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 Affordable Care Act, or Obamacare, has a lot of people confused. That's not surprising. It's a long and complex law that has produced even longer and more complex regulations. Implementation of the law differs from state to state and some provisions have been delayed, repealed, or modified. There are thousands of health policy professionals like me who try to keep track of it all, and no one has mastered all there is to know. Part of the reason for creating this blog is to provide a resource that includes understandable and accurate information about Obamacare, especially in terms of how it impacts occupational therapy practitioners and consumers.
Since some people are confused about terminology used to describe the law, let's start there. The Patient Protection and Affordable Care Act of 2010 (or PPACA), the Affordable Care Act (or ACA), and Obamacare are all terms used to describe the exact same thing. Sometimes people just use the terms "health care reform" or "health reform" to describe the ACA as well, which makes it even more confusing. There was a time when only opponents of the law referred to it as Obamacare, but now President Obama has embraced the term.
Now that that's out of the way, another issue that has received a lot of news coverage lately is the average price of health insurance premiums under Obamacare. First, let's consider the value of talking about the average for everyone around the country. Since premiums will vary based on the plan an individual selects, an individual's age, where an individual lives, whether an individual is a smoker, the size of an individual's family, and how much of a subsidy (if any) an individual is entitled to, the "average" premium is somewhat meaningless to any particular individual or family. It's tempting to compute an average and then compare it to averages from prior years, but that doesn't tell us much either, because premiums for 2014 are for an insurance market where certain benefits have to be covered (essential health benefits), people can't be charged more or denied coverage because they are sick, and health insurers can't place lifetime or annual dollar limits on benefits, among other reforms. To compare next year to this year is to compare apples to oranges. So what can people do to get a more useful sense of the cost of health insurance for individuals and families based on their unique circumstances? The Kaiser Family Foundation's subsidy calculator is an excellent resource. It's not perfectly precise either, but it will produce information substantially more accurate and useful than the averages often cited by news outlets. Note: This is further complicated by the fact that only a relatively small portion of the population will be buying insurance on the health insurance exchanges, which is what discussion of these premiums relates to. In other words, people who receive employer-sponsored coverage or are Medicare or Medicaid beneficiaries (which together comprise the majority of the population), are not purchasing coverage where these premiums matter.
If you have questions about the ACA, please send them my way in the comments or ask me on Twitter @healthpolicypro.