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Affordable Health Care Act

  1. -001 Key Features of the Affordable Health Care Act (
      Provides features by year that they will come into effect. Some examples starting in 2010 include:

      -Prohibiting -Denying Coverage of Children Based on Pre-Existing Conditions.
      -Eliminating Lifetime Limits on Insurance Coverage.
      -Regulating Annual Limits on Insurance Coverage.
      -Appealing Insurance Company Decisions.
      -Providing Small Business Health Insurance Tax Credits.
      -Offering Relief for 4 Million Seniors Who Hit the Medicare Prescription Drug “Donut Hole.”
      -Preventing Disease and Illness.
      -Providing Access to Insurance for Uninsured Americans with Pre-Existing Conditions.
      -Extending Coverage for Young Adults.
      -Expanding Coverage for Early Retirees.
      -Rebuilding the Primary Care Workforce. To strengthen the availability of primary care, there are new -incentives in the law to expand the number of primary care doctors, nurses and physician assistants. -Holding Insurance Companies Accountable for Unreasonable Rate Hikes.
      -Allowing States to Cover More People on Medicaid.
      -Increasing Payments for Rural Health Care Providers.

      -Examples of new features for 2011 include:
      -Offering Prescription Drug Discounts.
      -Improving Care for Seniors After They Leave the Hospital.
      -Bringing Down Health Care Premiums. To ensure premium dollars are spent primarily on health care, the law generally requires that at least 85% of all premium dollars collected by insurance companies for large employer plans are spent on health care services and health care quality improvement.

      -Examples of new features for 2012 include:
      -Linking Payment to Quality Outcomes.
      -Reducing Paperwork and Administrative Costs.

      Examples of new features for 2013 include:
      -Increasing Medicaid Payments for Primary Care Doctors.
      -Providing Additional Funding for the Children’s Health Insurance Program.

      Examples of new features for 2014 include:
      -Prohibiting Discrimination Due to Pre-Existing Conditions or Gender.
      -Eliminating Annual Limits on Insurance Coverage.
      -Ensuring Coverage for Individuals Participating in Clinical Trials.
      -Making Care More Affordable. Tax credits to make it easier for the middle class to afford insurance will become available for people with income between 100% and 400% of the poverty line who are not eligible for other affordable coverage.
      -Establishing Affordable Insurance Exchanges.
      -Increasing the Small Business Tax Credit.
      -Promoting Individual Responsibility. Under the law, most individuals who can afford it will be required to obtain basic health insurance coverage or pay a fee to help offset the costs of caring for uninsured Americans. If affordable coverage is not available to an individual, he or she will be eligible for an exemption.
      -Ensuring Free Choice. Workers meeting certain requirements who cannot afford the coverage provided by their employer may take whatever funds their employer might have contributed to their insurance and use these resources to help purchase a more affordable plan in the new health insurance Exchanges.

      The new feature for 2015 is:
      -Paying Physicians Based on Value Not Volume. A new provision will tie physician payments to the quality of care they provide. Physicians will see their payments modified so that those who provide higher value care will receive higher payments than those who provide lower quality care. 07-12

  2. -Affordable Care Act News (CBS News)
      Provides news on Obamacare. 11-13

  3. Affordable Care Act (
      "On September 23, 2010 new reforms under the Affordable Care Act begin to bring to an end some of the worst abuses of the insurance industry. These reforms will give Americans new rights and benefits, including helping more children get health coverage, ending lifetime and most annual limits on care, and giving patients access to recommended preventive services without cost-sharing."

