ACA Flashcards
Goal of ACA
(1) expand access to health insurance,
(2) protect patients against arbitrary actions by insurance companies,
(3) reduce costs.
Some roles of the ACA
●The ACA also required mental diseases to be receive the same coverage as physical diseases. It’s not clear whether that provision will continue.
●The ACA had put an end to a decades-old practice. Health insurance companies were able to charge rates that led to profits up to 50% of income. The ACA cut that back first with a requirement that at least 80% of income be spent on health care, and later upped it to 85 %.
●The ACA right now requires health insurance companies to insure someone even if the person has diabetes or some other pre-existing condition.
4 groups of coverage
- Employer (50%)
- Government (30%)
- Buy your own (10%)
- Uninsured (10%)
Caps on
how much you pay out of pocket
Free
preventative care
Medicaid expansion
cover poor adults (up to 138% above poverty line)
●State decision to expand
●If state decides to expand, federal government covers cost
Health Insurance Marketplaces
● In places without state marketplaces, federal marketplaces setup
● Most who buy their own eligible for tax credits though some will have to pay more
● Can get coverage under enrollment periods, otherwise pay fine for not being covered
All plans must include
(1) hospital visits
(2) doctor visits
(3) maternity care
(4) mental health care
(5) prescription drugs
Same prices for
Smaller price for
Genders
Elderly
Repeal-cut
Medicaid to lower state and federal expenditures
Repeal- end individual
mandate to lower individual subsidy
Repeal -parity for
mental illness costs
Repeal -end cap on
insurance company profits
right now can only make 15% profit
Repeal -large employers
don’t have to provide coverage
Repeal-end state
market places
large corps can takeover market then
