We are about to experience the biggest change in the health care history of our nation. Time is quickly approaching for the opening enrollment day of the new Patient Protection And Affordable Care Act, also called “Obamacare,” that may very well mark the most important day in your health coverage history.
Ironically, it is estimated that less than half of Americans have any degree of significant understanding of how the PPAAC Act is going to work and how it will affect them. This bill now encompasses more than 22,000 pages with more changes happening every day. No wonder it is baffling for so many.
The PPAAC was a congressional bill that was signed into effect March 2010 amongst heavy opposition and debate, which still continues to some degree today.
This bill was intended to broaden the reach of health care to primarily those who were previously deemed “uninsurable” because of health afflictions.
It was also to help provide health care coverage to some 41 million individuals today (1.8 million in Georgia) who could not afford costly premiums.
This would be achieved by broadening Medicaid and by offering Federal government subsidies to help on premium costs to those at or below four times the poverty level.
Georgia is one of the 14 states that has decided not to broaden its Medicaid base. Certain key “essential elements” of coverage would be in plans offered through the exchange. There will be four basic “metallic plans” available with varying premiums and coverage.
These mandated elements would also be required for employer’s coverage as well and will come under Federal scrutiny for proper implementation.
Those businesses employing more than 50 employees will be required to offer this coverage or face a $2,000 penalty for each employee (less the first 30).
Most individuals’ current major medical plans do not meet all the Federal required qualifications for coverage. Because of this, many will receive letters in the mail this fall stating that their coverage will be terminated at the end of the year.
Only those plans in force prior to the signing of the bill, March 2010 will be grandfathered.
The Federal coverage exchange plans are being outsourced to various insurance companies that have submitted bids for plans in the states they wish to participate as an offered carrier.
Geographic district areas will be set up throughout the states in order to adjust premium charges for the more expensive health care areas — for example, rural or inner city.
Funding for this health incentive will come from several sources of various taxes and forecasted Medicare cuts over the next 10 years.
It will be interesting to see all the ramifications of this health care reform implementation. Sheridan & Associates will be holding free educational seminar meetings to help you understand how PPACA works and how it will impact your life.
Rhonda Sheridan is a registered nurse and an independent health insurance broker agent with Sheridan & Associates, Inc., and can be contacted at rsheridan12@cs.com.
This is the first of an occasional series on frequently asked questions Sheridan receives about health care coverage reform.