      "These reforms will apply to all new health plans, and to many existing health plans as they are renewed. Many other new benefits of the law have already taken effect, including rebate checks for seniors in the Medicare donut hole and tax credits for small businesses. And more rights, protections and benefits for Americans are on the way now through 2014." 11-10

  4. Who Is Buying in to Obamacare? (MSNBC News)
      "After stumbling out of the gate in early October, the nation’s new health-insurance exchanges are picking up steam. On the eve of the December 23 deadline for securing coverage that starts January 1, more than a million Americans have completed the enrollment process, according to the Commonwealth Fund. Just over half of the new enrollees (621,000) have joined Medicaid programs, and 525,000 have purchased private plans through the marketplaces." 12-13

  1. -01 Affordable Care Act "Obamacare" Insurance Cost Calculator (Kaiser Family Foundation)
      "This tool illustrates health insurance premiums and subsidies for people purchasing insurance on their own in new health insurance exchanges (or 'Marketplaces') created by the Affordable Care Act (ACA). Beginning in October 2013, middle-income people under age 65, who are not eligible for coverage through their employer, Medicaid, or Medicare, can apply for tax credit subsidies available through state-based exchanges."

  2. -01 Affordable Care Act "Obamacare" News (Wasthington Post)
      "On Oct. 1, millions of Americans gained access to the new marketplaces mandated by President Obama’s health-care law. Check back regularly for the latest news on the launch of the Patient Protection and Affordable Care Act and the ongoing political fight over the law in Congress."

  3. -01 Enrolling in Obamacare: What You Need to Know (CNN News)
      "If you have Internet access, start with the Web. Beginning October 1, will have the information you need. The government site will link to where you sign up for the program."

      "Go first to 'get insurance.' That tab will get you to a page that will walk you through whatever marketplace is available to you. Some states set up their own; the federal government runs the rest. On this site you can also compare the plans available in your area."

  4. -01 Summary of What is NOT in the Affordable Health Care Act (
      "Most of what the e-mail says is wrong. In fact, it's a clearinghouse of bad information circulating around the Web about proposed health care changes, so we thought it would be helpful to address a bunch of its claims." 07-12

  5. -01 Timeline for the Affordable Health Care Act (
      "View items by selecting blocks on the timeline, or click the arrows. You can also see all of the timeline items on one page in printable format. Read the Affordable Care Act in full or browse it section by section." 07-12

  6. -Affordable Care Act (Government Printing Office)
      Provides the text of the Patient Protection and Affordable Care Act. 08-12

  7. -Affordable Care Act (
      "On September 23, 2010 new reforms under the Affordable Care Act begin to bring to an end some of the worst abuses of the insurance industry. These reforms will give Americans new rights and benefits, including helping more children get health coverage, ending lifetime and most annual limits on care, and giving patients access to recommended preventive services without cost-sharing."

      "These reforms will apply to all new health plans, and to many existing health plans as they are renewed. Many other new benefits of the law have already taken effect, including rebate checks for seniors in the Medicare donut hole and tax credits for small businesses. And more rights, protections and benefits for Americans are on the way now through 2014." 11-10

  8. -Affordable Care Act: Timeline by Type of Provision (Kaiser Family Foundation)
      "The implementation timeline is an interactive tool designed to explain how and when the provisions of the health reform law will be implemented over the next several years."

      "You can show or hide all the changes occurring in a year by clicking on that year. Click on a provision to get more information about it. Customize the timeline by checking and unchecking specific topics." 11-12

  9. -Editorial: Republicans Are Misleading About Obamacare (
      "Both Cruz and Rubio are screaming fire in a crowded theater when they describe Obamacare as 'job-killing.' ”

      "The bottom line is that Obamacare is not a disaster, but it could have been—and could still be—made better if the Republicans had decided to negotiate a more efficient system. The original Heritage Foundation plan had the advantage of being intellectually honest; it covered everyone, it limited the deductibility of health insurance for wealthier people, but it assumed that individuals could decide the type of health care they wanted. I still think it’s a good idea."

  10. -Editorial: Stop Discrimination in Health Insurance Costs (CNN News)
      "Women face shocking disparities when buying health insurance on the individual market: In the vast majority of states, nearly all the best-selling plans charge women more than men for the same coverage, a discriminatory practice known as 'gender rating.' "

      "New research by the National Women's Law Center released Monday shows that, in states that have not banned gender rating, 92% of the top plans charge women more -- despite the fact that the vast majority of them do not cover maternity services. This indefensible practice will not abate until the Affordable Care Act is fully implemented in 2014."

