The discussion for this paper addresses key elements of the Affordable Care Act. These areas include the following requirements for implementing this act among employers, employees on benefits and drawbacks of health insurance coverage. These areas will include coverage for the individual, businesses, expansion of coverage and what and who is covered under these types plans. Individual Coverage
The first component addresses that U.S. citizens and legal residents are required to have health coverage. If these persons do not have health coverage, they will pay a penalty either per individual or income for each family. These penalties will vary each year and according to their income along with the cost of living. Exemptions will be given to individuals or families who have financial hardship, are without coverage for less than three months and individuals whose income is below a certain tax threshold (www.hhs.gov, 2014).
Employer Requirements
Employers who have more than 50 employees and does not offer coverage, but also has at least one employee who is receiving a tax credit of $2,000 will receive a tax credit. Employers who provide insurance coverage to 50 or more employees and has at least one full-time employee will receive a tax credit but will pay $3,000 for per employee receiving the credit of $2,000. These policies will exclude the first 30 employees from this type of assessment. Meaning that employers with 50 or more employees will be exempt from the penalties implied. Employers who have more than 200 employees will automatically be enrolled in an insurance plan. Expansion of Public Programs
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Expanding Medicaid to individuals under the age of 65 with incomes based on their adjusted gross income, such as pregnant women, children and adults without dependent children. Since the HHS is not enforcing the expansion of Medicaid, it will be left up to the individual states to expand Medicaid eligibility to adults with medical assistance of up to 100%. Another program which many states maintain is eligibility of the Children’s Health Insurance Program (CHIP).
This program is provided to children who are at or below the poverty level. To enroll a child in this program, they first must meet certain criteria for this type of insurance. Premiums and Subsidies to Individuals and Employers
Limit the access and eligibility of U.S. citizens and legal immigrants who have to meet certain income limits. Premium credits and subsidies are provided to families and individuals whose income is between 100-400% FPL. The FPL limits the cost-sharing amounts for the basic benefits plans. This type of coverage requires some verification, such as income and citizenship. The employer who own’s a small business with less than 25 employees is entitled to a tax credit (Kaiser Family Foundation, 2013).
Tax Changes for Insurances
This area imposes different taxes associated with various types of accounts, such as Health Savings Accounts (HSAs) and Archer Medical Savings Accounts (MSAs).
This means limiting the qualified expenses to 20 percent of the disbursement. Another area that will change is the itemized deductions for medical spending goes from 7.5 percent to 10 percent of the individual’s adjusted gross income. Qualified Plans
Qualified plans in the exchange are required to report claims on payment policies, enrollments, denying claims and other requirements for the individual’s rights under their health plans. Denying Coverage
The Affordable Care Act (ACA) says that insurance companies cannot deny coverage to children under the age of 19 with any type pre-existing conditions. Another area of concern is the insurance companies charging higher premiums to individuals because of their gender or health status. Health Quality
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... health care coverage for all. Considering that the United States ranks low in health status, the percentage of its population covered by health insurance ... just can't afford the insurance. Health care has become increasingly unaffordable for businesses and individuals. (Reese) Premiums grow ... preventative care also follows to Medicaid problems. As Medicaid only covers some people like children and ...
The ACA provides several positions which relate but are not limited to the health care quality, such as effectiveness of a variety of medical treatments, reducing medical errors, invest in Health Information Technology (HIT) and improve the performance of data collection from various locations in our country (www.hhs.gov, 2014).
Private Insurance
Establishing a high-risk pool for individuals and provide them with health insurance even though they have a pre-existing condition. Persons who have been without medical insurance for more than six months will be eligible to receive subsidized premiums with limited costs. Covering options for women and young adults, such as preventative measures and coverage until the adult is over the age of 26. Cost of Health Care
The ACA addresses issues such as prevention, reduce healthcare fraud, active treatment, testing new payment modules while using Medicare or Medicaid. Conclusion
In conclusion, the essential elements of Affordable Care Act enhance many areas of our health insurance by providing coverage for children, young adults, middle age, and seniors. Another area the ACA has established is the various penalties for large and small business owners. In our society, everyone should and be eligible for some health care coverage regardless of their age, religion, etc.
References
The Henry J. Kaiser Family Foundation (2013).
Focus on Health Reform – Summary of the Affordable Care Act. Retrieved from: www.kff.org. U.S. Department of Health & Human Services (2014).
What is the Affordable Care Act? Retrieved from: www.hhs.gov.
