On March 23, 2012, the White House issued a new report summarizing in simple and clear terms what the Patient Protection & Affordable Care Act (Affordable Care Act), which some call “Obamacare,” actually does.
In short, as its name implies, the Patient Protection & Affordable Care Act actually protects patients from insurance companies and makes care better, more affordable, and more available for all Americans, as the report details.
The new report, entitled, “Affordable Care Act: The New Health Care Law at Two Years,” is found on the White House website, linked from a news release (headlined: “New Report: Affordable Care Act Gives Americans More Security, Better Benefits”) issued by the White House on Friday.
At the same time, the White House includes on its website the Facts debunking several Myths (falsehoods) that have been spread about the health reform law, as summarized further below.
Benefits of the Affordable Care Act
Here is some of what the Affordable Care Act actually does, as described more fully in the new White House report:
- Holds Insurance Companies Accountable.
- Insurance companies will no longer be allowed to deny health care coverage because of pre-existing conditions. Already, insurers can no longer deny children health care coverage because of pre-existing conditions. After 2014, no one can be denied health care coverage because of a pre-existing condition (that is, assuming the Supreme Court does not strike the law down).
- Insurance companies can no longer impose lifetime dollar limits on coverage. Already, 105 million Americans no longer have a lifetime dollar limit on essential health benefits. And, “Annual dollar limits are set at increasingly higher amounts until January 1, 2014 when most plans issued or renewed are banned from having an annual dollar limit on coverage.”
- Insurance companies can’t drop your coverage when you get sick. “Americans no longer need to fear that their insurance company can rescind or take away coverage when they get sick because of an unintentional mistake on an application,” the White House report states.
- No more coverage denials without appeal. The Affordable Care Act protects Americans who are denied coverage by private insurance companies, by assuring they now have the right to appeal and provides information and assistance to help them understand and protect their rights as patients.
- Helping consumers understand their coverage. Starting in the fall of 2012, all health insurance policies must provide consumers clear, understandable and comparable information, including a Summary of Benefits and Coverage, which will “enable consumers to easily understand their health coverage and determine the best health insurance options for themselves and their families.”
- Makes Care More Affordable
- The 80/20 Rule. Health insurance companies “must [now] spend at least 80 cents of your premium dollar on your health care or improvements to care. If they fail to meet this standard, they must provide a rebate to their customers.”
- Review of premium increases. For the first time, insurance companies must publicly justify any rate increase of 10 percent or more. This has already resulted in a decline in premium rate increases, and some premium reductions.
- Small business tax credits. The law provides tax credits for small businesses providing health insurance to their estimated 2 million workers. This will help level the playing field. Previously, “small businesses have long paid a higher price for health insurance – often 18 percent more than larger employers,” the report states. In 2014, when new Affordable Insurance Exchanges go into effect, “for the first time, [small businesses and individuals] will have a marketplace where they can see and compare their health plan options in one place, and insurers will have to actively compete for their business,” according to the report.
- Increases Access to Affordable Care
- Coverage for young adults. “2.5 million young adults who were uninsured have already gained coverage by being able to stay on their parent’s health plan, giving their families peace of mind.”
- Access to free preventive services. “54 million additional Americans now receive coverage through their private health insurance plan for many preventive services without cost sharing such as copays or deductibles. That means that more Americans will receive wellness visits, cancer screenings and other services that will help them get and stay healthy.”
- Coverage for people with pre-existing conditions. More than 50,000 Americans with pre-existing conditions have already gained coverage through the new Pre-Existing Condition Insurance Plan. As mentioned above, starting in 2014, all Americans will be protected against insurance companies denying them health care because of pre-existing conditions.
- Addressing Shortages of Primary Care Doctors and Nurses. “The new health care law also invests in training and supporting thousands of new primary care doctors and nurses by providing bonus payments, scholarships and loan repayment, and new training opportunities,” the report states. Other new primary care initiatives focus on benefitting seniors in their homes.
- Strengthens Medicare
- Lower Costs & Extended Life of Medicare. According to the White House report, “The new health care law makes Medicare stronger by making several key improvements, from new benefits and lower costs to fighting fraud and extending the life of the Medicare Trust Fund by eight years. Medicare cost growth has slowed, the Part B deductible has fallen, and since 2010, Medicare Advantage enrollment is up by 17 percent while average premiums are down by 16 percent.”
- Lowering Medicare prescription drug costs. “In 2010 and 2011, over 5.1 million seniors and people with disabilities on Medicare saved over $3.1 billion on prescription drugs thanks to the Affordable Care Act. These savings include a one-time $250 rebate check to seniors who fell into the prescription drug coverage gap known as the “donut hole” in 2010, and a
Coverage for Americans with Pre-Existing Conditions. Through the first two months of 2012, 70,000 seniors and people with disabilities have already received $65 million in savings in the donut hole,” the report states.
- New preventive benefits for those on Medicare. “The Affordable Care Act makes many key preventive services available with no co-pay or deductible to help ensure that seniors don’t have to skip a potentially life-saving cancer screening because they can’t afford it. More than 32.5 million seniors have already received one or more free preventive services, including the new free Annual Wellness Visit.”
- Saving money for seniors. “The average person with Medicare will save approximately $4,200 from 2011 to 2021, while those with high prescription drug costs will save much more – as much as $16,000 over the same period. This is especially good news for people with chronic conditions such as diabetes and high blood pressure who must take their medication every day for many years,” the White House report states.
