Highlights of the Patient Protection and Affordable Healthcare Act

By now you know at least something about that new healthcare program that was signed into law in 2010.  You’ve probably heard it called many things — the Patient Protection and Affordable Care Act (PPACA), the Affordable Healthcare Act (ACA), the Healthcare Reform Act, and also, good or bad, “ObamaCare”.   And you probably are in one of two mindsets – trying to understand how it will affect you and your family, or you haven’t a clue on what to do and are waiting for some date in the future when you are forced to make a decision.

The major goals of the PPACA are to reform the current healthcare system by providing affordable, minimum essential coverage to all legal Americans.  And it is also supposed to reduce costs of insurance premiums to millions of families and small businesses. The PPACA wants to put individuals, businesses, and small business owners in control of their own healthcare.

Here are some highlights of the PPACA – for individuals/families

·         First and foremost, you will be required by law to have health insurance by 2014

·         It will provide access to health insurance for millions of uninsured Americans through an insurance marketplace (also referred to as an exchange).

·         It will cap out-of-pocket expenses and require preventative care to be fully covered at no cost to you.

·         You can’t be denied health coverage due to a pre-existing medical condition and health insurance companies can’t drop you because of an illness.

·         Children can stay on their parent’s plan until they are 26 yrs old regardless if they are in school, married, or considered a dependent.

·         Depending on your income level, you and your family could qualify for tax credit that would offset part of your insurance premiums.  For those who qualify, there will be state/federally-run insurance marketplaces where you can compare insurance plans and purchase accordingly.  Tax credits will ensure that those in need will have access to health insurance.  Note however, to see if you even qualify for a tax credit, you will be required to complete the Application for Health Insurance (currently in draft form).

·         If you currently have health insurance, you are “good to go”.  The PPACA won’t force you to drop your coverage.

·         What if you don’t qualify for a tax credit and therefore think you can’t get insurance?  You will still be able to keep your existing health insurance plan or purchase new coverage through the open market.  And, you will receive the same care that is available today.

·         National campaigns and strategies for health wellness will be developed to reduce preventable illness and thereby keep healthcare costs down.

Here are the main highlights of the PPACA – for business owners

·        Those companies with 25 or fewer full-time equivalent employees may qualify for tax credits, tax breaks and other assistance for insuring employees.

·         Those employing at least 50 full-time equivalent employees are given the choice between providing insurance that meets the standards of the PPACA or paying a penalty.

 Now you are asking, what if I choose, as an individual or family, not to have health insurance in 2014?  The PPACA is requiring everyone to have health insurance BUT the PPACA won’t force you to have health insurance.  It seems as though the PPACA is contradicting itself.  If you read the ‘fine print’ it says, “If you don’t have health insurance be prepared to pay a penalty (tax) for not having it”.  This penalty, or tax, will be discussed in a future blog.

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