How Does The Affordable Care Act Affect Medical Expenses In Personal Injury Cases?
Prior to the enactment of the Patient Protection and Affordable Care Act (ACA) on January 1, 2014, it was generally assumed that most personal injury plaintiffs would pay for future medical expenses out-of-pocket rather than with any type of insurance. Now with "Obamacare" comes the potential for significant changes to the way personal injury cases are settled, and the amount for which they are settled. In examining its impact on damages awards, it must be noted that the ACA has survived many legal challenges and will likely have to survive more.
Probably the ACA 's most important effect is that all Americans must be covered by some minimum level of health insurance. Private insurers are no longer allowed to discriminate against individuals with pre-existing conditions. Also, most health insurance plans must include and cover “essential health benefits,” such as hospitalization, therapy, medication, and other types of "essential" services. Thus, most, if not all, of the health benefits a victim may require are included in the definition of “essential health benefits.”
Personal injury plaintiffs often utilize a life care plan which details the client 's current and future medical needs and expenses arising from a defendant’s negligence. The jury considers the life care plan as it considers any other evidence. As the effects of the ACA manifest over time, life care plans may no longer assume
President Barrack Obama proposed the idea of the Affordable Care Act (ACA) or otherwise known as ObamaCare in 2010 according to the American Public Health Association (APHA)(2014). The ACA is intended to provide health insurance to people in the United States who cannot afford it. According to Norton (2014), not very many people actually understand the new Health Care Reform, 64 percent of Americans say that they don’t understand it. Also, 40 percent of those same people said that they don’t know what an insurance deductible is either. I had to do a little research myself and found that Lalli (2013) reports that we the people of the United States will have many benefits from the ACA. The first one is ambulatory patient services. This means that you come in, they will take care of you, and then you can leave. The second benefit is prescription drugs, which means that under the ACA people will be able to afford the medicine that they need. Another benefit is emergency care, which includes visits to the emergency room for reasons such as a stroke. The fourth benefit is mental health services, which provides a limited amount of visits to professional help and will only be billed about 40 dollars for their session. The fifth benefit is hospitalization, which can be very expensive but with the ACA, people will only have to pay 20 percent of the bill. Lalli (2013) continues the list of benefits: the sixth benefit being
The Affordable Care Act (ACA), also known as ObamaCare, is a healthcare reform law that focus on providing more Americans with access to affordable health insurance. “The ACA is expected to add 32 million people seeking primary and preventive service and treatment” (journalofnursingregulation.com). It was first enacted by President Barack Obama on March 23, 2010. The act has offered a number of people with benefits, set up a place they can purchase health insurance, expanded the use of Medicaid and Medicare to the disabled and senior citizens. The Act has forced many employers to offer coverage to their employees. Despite all of the positive attributes this act has provided, there is a flip side to it. Americans are required to have health
In February 2017, the news was dominated by stories and video of town hall meetings with constituents telling their representatives stories of how the ACA had benefitted them or their loved ones in one way or another (Colliver, 2017). There is no doubt that the law has helped thousands, maybe even millions of people across the country. There have also been stories of individuals who have health insurance, but are unable to use it because of high deductibles, which effectively render the insurance policies these people hold emergency only plans (Luhby, 2016). This is most certainly an unintended consequence of a law that was written with good intentions, but which needs to be modified to work with the real life situations the citizens of this country are faced with.
