CRS Two federally regulated "multi-state plans" MSP —one of which must be offered by a non-profit insurer, and the other cannot cover abortion services—become available in a majority of state health insurance exchanges.
ObamaCareFacts is a free informational site. It's privately owned, and is not owned or operated by the US federal or state government.
The other titles discuss changes to Medicare and Medicaid, the health care workforce, changes for healthcare providers, new taxes, and more. These changes are reflected in the summary below.
In some cases additional rules have changed parts of the law. We will add notes of those changes as we continue to update this summary. If you are looking for a specific title or provision please use the basic find command on your browser.
Amendments to the Public Health Service Act. No lifetime or annual limits. Prohibits all plans from establishing lifetime or unreasonable annual limits on the dollar value of benefits.
Prohibits all plans from rescinding coverage except in instances of fraud or misrepresentation. Coverage of preventive health services. Requires all plans to cover preventive services and immunizations recommended by the U.
Extension of dependent coverage. Development and utilization of uniform explanation of coverage documents and The patient protection and afforable care definitions. Requires the Secretary to develop standards for use by health insurers in compiling and providing an accurate summary of benefits and explanation of coverage.
The standards must be in a uniform format, using language that is easily understood by the average enrollee, and must include uniform definitions of standard insurance and medical terms. The explanation must also describe any cost-sharing, exceptions, reductions, and limitations on coverage, and examples to illustrate common benefits scenarios.
Prohibition of discrimination based on salary. Employers that provide health coverage will be prohibited from limiting eligibility for coverage based on the wages or salaries of full-time employees. Ensuring quality of care.
Requires the Secretary to develop guidelines for use by health insurers to report information on initiatives and programs that improve health outcomes through the use of care coordination and chronic disease management, prevent hospital readmissions and improve patient safety, and promote wellness and health.
Bringing down the cost of health care coverage. Health insurance companies will be required to report publicly the percentage of total premium revenue that is expended on clinical services, and quality rather than administrative costs. Health insurance companies will be required to refund each enrollee by the amount by which premium revenue expended by the health insurer for non-claims costs exceeds 20 percent in the group market and 25 percent in the individual market.
The requirement to provide a refund expires on December 31,but the requirement to report percentages continues. Health insurers will be required to implement an effective process for appeals of coverage determinations and claims.
Health insurance consumer information.
The Secretary shall award grants to States to enable them or the Exchange to establish, expand, or provide support for offices of health insurance consumer assistance or health insurance ombudsman programs. These independent offices will assist consumers with filing complaints and appeals, educate consumers on their rights and responsibilities, and collect, track, and quantify consumer problems and inquiries.
Ensuring that consumers get value for their dollars. For plan years beginning inthe Secretary and States will establish a process for the annual review of increases in premiums for health insurance coverage. Requires States to make recommendations to their Exchanges about whether health insurance issuers should be excluded from participation in the Exchanges based on unjustified premium increases.
Except for sections and effective upon the date of enactment of this Actthis subtitle shall become effective for plan years beginning on or after the date that is 6 months after the date of enactment of this Act. Immediate access to insurance for people with a preexisting condition. Enacts a temporary insurance program with financial assistance for those who have been uninsured for several months and have a pre-existing condition.The Patient Protection and Affordable Care Act of is a law that significantly changed health care in the United States.
It made insurance available to between 32 million and 50 million more Americans or 95 percent of the legal population. The Patient Protection and Affordable Care Act (PPACA), also called the Affordable Care Act (ACA) or “Obamacare,” was widely considered the most far-reaching health care reform act since the passage of Medicare, the U.S.
government program guaranteeing health insurance for the elderly, in The Patient Protection and Affordable Care Act, also known as PPACA, healthcare reform, Obamacare, or the ACA, is a law passed to issue rules and guidelines on the offering, administration, and acceptance of healthcare coverage in the United States.
Official site of Affordable Care Act. Enroll now for coverage. See health coverage choices, ways to save today, how law affects you. The Patient Protection and Affordable Care Act: Implications for Public Health Policy and Practice Sara Rosenbaum, JD Sara Rosenbaum is the Hirsh Professor and Chair in the Department of Health Policy, School of Public Health and Health Services at The George Washington University Medical Center in Washington, D.C.
The Patient Protection and Affordable Care Act will improve the quality and efficiency of U.S. medical care services for everyone, and especially for those enrolled in Medicare and Medicaid. Payment for services will be linked to better quality outcomes.