President Barack Obama signed the Affordable Care Act into law on March 23, 2010. According to the U.S. Census numbers and the insight of Andrea Kovach, staff attorney for the Shriver Center, approximately 48 million people in the United States were uninsured, although the National Review Institute estimates the real number is between 10 and 12 million people. Nevertheless, the ACA has the potential to help and reach those millions of uninsured individuals and by 2014 will change the landscape for obtaining insurance.
Among changes that were implemented through this law was an individual mandate which states that each person is required to have health insurance or be penalized $95 each year beginning in 2014. Currently, those with insurance pay approximately $1000 for the uninsured. By instating the mandate, it broadens the pool of those insured and lowers the cost for everyone. There are, however, exemptions that include religion, Native American status, being extremely poor or undocumented.
· The ACA, known as “Obamacare” to some, now requires for all health care insurance plans to cover emergency room services without prior authorization as well as allows the consumer to select any doctor as their health care provider. This includes a provision that requires parents to choose any pediatrician for their child.
· Since the inception of the ACA, about three million young people between the ages of 19-25 gained coverage due to the provision of the ACA stating that they could stay on their parents’ health insurance plans up to age 26.
· Multiple changes within the law are being rolled out, coming to full effect in 2014. For years, health care plans were charging women more than men for services. In 2014 this would be banned, making it equal for all individuals, regardless of sex.
· Currently, insurance companies can no longer ban children under 19 for pre-existing conditions. This will also be instated for adults in 2014.
Beginning on August 1, preventative services are covered by the ACA at a no-cost provision. For those who were enrolled in new health insurance plans, created after the signing of the ACA, doctor’s visits, mammograms, prostate screenings, immunizations as well as women’s visits, gestational diabetes screening, contraceptives and breast feeding support fall under this category as well.
In terms of Medicaid, there will be a new eligibility program introduced. To qualify for Medicaid, you can now be under 65 and living at or below 133% of the poverty level, applying to U.S. citizens or permanent residents who have been living in the U.S. for five years. Gov. Pat Quinn has stated multiple times that this will be implemented in Illinois in 2014, covering 500,000 people.
The ACA also allows for competitive health insurance exchanges within states. Consumers within the state will be able to compare and enroll in selected benefit plans. All plans will cover essential benefits such as emergency room services, hospitalization, lab services, rehabilitation services and maternity care.
Illinois received grants in order to build or expand on health centers across the state, which will be implemented over the next few years.