The Patient Protection and Affordable Care Act establishes new requirements for health plans and insurers changed in order to expand access to affordable coverage, and prevent individuals from losing certain coverage. New coverage insurance market regulations will prevent health insurers from denying coverage to people for any reason, in which their health status, and charging people more based on their health status and gender. These new rules will also require that all new health plans provide extensive coverage that include at least a minimal set of services, caps annual out‐of‐pocket spending that does not impose cost‐sharing for preventive services, as well as no impose annual or lifetime limits on coverage. For example, new insurance market regulations within private insurances allow young adults are able to stay in their parents health insurance up to the age 26. Once an employee has reached age 26 they have to upgrade from their parents insurance plan to defendant coverage plan eliminating annual and lifetime limits on coverage such as rescissions and waiting periods within 90 days. Health insurers will be prohibiting from placing an age limit to their coverage in case of fraud. Large employer that offer coverage plans will have to automatically places employs in to a low cost premium plan if the employ sign up or exit out of coverage. Overall health plan premiums will be able to vary based on an age, geographic area tobacco
Understanding the Affordable Care Act (ACA) can be problematic, the goal of the ACA is to address the fact that millions of Americans do not have health insurance, yet they are contributors to the health care market, consuming health care services for which they do not pay. While this may seem to be a great idea, many Americans are not really sure how they are affected by this Health Care Reform. The goal is to make health insurance affordable, secure, and reliable for all. The ACA is a minimum coverage provision, individuals are given health insurance by amending the tax code. There is an individual mandate which stipulates all non-exempt individuals must maintain a minimum level of insurance or pay a tax penalty. ACA extends Medicaid, states have to accept or they will not receive Federal funding. The act also includes an employer mandate to obtain health coverage for employees. The Affordable Care Act has changed the way health care is provided and the way individuals will participate (The Affordable Care Act Cases. (n.d.). Retrieved September 3, 2015)
A dramatic impact the Senate's proposed healthcare reform would have on the ACA is the ability for states to opt-out of the essential health benefits portion of Obamacare. Under the ACA, there are 10 essential health benefits plans must cover such as prescription drugs, ambulatory services, lab services and mental health and substance abuse disorder treatments. If the new legislation became law, plans could scale back their coverage options and offer cheaper premiums with much higher out-of-pocket costs.
The Affordable Care Act, in its time, has helped many uninsured Americans to obtain health insurance by giving them guaranteed coverage. About 20 million Americans, based on the statistics from the New York Times’s article titled “Fact Check: Trump’s Critiques of the Affordable Care Act.”, have obtained health insurance through the ACA. Dropping the uninsured rate to 11 percent by 2013 (Qiu 2017). Americans, through the ACA, were able to get health insurance even if they got sick, which inevitably happens to many. This put insurers in a place where they cannot deny coverage to people who have preexisting conditions, or their health history. Other main points that are included in Former President Obama’s Affordable Care Act is that one, it was given as an individual mandate that all U.S. Citizens and legal residents must enroll for qualifying health care or get penalized for not signing up for insurance at all. Making the fact that getting health care is mandatory is a good way to lower the insured rates and save many Americans money when the next unexpected hospital visits or illnesses come up. Another thing is that the ACA has also expanded medicaid to all non-Medicaid eligible individuals that are under the age 65 and making medicaid more federal funded based rather than a state issue. Thus helping those who could not afford
The Affordable Care Act (ACA), expands the access to health insurance coverage primarily for those who fall through the cracks of the private and public
Texas’s decision the not expand Medicaid under the Affordable Care Act has took a toll on many Texans. Texas is one of many states yet to expand the Medicaid program. With the decision not to expand Medicaid, it have left many low-income families uninsured and without an option for affordable healthcare. Texas has the highest number of people uninsured in the Unites States of America. The change has now entered the third year and only 30 states have expanded the program. There is an ongoing outreach to get Texas state leaders to expand the coverage.
