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Registered Nurse: "My Patients Will Love Obamacare"

It’s almost 2014, which means the provisions of the Affordable Care Act (ACA) were signed into law and the measure will meaningfully improve the health care system for many individuals who have desperately needed access to affordable healthcare services.

While the ACA has proven to be the center of debate across the nation, the positive aspects outlined in the plan far out-weigh the negatives. As a nurse, I have my opinion regarding the act itself, but professionally, it is important to note that the risks of not having insurance and the associated costs to the healthcare system can be futile to the economy.

Here are a few ways that the ACA is helping my patients:

1) More cancer survivors can now get care – High-risk pools were established in every state to provide coverage for the uninsured.  The program launched on July 1 and is providing immediate access to coverage for people in every state who have been uninsured for six months or more and have cancer or another pre-existing condition. With conventional insurance underwriting processes, many patients were unable to obtain health insurance due to pre-existing conditions. Perhaps they lost benefits from unemployment or for reasons out of their control, so this provision can help assure people can be covered.

2) No more “doughnut holes” – The Affordable Care Act is finally closing the Medicare Part D “doughnut hole”.  Immediately after the enactment, the law provided a $250 rebate to seniors who hit the coverage gap in Medicare’s prescription drug program.  In addition, Medicare beneficiaries will receive discounts on brand-name drugs next year, and the coverage gap will be closed completely by 2020.

3) Investments in our youth– Under the ACA, health plans will be prohibited from denying coverage to children up to age 19 with pre-existing conditions such as cancer.  Therefore, if there is a child who is a cancer survivor, parents will no longer have to worry about their insurance if they change jobs. The ACA mandates that beginning January 2014, individuals under 65 years of age with income below 133 percent of the federal poverty level will be eligible for Medicaid. This will now allow those who had difficulty meeting criteria for subsidies in the past will likely be able to obtain healthcare access.  I have seen cases where children were declined assistance because the family income exceeded guidelines by fourteen dollars.

4) Uncapped lifetime limits – Under the ACA, health plans will no longer be allowed to set lifetime dollar limits on coverage. This ensures that people with chronic diseases will have access to needed care throughout their lifetimes. This also means that chronically ill pediatric patients can receive palliative care while undergoing life-sustaining treatments. Patients will no longer have to put off treatments waiting for the new plan year to start. This can prove to assure quality of life, which is priceless.

5) Consumers, not just patients – Under the ACA, your health plan now contracts with you when they take your business.  Health insurers are barred from dropping people from coverage when they get sick.  In other words, a person cannot lose their coverage if diagnosed with cancer.

6) Prevention keeps the doctor away. Within the provisions of the ACA, coverage is guaranteed and out-of-pocket costs will be eliminated in new insurance plans for proven preventive services, giving people access to lifesaving screenings for breast, cervical, and colorectal cancer.

Let’s face it, health care is confusing and even overwhelming, but it is new, and offers unknown opportunities. We see that many lobbyists or politicians do not support healthcare reform; however, I can merely speak from a healthcare perspective. The benefits of the ACA alone will have a positive impact on the lives of Americans, bringing us all one-step closer to becoming a healthier nation. Yes, my patients will love Obamacare.

Registered Nurse: “My Patients Will Love Obamacare”

It’s almost 2014, which means the provisions of the Affordable Care Act (ACA) were signed into law and the measure will meaningfully improve the health care system for many individuals who have desperately needed access to affordable healthcare services.

While the ACA has proven to be the center of debate across the nation, the positive aspects outlined in the plan far out-weigh the negatives. As a nurse, I have my opinion regarding the act itself, but professionally, it is important to note that the risks of not having insurance and the associated costs to the healthcare system can be futile to the economy.

Here are a few ways that the ACA is helping my patients:

1) More cancer survivors can now get care – High-risk pools were established in every state to provide coverage for the uninsured.  The program launched on July 1 and is providing immediate access to coverage for people in every state who have been uninsured for six months or more and have cancer or another pre-existing condition. With conventional insurance underwriting processes, many patients were unable to obtain health insurance due to pre-existing conditions. Perhaps they lost benefits from unemployment or for reasons out of their control, so this provision can help assure people can be covered.

2) No more “doughnut holes” – The Affordable Care Act is finally closing the Medicare Part D “doughnut hole”.  Immediately after the enactment, the law provided a $250 rebate to seniors who hit the coverage gap in Medicare’s prescription drug program.  In addition, Medicare beneficiaries will receive discounts on brand-name drugs next year, and the coverage gap will be closed completely by 2020.

3) Investments in our youth– Under the ACA, health plans will be prohibited from denying coverage to children up to age 19 with pre-existing conditions such as cancer.  Therefore, if there is a child who is a cancer survivor, parents will no longer have to worry about their insurance if they change jobs. The ACA mandates that beginning January 2014, individuals under 65 years of age with income below 133 percent of the federal poverty level will be eligible for Medicaid. This will now allow those who had difficulty meeting criteria for subsidies in the past will likely be able to obtain healthcare access.  I have seen cases where children were declined assistance because the family income exceeded guidelines by fourteen dollars.