- Fighting fraud and saving taxpayer dollars. “The health care law helps stop fraud with tougher screening procedures, stronger penalties, and new technology,” the report states. “All told, our anti-fraud efforts have recovered $4.1 billion in taxpayer dollars in 2011, the second year that recoveries have hit this record breaking level. Total recoveries over the last three years were $10.7 billion. Prosecutions are way up, too: the number of individuals charged with fraud increased from 797 in fiscal year 2008 to 1,430 in fiscal year 2011 – a 79 percent increase,” according to the report.
- Provides Many Other Benefits
- Improving Quality of Care.
- Cutting red tape and paperwork in order to free physicians to focus on practicing medicine,
- Supporting broader use of health care IT and providing patients better access to their health records,
- Reducing unnecessary hospital admissions and re-admissions, and
- Improving coordination of care, according to the report.
- Improving Public Health; Focus on Prevention & Wellness.
- The new National Prevention Strategy,
- The 2010 Prevention and Public Health Fund,
- Increasing funding for Alzheimer’s research,
- The National Health Service Corps, and support for Community Health Centers that focus on helping underserved communities, and
- The Million Hearts Campaign, a public-private initiative that aims to prevent one-million heart attacks and strokes over the next five years.
“Before the Affordable Care Act, most insurers could raise premiums without any explanation, spend much of your premium dollars on administration and profits, and deny or limit coverage to those with pre-existing conditions,” the report explains. “Under the new law, patients have more rights and protections – and more security that their coverage will be there for them when they need it. For example:”
The White House report also details many benefits in improved quality of care under the new law, for women and for all Americans. These arise from innovations in health care delivery and payment systems to reward high quality care and results, rather than simply encouraging more high-priced procedures, as previous practices have done.
Other programs under the new law are also expected to lead to improvements in the quality of care, through:
In addition, the White House report highlights important investments in public health made under the Affordable Care Act. The Affordable Care Act is focusing increased attention on prevention and wellness and strengthening the public health infrastructure so that it can help prevent disease and illness, through such initiatives as:
The new White House report, “Affordable Care Act: The New Health Care Law at Two Years,” is available in its entirety on the White House website.
Debunking Myths About the Affordable Care Act
On its website, A More Secure Future: What the Affordable Care Act Means for You, the White House devotes a section to “Myths and Facts,” where it debunks some of the more prevalent “myths” (falsehoods) about the health care law that have been widely circulated by its opponents (who like to call it “Obamacare”).
Here is a sample of some of the Myths (falsehoods) and corresponding Facts about the Affordable Care Act, presented by the White House:
Health insurance reform will use my tax dollars to fund abortions.
No. The health insurance reform legislation maintains the status quo of no federal funding for abortions, except in cases of rape, incest or when the life of the woman is endangered. A federal judge recently wrote “the express language of the [Affordable Care Act] does not provide for taxpayer funded abortion. That is a fact and it is clear on its face.”
Health reform will lead to a government takeover of health care.
False – one independent group even called this myth the “lie of the year.” The Affordable Care Act puts people, not health insurance companies or government, in charge of health care. The new law strengthens the existing employer-based health insurance market while making the market fair for consumers by implementing landmark consumer protections. Families and individuals that don’t have access to affordable coverage can receive tax credits to help them purchase coverage in the private health insurance market. There is no government-sponsored, public, or “single payer” plan in the law.
Businesses will suffer under health reform.
Health insurance reform lowers costs for American businesses – especially small businesses – who are struggling to remain profitable and competitive under the status quo. The independent Congressional Budget Office confirmed that the bill would lower health insurance premiums for the same insurance plan by up to 4 percent for small businesses and 3 percent for large businesses, and estimates indicate that reform could save businesses $2,000 per person in health costs.
Employers will stop offering insurance to their workers in 2014 when the law is implemented.
Independent analyses conducted by the RAND Corporation, Urban Institute, the Congressional Budget Office and Mercer, have found that employers will continue to offer health coverage to their workers. Economists agree that employers offer health insurance to help attract and retain the most talented employees and employers will continue to seek out top talent. Further, when health reform was enacted in Massachusetts more than five years ago, the percent of businesses offering insurance in Massachusetts increased.
This bill does nothing to bring down the cost of health care.
Not true. The health policy experts and economists who have looked at this legislation have said we are pursuing every possible mechanism to reduce health care costs. The Congressional Budget Office found that health insurance reform will reduce the deficit by $210 billion in this decade and by more than $1 trillion over the following 10 years. And a family of four would save as much as $2,300 on their premiums in 2014 compared to what they would have paid without reform.
The Affordable Care Act‘s individual responsibility requirement is unconstitutional.
Legal experts and federal judges appointed by Democrats and Republicans agree that the Affordable Care Act is constitutional.”
The fate of the Affordable Care Act, or at least the individual insurance mandate it contains may soon be decided by the U.S. Supreme Court, which is hearing oral arguments today about the constitutionality of the individual insurance mandate in the law.
To learn more about how the Affordable Care Act is strengthening the health insurance marketplace and improving health care in your State, visit HealthCare.gov, a site maintained by the U.S. Department of Health & Human Services.
For more information about the litigation challenging the constitutionality of the individual insurance mandate in the Affordable Care Act, which is now pending in the U.S. Supreme Court, see the HelpingYouCare™ reports on:
- News on Health Care Reform;
- Editorials: What Needs Improvement, With Your Comments;
- Advocacy: Proposals for Reform, With Your Comments;
- Legislation: Pending & Recently Adopted; and
- International Health Care Compare: Information on Health Care & Long-Term Care Solutions in Other Countries.
Copyright © 2012 Care-Help LLC, publisher of HelpingYouCare™.