It established itself as an “active” exchange that set benefit and quality rules for participating insurers to meet, in many cases more stringent than the ACA’s rules. It mandated that carriers spend at least 80% of their premiums on medical claims and improving the quality of care, outlawed refusing or surcharging coverage for people with preexisting medical conditions, and required the carriers to cover a menu of essential benefits, including prescriptions, hospitalization, and maternity and mental health services.Ĭovered California, however, went further, Lee told me. I’m going to not offer mental health benefits.” They would say, ‘I’m going to offer these benefits to some, I’m going to turn these people down but not these people. Up to then, in the individual market, “insurers wrote their own rules. The advent of the Affordable Care Act marked what Lee calls “a major pivot as a nation” on healthcare.
Obamacare success story how to#
This is just one story of the tens of thousands of Mainers whose lives have been changed by the Affordable Care Act.Business Column: California is still showing how to make Obamacare work, even with COVID-19Ĭalifornia’s Obamacare exchange will have minimal rate increases next year, despite COVID “We are grateful for the protections the ACA offers to all Americans.” I believe that’s what health insurance is for,” says Alison. “My daughter was just 8 years old when she was diagnosed with a severe heart condition. She wasn’t a smoker, she didn’t eat a lifetime of junk food, or have any ‘bad habits’ to blame – sometimes people get sick. Given the significant costs associated with caring for complex heart conditions (over $1000 a month for prescriptions alone), her daughter could quickly trigger a lifetime limit on her plan, on top of the significant out-of-pocket costs she would incur.
If the ACA were repealed, her daughter could be denied coverage for her pre-existing condition, and even if she did obtained coverage, she could face mountains of medical bills. For at least a while, she did not have to worry about how her daughter would obtain coverage, which was a serious issue for many young adults prior to the ACA. Before the ACA took effect, one in three young adults between the ages of 19 and 25 were uninsured.Īlison’s daughter recently turned 26, and because of the ACA’s ban on insurer discrimination against individuals with preexisting conditions, she doesn’t have to worry about whether she can access coverage now that she is off her mother’s plan.īut Alison is worried about politicians making health care unaffordable for her daughter in the future. Alison was relieved that she was able to keep her daughter on her plan until she turned 26. Without the ACA, it’s clear that Alison would face significant barriers to entrepreneurship.Īnother source of comfort for Alison are the protections guaranteed for her daughter, who had a heart transplant when she was just 8 years old. “It’s tough enough having to start a business without having to worry about health insurance,” explains Alison. The ACA plays a critical role in providing health coverage to entrepreneurs and other independent contractors. Her contracted employees could also use the Marketplace to find options that would work for them, allowing them the freedom to remain independent, rather than getting locked in a position with a company that offers health benefits.
Obamacare success story free#
Thankfully, Alison was able to obtain insurance through the Marketplace, leaving her free to run her own business rather than chase a benefits package at a job she didn’t want. When her husband’s COBRA coverage ran out, she knew she needed to find her own coverage. Prior to obtaining Marketplace coverage, Alison was insured through her husband’s employer until he was diagnosed with MS and had to leave his job. “The Affordable Care Act allowed me to start my own business, a business that provides work for many independent contractors.”
0 kommentar(er)
