The PPACA and Insurance Companies


Because of the incredible rhetoric against The Patient Protection and Affordable Care Act of 2010 (PPACA),  euphemistically called ObamaCare, I’m trying to summarize this legislation in bits and pieces to make it a little easier for us folks-on-the-street to absorb.  If you find this helpful, or if I get something wrong, just let me know in the comments below.

Here is some of what the PPACA requires of private health insurance companies:

1. They cannot exclude applicants because of pre-existing conditions.

2. Policies must be renewable.

3. Plans can no longer charge more because of the health status of a population, but they may vary ratings based on age, number of family members, tobacco use, and other non-health issues.

4. There will be no lifetime or annual limits.

5. Dependents up to age 26 are covered.

6. Companies with more than 50 employees must buy health insurance for their employees.

7. Qualified health plans must cover preventive services such as immunizations and other preventive care and screenings for women and children.

8. Health plans must report the proportion of premium dollars spent on cost of services, and if it goes above that prescribed by a pre-calculated Medical Loss Ratio, rebates must be given to policy holders.

9. Unreasonable premium increases must be vetted through the Secretary of Health and Human Services and state regulators.

These are just a few of the provisions of the PPACA.  You can find out much more at http://www.healthcare.gov/law/index.html

You can decide for yourselves whether or not you believe this plan is in the best interests of the people of our nation.  The plan sets in place regulations to govern health care.  Yes, it does.  If you are one of those that believes that all regulations are bad and lead to socialism, you might want to temper that view just a bit.  Right now, we have millions of fellow citizens who are shut out of adequate health care plans by circumstance or by choice.  When these people seek care through hospital emergency rooms because they have nowhere else to go, the rest of us are the ones who pay.  Personally, I would rather that people pay for their own health care through affordable premiums and stay out of my pocketbook.

More later. . . .

 

 

 

About R. Z. Halleson

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5 Responses to The PPACA and Insurance Companies

  1. It’s hard to find experienced people on this topic, however, you sound like you know what you’re talking about!

    Thanks

    Like

    • I only know what I read and what I see on TV, which is not always reliable. I did audit a course on U.S. Healthcare Management at Northwestern’s Kellogg School of Management a couple of years ago, and it was an eye-opener for me. Most of the students were physicians working on getting an MBA, so their comments were also helpful. We were given many well-researched articles to study, and I pulled info from them as well. Understanding healthcare in the U.S. is difficult. It is convoluted and complex and desperately needs to be sorted out. ObamaCare, in my opinion is a start, but should be viewed as an interim step toward bringing affordable and GOOD healthcare to all U.S. citizens.

      Like

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