Obamacare: 6 aspects to consider


Jessica Lu, spotlight editor

Background:  In 2010, President Barack Obama signed the Affordable Care Act (ACA) into law. According to the U.S. Department of Health & Human Services’s website, the Act, popularly nicknamed Obamacare, is in place to reduce premium costs for working families and small businesses through tax relief, without forcing Americans to change their current insurance. Those previously uninsured must use a competitive insurance market to select coverage, or else face a tax starting at about $95 per adult and $47.50 per child, which will increase over time. Open enrollment in the Health Insurance Marketplace began Oct. 1, and starting Jan. 1, almost every American is required to be insured or else he or she will pay the above fee.

Recent Controversy: Obamacare has been a source of political debate and has been directly linked to the Oct. 1 government shutdown, when Congress was divided over raising the debt ceiling and defunding Obamacare. The ACA contains several controversial factors that have caused some Democrats and Republicans alike to waver in their support for Obamacare.

Important Aspects: The ACA contains several pieces of legislation, but not everything applies to everyone.  Here are six aspects that may affect the Beverly student.

New: The “individual mandate” requires everyone eligible to buy health insurance. This does exclude many adults, such as illegal immigrants, some Native Americans, those on Medicaid, etc.

Pros: Everyone must buy into the system and so everyone is covered.

Cons: The law coerces those who think they do not need health insurance (usually the young and/or healthy) to cover the costs of those who do–a downside for those feel they shouldn’t pay for others’ health care.

New: It is unlawful for health insurance companies to reject a customer because of a preexisting condition.

Pros: People with medical conditions and a need for healthcare are now guaranteed coverage.

Cons: The insurance companies could raise prices to compensate for these customers.

New: There is no longer any lifetime dollar limit on coverage, and most plans are banned from having annual caps starting 2014.

Pros: A person on treatment will be able to continue receiving treatment without the possibility of “running out” of coverage.

Cons: Again, insurance companies have to compensate somehow for this expense, likely through raising prices on plans.

New: Up until age 26, children are able to stay on their parents’ plan, even if said children are married, attending school or financially independent.

Pros: The plan alleviates the risks and costs of the transition for people becoming independent from their parents, especially for those with college expenses.

Cons: Those 27 and older are not guaranteed to be able to afford the health insurance they need. For health care providers, this rule means fewer people pay into the markets.

New: All businesses with 50 or more people must offer insurance for their employees by 2015. Employees are not required to sign up with that insurance, however, and may still choose a private option.

Pros: Employees have increased access to a health care plan.

Cons: Businesses may close, move or raise prices on their goods or services in order to compensate for providing insurance.

New: The 80/20 Rule states that health insurance companies must spend at least 80 percent of their revenue on providing health care, or else they pay a rebate to customers.

Pros: This encourages insurance companies to focus on quality health care using the dollars people pay into the system.

Cons: Insurance companies may want to raise prices with the rule in mind.