Health Care Reform
Affordable Care Act/"Obamacare"
Here you can find out more information about the Affordable Care Act (ACA), how it will impact you, and where you can find more information about implementation in your state. One of the key provisions in the ACA is the requirement that states must set up insurance exchanges and that those exchanges must have a basic Essential Health Benefit (EHB). The Amputee Coalition is working with advocates to ensure that prosthetic devices and custom orthotic devices are included in every state's EHB which would go toward achieving insurance fairness for amputees by ensuring adequate and affordable prosthetic care.
States Continue to Move Forward on Essential Health Benefits
Almost every state is currently looking at the establishment of EHB's in their state. States are expected to announce their plans and findings by the end of 2012, and the plans will be reviewed to ensure they fully comply with the requirements laid out in the Affordable Care Act.
To find out more about the implementation of EHB's and the Affordable Care Act in your state, the Amputee Coalition encourages you to go to http://www.statereforum.org/states. You can also find more information about the ACA here: http://www.healthcare.gov/law/index.html
What is in the Affordable Care Act?
- Young adults can stay on their parents health insurance until 26 years of age
- Pre-existing illnesses and conditions cannot be denied health insurance benefits
- There is no ceiling on the cost of health care for a specific medical condition
- Significant Medicaid expansion is called for but states do have the right to opt out without losing current benefits covered by the Federal Government
- Medicare benefits are kept constant
- Prescription drug costs will decrease because of the elimination of the "gap in payment that currently exists under Medicare Part D
- You have the right to keep your employer's coverage
- In 2014, you can purchase health insurance through your state's health insurance exchange, low to middle income individuals may be eligible for a subsidy to help pay for their health insurance costs
- Taxpayers who don't have health insurance by January 1, 2014 will be required to pay a penalty tax on their annual tax returns. This would not apply to individuals on Medicare, Medicaid, employer insurance, or self insured
Supreme Court Ruling June 2012
The Supreme Court of the United States (SCOTUS) found major provisions in the Patient Protection and Affordable Care Act (ACA) to be constitutional. The court has ruled that the individual mandate that virtually all Americans buy health insurance is constitutional. Although the mandate was not upheld on the grounds that Congress could use its power to regulate commerce between the states, five justices, including Chief Justice Roberts, and Justices Ginsburg, Breyer, Sotomayor and Kagan, ruled that it is constitutional to require someone to pay the tax penalty if they refuse to buy insurance under Congress' authority to impose its taxing power. This penalty upholds the individual mandate portion of the ACA.
Due to the fact that the Court has ruled that the Mandate is constitutional, the Court did not need to decide what other parts of the statute were constitutional, except for a provision that required states to comply with new eligibility requirements for Medicaid or risk losing their funding. On that question, the Court held that the provision is constitutional as long as states would only lose new funds if they didn't comply with the new requirements, rather than all of their Medicaid funding.
The ruling on Medicaid will result in some changes to the implementation of the law and how states go about expanding of the Medicaid program. States deciding to forego Medicaid expansion will not be putting in jeopardy all of the Medicaid funds only the additional dollars that were set aside for the expansion. The remainder of the law is upheld which will result in the Department of Health and Human Services to continue to move forward with the development of rules, regulations, and the implementation schedule as laid out in the law.
To this end, the Amputee Coalition will continue to work toward ensuring that prosthetic and custom orthotic devices are deemed Essential Health Benefits which would require base coverage for the devices in all insurance plans. The Court's ruling also upholds the provision that individuals cannot be denied coverage based on a pre-existing condition.
To read the Court's decision in its entirety, you can see it on the Court's website here: http://www.supremecourt.gov/opinions/11pdf/11-393c3a2.pdf
With the re-election of President Barack Obama, it appears likely that health care reform will continue to move forward as previously outlined by the administration.