Obamacare: What You Should Know

By: Muaaz Masood

According to a U.S. Census Bureau report, 15 percent of Americans, or about 48 million people, did not have health insurance coverage in 2012.  Many people, including low-income families, could not afford insurance, leaving a huge portion of the American population uninsured. Individuals without insurance have limited access to care and often face unaffordable medical bills when they do seek care. President Obama attempted to resolve this dilemma by introducing the Patient Protection and the Affordable Care Act (PPACA) in 2010.

The PPACA, also known as Obamacare, was a bill signed by the President on March 23, 2010 to reform the healthcare industry in America. Obamacare strives to give more Americans accessible and affordable healthcare while reducing healthcare spending. Many Obamacare provisions have already been set in motion or will be fully active by 2014.

So, what does Obamacare actually do?

Several key provisions give patients unprecedented protection but require that everyone to obtain health insurance by 2014 or risk incurring a hefty fee which can be waived if the individual is below a certain income.

The 82 percent of Americans who currently have health insurance will most likely be able to keep the same health plan with some minor changes. It is required of all insurance plans to provide essential health benefits including hospitalization, preventive visits, maternity and mental health treatment. One provision prohibits insurance companies from ending patients’ coverage if they become ill or make an honest mistake on their application. Insurance companies can also not deny patients on the basis of pre-existing medical conditions or gender discrimination. Business owners are mandated to provide health insurance to full-time employees.

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Photo credit: PilotGirl / Foter.com / CC BY-NC-SA

For the uninsured, Obamacare creates state-specific exchange marketplaces where low-income individuals can shop for subsidized health insurance. Furthermore, Medicaid is expanded to those earning up to 133 percent of the federal poverty line. However, not all states have elected to expand Medicaid even though the federal government will subsidize it.

How will Obamacare specifically affect us Georgians?

The U.S. Department of Health and Human Services released prices on October 1, stating that the cheapest silver plan will cost on average $304 monthly. There are four levels of coverage, from bronze to platinum, that all have the same benefits and limit out-of-pocket expenses. However, the lower-tier plans require Georgians to pay higher deductibles and copayments. Republican Governor Nathan Deal decided against expanding Georgia’s Medicaid program to cover the uninsured, so federal officials will be in charge of Georgia’s exchange.

While Obamacare shows great potential in providing more Americans access to healthcare and protecting patient rights, many Georgians are not so optimistic. According to an Atlanta Journal-Constitution poll, 57 percent of Georgians have a generally unfavorable opinion of Obamacare. 94 percent of Georgians view their current coverage as “good” or “adequate” according to a poll released by the Healthcare Foundation Georgia.  Uninsured Georgians will benefit most from the plan.

Obamacare represents the largest reform of the United States’ healthcare system since the passage of Medicare and Medicaid in the 1960s. Obamacare strives to make healthcare more affordable and to provide a higher level of patient protection. With new provisions and changes to existing ones, confusion and lack of familiarity is commonplace. It is simply a matter of time until the efficacy of the new laws, many of which have already been implemented, can be fully determined.