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Healthcare Reform: The ABC’s of the ACA

How many of us Moms, in our abundance of free time, have read the 2300+ pages of the healthcare reform bill – The Affordable Care Act (ACA). I am going to go out on a limb and say most have NOT read it!

For those of you that tried to read it or follow the news around it, is it clear as mud? I am going to wear my two hats as a Mom and health professional for a minute and attempt to break down the legislation into what really matters for our families.

Here are the ABC’s as I see them:

A. Affordable Care  – You may qualify for assistance to buy insurance if you make less than $88,000 per year for a family of four. This is for people who don’t get insurance from their employer and therefore have to buy it on their own. The amount of assistance  depends on your income, whether you’re single or have a family, your age, and where you live. For example, based on a Kaiser Family Foundation Study, a • A family of four making $60,000 will get a $4,220 subsidy toward a policy that costs $9,400
B. Business Changes – If you don’t get insurance from your employer, that might change. Starting in 2014, if your company employs more than 50 people, it will be required to offer you a health plan that covers at least 60 percent of your overall health costs, or the company will be fined $750 per year per full-time worker.
C. Coverage for pre-existing conditions – Kids with health problems are protected under the healthcare reform legislation. It prohibits insurers from excluding coverage for children with pre-existing health conditions. Health insurance plans will also not be able to use pre-existing conditions to limit or set unrealistic rates on the coverage an individual or dependent can receive.The same will be true for adults starting in 2014.

D. Dependents – Young people can remain on parents’ insurance until age 26. The children can’t have jobs that offer insurance, and they must be claimed as dependents on their parents’ taxes. Also,  kids’ eligibility for the popular CHIP (Children’s Health Insurance Program), which helps lower-income families, must be maintained, under the bill. States, even if hard-pressed by budget shortfalls, will not be able to cut children from the program until 2019

E. Expecting Mothers – Starting in 2014, essential health benefits such as pregnancy and newborn care, along with vision and dental care for children, will be covered in all new individual and small business plans. Also,  if you get pregnant in 2014 and apply for health insurance, health insurance companies will have to cover both you and your pregnancy. You can not be charged more than a non-pregnant person either.  Moreover, the state health insurance exchanges benefit package must include maternity care. So there you have it…that is just touching the surface of this large reform. It will effect all families differently, but hopefully it will solve some of the healthcare difficulties. If you would like more information about how this will effect us locally checkout the Texas Department of Insurance.

We would love to hear how these laws have effected your family or if you have tips on how to navigate it.

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