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.