      "The discrimination is so pronounced and the practice so arbitrary that in most states, women who do not smoke are often charged more than men who do smoke. For example, the center found that 56% of best-selling plans charge a 40-year-old woman who does not smoke more than a 40-year-old man who does." 03-12

  11. -Editorial: The Health Care Act and Cancer (CNN News)
      This editorial is by John R. Seffrin. Seffrin the is chief executive officer of the American Cancer Society and its advocacy affiliate, the American Cancer Society Cancer Action Network (ACS CAN)."

      "The debate over health care has been epically divisive. But it is almost universally accepted that the existing health care system is badly in need of repair. People with cancer and other life-threatening chronic diseases have long been routinely denied coverage outright, charged exorbitant costs for care and forced to spend their savings to get the care they need, simply because they have a pre-existing condition."

      "The law addresses this national moral failing with numerous provisions that help to expand access to quality, affordable health care, including those that prohibit insurance companies from denying coverage to people with pre-existing conditions, charging patients higher premiums because of their health status and suddenly revoking coverage when a person falls ill with a disease such as cancer." 06-12

  12. -Has "Obamacare" Caused Reduced Work Hours? (
      "One of the most-cited arguments made by opponents of Obamacare is that the law is bad for business. The Affordable Care Act requires that companies with more than 50 full-time workers provide health insurance and the law’s critics have faulted this provision for accelerating a trend of businesses scaling back hours and eliminating full-time jobs in favor of part-time positions. Writing in the Detroit News in September, Republican Rep. Mike Rogers said the health care law had caused an 'unsettling trend of a permanent part-time workforce.' CNBC’s Maria Bartiromo said as recently as Sunday the health care law was transforming the U.S. into a 'part-time employment country.' ”

      "The problem with this line of thought was that there wasn’t any good evidence to support it. And a new federal jobs report released Tuesday shows that Obamacare’s effect on employment is not what its critics have claimed."

      "After an uptick in part-time work earlier this year, which Republicans seized on to attack the law, the new jobs report shows that, for the second straight month, the number of part-time jobs reported by the Bureau of Labor Statistics fell."

  13. -How Medicaid Expansion Could Impact Each State (
      Provides a map of potential Medicaid coverage by state. "The United States would inch closer to universal health care by expanding the Medicaid program to about 17 million low-income people. The federal government would pick up 100 percent of the tab for the expansion and force states to pay for 10 percent of the cost a few years down the line."

      "But in its ruling on the Affordable Care Act last Thursday, the Supreme Court added a twist: Expanding Medicaid is constitutional, the justices ruled, but forcing states to participate by threatening to withhold the rest of their Medicaid cash is not." 06-12

  14. -New Preventive Health Services Now Free (
      "From birth control to breast-feeding support, American women are now eligible for eight additional preventive health care benefits without copay under the Affordable Care Act."

      "Comprehensive preventive care coverage will now be provided for insured women enrolling in new health care plans or renewing their existing policies on or after Aug. 1, 2012." 08-12

  15. -Patient Protection and Affordable Care Act (
      "The Patient Protection and Affordable Care Act (PPACA)[1][2], is a United States federal statute signed into law by President Barack Obama on March 23, 2010. The law (along with the Health Care and Education Reconciliation Act of 2010) is the principal health care reform legislation of the 111th United States Congress. PPACA reforms certain aspects of the private health insurance industry and public health insurance programs, increases insurance coverage of pre-existing conditions, expands access to insurance to over 30 million Americans,[3][4] and increases projected national medical spending[5][6] while lowering projected Medicare spending.[7]"

      "Insurers are prohibited from imposing lifetime dollar limits on essential benefits, like hospital stays, in new policies issued.[48]

      Dependents (children) will be permitted to remain on their parents' insurance plan until their 26th birthday,[49] and regulations implemented under the Act include dependents that no longer live with their parents, are not a dependent on a parent’s tax return, are no longer a student, or are married.[50][51]

      Insurers are prohibited from excluding pre-existing medical conditions (except in grandfathered individual health insurance plans) for children under the age of 19.[52][53]

      Insurers are prohibited from charging co-payments, co-insurance, or deductibles for Level A or Level B preventive care and medical screenings on all new insurance plans.[54]

      Individuals affected by the Medicare Part D coverage gap will receive a $250 rebate, and 50% of the gap will be eliminated in 2011.[55] The gap will be eliminated by 2020.

