The Patient Protection and Affordable Care Act (the official title for ObamaCare, “ACA”) was signed into law March 23rd, 2010 and upheld by a supreme court ruling on June 28, 2012. The Affordable Care Act (ACA) changes the way health insurance is provided and paid for in the United States, as well as reforms the health insurance industry and the American health care system as a whole.
The ACA offers important benefits and protections for patients who already have health insurance as well as those who need it, including requiring health insurers to follow new rules. The ACA:
- Requires insurance companies to cover patients who have a pre-existing health condition
- Provides preventive care for immunizations, preventive care for children, and additional preventive care and screenings for women at no cost to the patient
- Permits young adults to stay on their parents’ plans until age 26
- Makes health insurers accountable by requiring them to spend a certain amount of the premium on actually providing services rather than on administrative costs
- Makes it illegal for health insurance companies to arbitrarily cancel health insurance just because a patient gets sick
- Requires health plans to accept every individual who applies for coverage and renew or continue coverage for all members
- Ends lifetime and yearly dollar limits so that coverage of essential health care services does not “run out”
- Requires health plans to cover participation in clinical trials
- Guarantees the right to appeal a health plan decision
ACA doesn't change the way insurance is obtained, you can still buy private insurance, get employer based insurance, or get insurance through a government program like Medicaid or Medicare.
Several provisions in the ACA already have been implemented; however, the effective date for one of the biggest changes was October 1, 2013. That’s when people began signing up for health insurance coverage through the new online marketplace at Healthcare.gov or by calling 800.318.2596. Patients who sign up for coverage and make their first premium payment by December 15, 2013, will have health coverage beginning January 1, 2014. The enrollment deadline for coverage in 2014 is March 31, 2014. After that date, patients can sign up for insurance through the Health Insurance Marketplace (also known as health insurance exchanges) only if they lose their job, give birth, are divorced or experience another qualifying life event.
Wisconsin joins a number of states that have decided to implement a limited expansion of Medicaid rather than full expansion through the ACA. The Wisconsin Department of Health Services (DHS) began notifying current Medicaid/BadgerCare beneficiaries in September 2013 that they may be affected by coverage changes and BadgerCare Plus.