What is this Obamacare?  What if I have a pre-existing condition, such as diabetes?

 

The Patient Protection and Affordable Care Act or Obamacare was signed into law March 2010.  The aim of the law is to increase access to medical care and ensure high quality care. The estimates are that there were about 65 million people in the US without healthcare coverage when this became law. Texas had the highest rate of uninsured people followed by Florida.

 

The health law is rolling out in phases through 2018.

 

• Young people can be covered under the parent’s insurance up to age 26.

 

•  Preventive care (well woman exams, mammograms) is covered without co-pay.

 

•  Insurance companies must publicly justify rate increases of 10 percent or more before raising premiums.

 

• Insurance companies are required to spend at least 80 percent of customer premiums on healthcare and quality improvement or issue a rebate to policyholders.  Quite a few people have already received a rebate check from their insurance carrier.

 

• Insurance companies are no longer allowed to place lifetime limits on coverage and they’re not allowed to rescind coverage except in cases of fraud.

 

•  And starting next year, insurance companies can no longer deny coverage to individuals based on preexisting medical conditions such as diabetes, or heart disease.

 

The centerpiece of the healthcare reform law, the online health insurance exchanges unveiled Oct. 1 where Americans can shop for health insurance plans at http://www.healthcare.gov/

 

On the exchanges, people will find out if they are eligible for federal subsidies to help pay for insurance premiums and out-of-pocket costs such as deductibles, or if they are eligible for Medicaid, the federal-state health insurance program for the poor.

 

For the physician the great part of the Affordable Care act is the incentives for people to get preventive services, get checkups, find things early, get it taken care of, fill their prescriptions and follow the doctor’s advice so that you don’t end up back in the hospital. Physicians see people come in to the office or ER with advanced stage diseases/ problems that there may be little or nothing that can be done.  If these people had the ability to afford healthcare or had come in earlier, the problems could have been taken care of simply and completely. It breaks your heart to watch someone suffer, die of a problem that with all the technical advances in medicine could have been avoided.

 

It should be pointed out the Affordable Care Act does not mean the government will be doing your pelvic exams or the cost of insurance will be going up for the people who already have insurance.  As millions more people enter the healthcare market and purchase insurance with or without government subsidies, the overall cost of insurance is spread out over more individuals.  Right now, when a very sick person is admitted to the hospital without insurance coverage, the cost of that care is eventually passed on to everyone else who does have insurance in greater costs overall.  The sick person is not working, is not contributing to society.  Healthy people obviously do not utilize as much healthcare, so costs for everyone goes down.