to cuts in benefits and services for some seniors.
Medicare changes also close the so-called “donut hole” in drug coverage, giving seniors a break on their out-of-pocket costs for medications.
But, higher-income earners — individuals earning $85,000 or higher and couples exceeding $170,000 — will receive reduced subsidies to pay for drugs.
: Need to Know More About Medicare? It’s All Explained in Chapter 6 — Click Here Now.
5. Independent Payment Advisory Board
One very controversial aspect of ObamaCare involves the creation of a new presidential commission called the Independent Payment Advisory Board (IPAB). This board of 15 experts — chosen by the president and approved by the Senate — will be empowered to cut Medicare spending and make other healthcare decisions independently, unless counteracted by a three-fifths “super-majority” vote in Congress.
The driving idea behind the IPAB’s creation is that the board would be able to make tough budgetary decisions that might be politically difficult for Congress or the president to implement (such as additional Medicare reductions). But because the IPAB won’t be elected, critics argue the board could wield enormous power and increase government control over of the nation’s healthcare system.
As is true with many aspects of ObamaCare, the devil will be in the details of the law’s implementation. And, like the IPAB itself, ObamaCare is very much a work in progress.
What’s Really Ahead?
Will ObamaCare limit soaring healthcare costs for most Americans? It’s too early to say for sure. But it seems unlikely, at least in the short run.
Since the law’s signing in 2010, costs and premiums have been increasing. According to the nonpartisan Health Care Cost Institute, U.S. healthcare spending grew at a faster pace last year than in the previous two years, when increases in costs actually slowed.
ObamaCare proponents say over time that will change. They argue that people who have insurance are more likely to see their doctors and to manage chronic conditions — such as diabetes, heart disease, and cancer — in ways that are less expensive than hospital care and emergency room visits.
The true test of the law’s viability will likely be seen in the coming year to 18 months when ObamaCare’s most significant and costly provisions are implemented — including the individual mandate, the expansion of Medicaid, and the creation of the new state healthcare exchanges.
And now with President Obama in the White House until 2016, it’s unlikely that Congress will make significant changes to the Patient Protection and Affordable Care Act — at least any time soon.
: Get Prepared for ObamaCare — Click Here.
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