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Thursday, January 28, 2016

Top 10 Things From The Affordable Care Act You Don't Want To Lose

As the election year gyrates along and the Republican contingent are myopic in their campaign to terminate the Affordable Care Act and the accompanying Health Care Education and Reconciliation Act, here are some facts about the landmark law which have helped healthcare consumers and healthcare facilities. This top ten list is in order of importance, based on an improved ability of the individual to access health treatment when needed:
1.      Outlawed the medieval  insurance company pre-existing condition clause which prevented people from obtaining health insurance and thus treatment, because of a medical condition
2.      Employer provided insurance contracts are no longer allowed to restrict essential benefits, such as the odious limits for organ transplants or fixed dollar amounts for maternity
3.      Tax subsidies from the Federal Supplementary Medical Insurance Trust Fund which enable people who don’t have employer provided health insurance to be able to buy medical insurance (thank you)
4.      Requiring insurance companies which participate in the exchanges to spend 80% of annual premium contributions  to pay for actual medical services, otherwise the exchange participants receive a refund of unused premium payments[1]
5.      Paying for performance with the Accountable Care Organization Shared Savings Program; a program administered by the Centers for Medicare and Medicaid (CMS), which is in its 5th year and has 333 participating health organizations, paid $422,000,000 in performance bonuses to 97 organizations which met quality of care benchmarks and saved CMS money[2]
6.      Removal of the Medicare Prescription drug gap, called the donut hole, which made it more difficult for seniors to afford their medications
7.      Creation of insurance exchanges, which provide health insurance purchasers a one-stop-shop web site for medical insurance; sure there have been some hiccups, but the program is working and just completed its third annual enrollment; states had the option of creating their own exchange or letting the federal exchange do the work
8.      Taxes on medical device companies to help fund the Federal Supplementary Medical Insurance Trust-that 3% doesn’t impact the viability of these companies and they won’t refund the money if the tax is repealed; everyone has to contribute
9.      Pay or Play rules-Yes, if you are an employer in this industrialized country you are expected to provide medical coverage for your work force, but if you opt not to do this, you will pay a tax which goes into the Federal Supplementary Medical Insurance Trust Fund, to help those valuable workers obtain their own insurance and your government provides tax subsidies for you to do this (thank you)
10.  Individual insurance mandate requiring residents to show proof of medical coverage or pay a tax penalty; as previously reviewed in this column, there are so many loop holes to this requirement including; religious exemptions and economic hardship, that complainers have probably not read the law, so here are the articles one more time for your convenience.[3]

     Though the Affordable Care Act is not perfect, few laws when initially enacted are. The Small Business Exchanges have been problematic and there is still a real patchwork of states which expanded Medicaid coverage, but this is a reality for many government funded programs which are administered by the states. This reflects the messy process of democracy. As to the hue and cry about socialism, I wonder how many of those Congressman are willing to give up their Cadillac healthcare coverage or their federal pensions? As for the military personnel who don’t want to pay taxes, yet receive government provided medical care, subsidized living expenses, education, and a pension, who should pay for this? And let’s give a shout out to those seniors who are receiving Medicare and Social Security, yet don’t want to pay taxes for “socialism.” We all have to pay our share and some people pay more than their fair share, these programs have to be funded and your entitlement is not greater than others. As a nation we could use some tax reform and definitely elimination of the Super Pac privileges to restore democracy back to the citizens. As for me, my government has been the most reliable partner I have had, providing Social Security income for my son when we lost his Dad, unemployment income through my periods of joblessness, federal loans and grants so that I, a farmer’s daughter could get a university education, and tax subsidies for my family to obtain medical insurance. God Bless America, but please don’t BS about not wanting your socialized benefits.

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