4) Uncapped lifetime limits – Under the ACA, health plans will no longer be allowed to set lifetime dollar limits on coverage. This ensures that people with chronic diseases will have access to needed care throughout their lifetimes. This also means that chronically ill pediatric patients can receive palliative care while undergoing life-sustaining treatments. Patients will no longer have to put off treatments waiting for the new plan year to start. This can prove to assure quality of life, which is priceless.

5) Consumers, not just patients – Under the ACA, your health plan now contracts with you when they take your business.  Health insurers are barred from dropping people from coverage when they get sick.  In other words, a person cannot lose their coverage if diagnosed with cancer.

6) Prevention keeps the doctor away. Within the provisions of the ACA, coverage is guaranteed and out-of-pocket costs will be eliminated in new insurance plans for proven preventive services, giving people access to lifesaving screenings for breast, cervical, and colorectal cancer.

Let’s face it, health care is confusing and even overwhelming, but it is new, and offers unknown opportunities. We see that many lobbyists or politicians do not support healthcare reform; however, I can merely speak from a healthcare perspective. The benefits of the ACA alone will have a positive impact on the lives of Americans, bringing us all one-step closer to becoming a healthier nation. Yes, my patients will love Obamacare.

Political Divide Will Not Stop Obamacare

Over a week has passed since the opening of the Healthcare Marketplace. The technical glitches and system overload continued to influence public support of the highly controversial subject. A stark review of news feeds and commentaries prove that “healthcare” seems to be the least important variable in the political mud-slinging arena. The American public and private sectors faced crippling economic wounds as the federal government shutdown for the first time since the Clinton Administration. The chokehold between the GOP and the Tea Party seemed as strong as ever, and in his speech on Tuesday, President Obama reiterated that the he was willing to talk about a budget proposal that could potentially raise the debt ceiling. What he was not willing to do was defund the Affordable Care Act (ACA) in order for the Republicans to have exactly what they “wanted”. The government shut down gains continued leverage as the tug of war between economics and public health manifest

This week, the silo of political disarray confronted the public sector as state and local public entitlement programs where frozen. All around the nation, state regulated DHHS programs like WIC, SNAP (food stamps), childcare subsidies programs and transportation services were no longer available for eligible recipients. The aftermath of the government shut down exposed divides in political agendas. Instead of the focus of how the ACA could reduce healthcare costs in the future, the majority of American citizens have experienced more defeat and disappointment. Many Americans eagerly awaited the opportunity to finally gain access to healthcare, however many of those who frequented the Healthcare Marketplace were discouraged by the costs of premiums and plans. Yet, several social media sites reported that consumers in over 36 states like Florida were surprised at how affordable the premiums were.

Case in point, what are the intentions for the outcome and greater good of the American citizens? The vision of healthcare reform supports health promotion and the reduction of public health disparities. It seems to be a double-edged sword. While it aims to make America a healthy nation, if not handled carefully, healthcare reform can prove to be an economic burden. The week in review sheds light on many needs of the American nation. The most important need perhaps, is regulation. The ACA provides a framework to transform the health of the people of the United States. When federal regulations are bottle necked into complex state mandated systems, the need for transparency and direction become priorities.

Many questions and thoughts will arise over the coming weeks as the ACA becomes less of a crutch for policy makers and a more permanent factor of human rights. The integrity of ethics and morality will become more of a driving force for political influences as more of the American nation become subjects of political divide.

New Marketplace Rates: "Less Than the Cost of Your Cell Phone Bill"

Photo courtesy of AP

Photo courtesy of AP

Starting October 1, federally run “marketplaces” under the Affordable Care Act (ACA) under Obamacare will roll out in 36 states. Today we just received our first preview of the health insurance premiums that will be offered in the federally-run health care exchanges.

The report from the Department of Health and Human Services uses the example of a healthy 27-year-old. This consumer would pay $163 /mo, on average, for the basic ‘bronze’ plan and $240 a month for ‘gold’ coverage a more comprehensive plan.

“If you’re a 27 year-old young woman, you’re going to be able to purchase high-quality health insurance for less than the cost of your cellphone bill,” President Obama said Tuesday.

For a family of four with an annual income of $50,000, the administration said, monthly premiums for the second-cheapest plan will vary widely, averaging $600 in Arizona, $800 in Georgia, $961 in Indiana, $1,069 in Mississippi, $859 in New Hampshire, $943 in New Jersey and $656 in Utah.

“I’m actually surprised they’re coming in so well. They’re very competitive and they definitely will save consumers money,” JB Silvers is a professor of Healthcare Finance at Case Western Reserve’s Weatherhead School of Management

The primary reason for the low rates is the competition among health insurance providers, said Silvers, because insurance companies “have looked at this big block of new business and found it irresistible.”

However, the plan still has critics. Men will pay nearly double what they would for coverage and young women as much as 50% more. The ideas is that healthy, younger adults will help subsidize people who have pre-existing conditions and wouldn’t be able to get coverage otherwise.

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