The ACA is made up of a series of additions of and changes, to the multiple laws that are made up from the legal framework of the U.S. healthcare system. This act establishes the basic legal protections that have been nonexistent to the United States, will now guarantee access to affordable health insurance coverage for Americans, from when they are born, all the way through his or her retirement. The act hopes in cutting the number of uninsured Americans by more than half of the U.S. population (Rosenbaum, 2011, p.130). This law hopes to result in health insurance coverage for about 94% of the American population (Rosenbaum, 2011, p. 130). This will reduce the population of uninsured Americans by 31 million people, and increase Medicaid enrollment by 15 million recipients (Rosenbaum, 2011, p. 130). Approximately 24 million people are still expected to remain without a coverage plan. The act has several goals. For instance, one goal of the ACA is to have a close to universal coverage system, with the help and responsibility among individuals, employers, and largely, the government. The second goal is to improve the fairness, condition, and affordable prices of health insurance coverage for Americans (Rosenbaum, 2011, p. 130). Lastly, a third goal is to improve the quality of health care through value, excellence, and effectiveness while trying to reduce inefficient spending and making the healthcare system more reachable to a diverse population (Rosenbaum,
The 2010 Affordable Care Act (ACA) is the most current governmental effort to bring a national health care plan to the United States (U.S.). Policy makers in the U.S. are hopeful the ACA will be able to extend health care coverage to 47 million nonelderly uninsured citizens (Kaiser Family Foundation, 2014). The ACA broadens the Medicaid eligibility for low income individuals at or below the 138% Federal Poverty Line (FPL) and adds tax credits to assist people to purchase insurance in the Health Insurance Marketplace (U.S. Department of Health and Human Services, 2015). In 2012, the Supreme Court the upheld the constitutionality of the ACA requiring most people to maintain a minimum level of health insurance, however they left the
The Affordable Care Act (ACA) was enacted in 2010 and was designed to insure millions of people, who did not have health insurance, reduce out-of-pocket expenses for families and reduce costs for small businesses. In essences, when enrollment opens in 2013, the ACA law will target the 42 million Americans that according to a Census Bureau Survey are uninsured (Klein). Indeed, Obama Care from a utilitarian point of view is a huge improvement in medical services to a larger proportion of the population, that prior to this law did not have insurance available to them, including improved availability of health care services and reigning in out of control insurance companies.
The Affordable Care Act is considered one of the most important legislations related to health care reform to ever been enacted in the history of the United States (Cannan, 2013). The ACA was developed in order to give consumers control of their health care and to provide them with a means of power. The intention was for Americans to have stability and flexibility when it came to making personal healthcare decisions. Many citizens have been able to opportunity obtain affordable healthcare coverage with this reform that they did not have before. Programs have been developed to assist those with pre-existing conditions that may have previously been unable to obtain coverage. Options for young adults under the age of 30 who may not have had coverage have been developed under other health coverage program enacted. The Affordable Care Act has also offered protection for those that received arbitrary withdrawals of insurance coverage. Many Americans have chosen to opt out of healthcare coverage altogether in the past, but this is no longer an option without a penalty. There is a fine that is required to be paid when filing annual income taxes. Unfortunately, some Americans are uninsured and do not have the means to pay for health insurance, and are forced to pay the fine. This has been a growing issue in America as many families cannot afford much more beyond the daily necessities. Therefore, any serious injury or illness can quickly diminish any savings or cause debt to those
As of January 2014, The Patient Protection Affordable Care Act, also known as the Affordable Care Act (ACA) was signed into effect to help lower income families be able to afford health care. The ACA was signed into effect with the idea that everyone needs health insurance at an affordable rate. There are some factors that were not taken into consideration about what it might cost to help lower income families. President Obama signed the ACA into effect as of March 23, 2010, with hopes of cutting our federal deficit down and to save lower income families money. With the new ACA in effect the ones who are dealing with the after effects are the businesses who now have to offer insurance and middle class who do not qualify for the lower
The Affordable Care Act (ACA) was signed into law on March 23rd, 2010 by President Barack Obama. This radical health care law was a much-needed step in comprehensive health insurance reform. Three important features of the Affordable Care Act are 1. Improving quality and lowering health care costs 2. New consumer protections and 3. Increased access to healthcare. (Key Features. 2014). Under the umbrella of these three key features additional benefits include free preventive care, drug discounts for senior citizens, increased protection against health care fraud, small business tax credits, increased access to health care through the health insurance marketplace, consumer assistance, and non-discrimination based on pre-existing conditions.