The Patient Protection and Affordable Care Act, often referred to simply as the ACA or Obamacare, was signed into law on March 23, 2010. The ACA is intended to expand access to health insurance coverage for millions of uninsured Americans by expanding eligibility for Medicaid and developing health insurance marketplaces where uninsured persons may be eligible for subsidies to make private health plans more affordable. While expanding access to health insurance is a big part of the ACA, there are many other purposes of the law, including provisions intended to reform the health care delivery system to produce better patient outcomes at lower cost.
AOTA was very active in the legislative process leading up to the passage and signing of the ACA, working to achieve victories such as inclusion of rehabilitation and habilitation in the essential health benefits package. AOTA has also been monitorting the regulatory process at the federal and state levels as the ACA has been implemented, and has been advocating for occupational therapy practitioners and consumers. The dynamic environment created by health care reform creates opportunities, but vigilant monitoring of implementation activities and carefully executed advocacy efforts are necessary to ensure occupational therapy is valued and protected in the future.
Please also see the Health Care Reform Implementation page on AOTA's website at: http://www.aota.org/Advocacy-Policy/Health-Care-Reform.aspx
The ACA's health insurance exchanges are scheduled to be open for enrollment on October 1, 2013. Every state will have its own exchange, although many states' exchanges will be operated by the federal government. All exchanges will sell plans covering the essential health benefits, which include rehabilitative and habilitative services. In virtually all cases, occupational therapy will be a covered service. The Congressional Budget Office estimates 7 million people will be enrolled in exchange health plans next year. That's a lot of new potential consumers of occupational therapy services.
Everyone is likely to hear a lot about the successes and failures of the exchanges in the coming weeks and months. Some of the government contractors responsible for creating key components of the information technology infrastructure that will allow the exchanges to function testified before Congress last week that they'll be ready on time. However, even proponents of the ACA in many states admit that bumps in the road are to be expected when launching new programs like this. Keep in mind that while the exchanges open for enrollment next month, the coverage they're selling doesn't kick in until January 1, 2014 at the earliest, and people will be able to enroll in exchange coverage through March of next year. It will take a while to determine the real successes and failures of the exchanges, and there is likely to be significant variation from state to state. AOTA will be monitoring the impact of the exchanges on occupational therapy practitioners and consumers and advocating for improvements that will benefit the profession.