The Provisions Of The Affordable Care Act

1319 WordsApr 10, 20176 Pages
3.0 PROVISIONS OF THE AFFORDABLE CARE ACT To Expand Health Care Coverage (a.) Expansion of Public Health Insurance Programs In order to decrease the amount of uninsured individuals one of the provisions of the ACA centered on expanding public health insurance programs namely Medicaid and Children’s Health Insurance Program(CHIP). Medicaid was expanded to include children, pregnant women, parents, and adults without dependent children up to 133% of the Federal Poverty Level (FPL). Medicaid expansion was contested in court challenging its constitutionality. The Supreme Court upheld the constitutionality of the Law based on the interpretation of the language of the Act, but restricted the ability of Health and Human Services(HHS) in…show more content…
Third, insurers were required to cover dependents up to the age of 26 notwithstanding group or individual coverage. (d.) Individual Mandate In the Pre-ACA Era, individuals were not required to purchase insurance. Most individuals were provided health benefits through their employer, but, a significant proportion of the population remained uninsured. This lead to increased health care costs overall and posed several challenges to insurers like adverse selection, moral hazard and high risk pools. In the ACA Era, by authorizing the individual mandate and setting up the insurance marketplace, individuals are pooled together with a patient characteristic other than their health status. This leads to an assortment of individuals in the insurance pool with a combination of high utilizers and low utilizers of health care. Furthermore, the healthy individuals in the risk pool will help offset the costs from sicker individuals. As a consequence of the individual mandate the number of insured individuals will increase as all individuals are required to have some form of insurance. (e.) Employer Requirements The employer requirements aspect of the Act helps assess the health care coverage options being made available to employees. Based on the size
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