Affordable Care Act

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affordable

With the implementation of the Patient Protection and Affordable Care Act (PPACA, better known as ObamaCare), many people are still not aware of how the new health care law will affect them. Certain provisions of the law are incredibly far-reaching; others are specific to certain small groups. However, there are several important points of which every American should be aware.

Individuals

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As a result of The Patient Protection and Affordable Care Act (PPACA), starting October 1, 2013 individuals in the state of Pennsylvania without health care coverage can begin shopping for affordable health care plans specialized to their individual needs and to those of their families.  The open enrollment period for 2015 closed February 15, but there are still opportunities to get coverage.

Insurance plans are offered by private companies, and offer what the PPACA calls essential health benefits, such as ambulatory services, emergency services, hospitalization, maternity and newborn care, mental health and substance use services, prescription drugs, rehabilitation and habilitation services, preventative and wellness services, and pediatric services.

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Businesses & Non-Profits

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Employers covered under the Fair Labor Standards Act must notify employees about the new health insurance marketplace. Sample letters can be found for employers that offer health insurance and for employers that do not offer health insurance.

Additionally, employers are required to provide employees with a summary of their benefits and coverage under their plan.

Insurance companies, under the ACA, are required to spend 80 percent of the premium dollars they receive on medical care. Companies that do not meet this ratio must provide a rebate to policy holders. This is known as the 80/20 Rule .

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Governments

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The Patient Protection and Affordable Care Act brings several changes to both state and federal governments.  One of the most important changes is the expansion of Medicaid.  As written, the PPACA requires states to expand their Medicaid programs to encompass a larger portion of their populations.  The Supreme Court, however, ruled that the federal government could not force states to expand Medicaid. Gov. Tom Wolf approved Medicaid expansion.

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