      Insurers' abilities to enforce annual spending caps will be restricted, and completely prohibited by 2014.[36]

      Insurers are prohibited from dropping policyholders when they get sick.[36]

      Insurers are required to reveal details about administrative and executive expenditures.[36]

      Insurers are required to implement an appeals process for coverage determination and claims on all new plans.[36]

      Enhanced methods of fraud detection are implemented.[36]

      Medicare is expanded to small, rural hospitals and facilities.[36

      ] Medicare patients with chronic illnesses must be monitored/evaluated on a 3 month basis for coverage of the medications for treatment of such illnesses.

      Non-profit Blue Cross insurers are required to maintain a loss ratio (money spent on procedures over money incoming) of 85% or higher to take advantage of IRS tax benefits.[36]

      Companies which provide early retiree benefits for individuals aged 55–64 are eligible to participate in a temporary program which reduces premium costs.[36]

      A new website installed by the Secretary of Health and Human Services will provide consumer insurance information for individuals and small businesses in all states.[36]

      A temporary credit program is established to encourage private investment in new therapies for disease treatment and prevention.[36] 01-12

  16. -Patient Protection and Affordable Care Act: Profits Soar (San Francisco Chronicle)
      "Insurance companies spent millions of dollars trying to defeat the U.S. health care overhaul, saying it would raise costs and disrupt coverage. Instead, profit margins at the companies widened to levels not seen since before the recession, a Bloomberg Government study shows."

      "Insurers led by WellPoint, the biggest by membership, recorded their highest combined quarterly net income of the past decade after the law was signed in 2010, said Peter Gosselin, the study author and senior health care analyst for Bloomberg Government. The Standard & Poor's 500 managed health care index rose 36 percent in the period, four times more than the S&P 500." 01-12

  17. -Seniors Saved $3.7 Billion Under Health Care Act (CNN News)
      "More than 5.2 million Medicare beneficiaries have saved a total of $3.7 billion on their prescription drugs since the health care reform law went into effect, the Centers for Medicare & Medicaid Services said Monday."

      "The Affordable Care Act -- also known as health care reform -- which passed in 2010 mandated financial relief for seniors who fall into Medicare's so-called 'donut hole.' " 06-12

  18. -Status of Obamacare, State by State (
      "The accompanying chart, based on a new report from the Commonwealth Fund, shows how different parts of the law are faring nationwide. Here are some of mixed-bag approaches states are taking to health care reform...." 02-14

  19. -Summary of the Patient Protection and Affordable Health Care Act (Henry J. Kaiser Family Foundation)
      Provides an analysis and summary. "The Kaiser Family Foundation is a non-profit private operating foundation, based in Menlo Park, California, dedicated to producing and communicating the best possible analysis and information on health issues." 07-12

  20. -Supreme Court Rules Most of the Affordable Care Act Is Constitutional (
      "In a historic decision, the Supreme Court on Thursday upheld the critical piece of President Obama's Affordable Care Act, the individual mandate."

      "By upholding the individual mandate -- the requirement for all Americans to acquire health insurance -- the court kept what many described as the 'heart' of the law. The decision creates some certainty surrounding federal health care policy, allowing federal and state rulemakers to implement the law."

      "The decision was 5 - 4, with Chief Justice John Roberts siding with the liberal justices and writing the majority opinion. The court ruled that the federal government does have the power to require all Americans to acquire insurance if the 'fine' imposed on those who don't is considered a tax." 06-12

  21. Obama Care's Other Surprise (New York Times)
      "The combination of Obamacare regulations, incentives in the recovery act for doctors and hospitals to shift to electronic records and the releasing of mountains of data held by the Department of Health and Human Services is creating a new marketplace and platform for innovation — a health care Silicon Valley — that has the potential to create better outcomes at lower costs by changing how health data are stored, shared and mined. It’s a new industry."

      "Obamacare is based on the notion that a main reason we pay so much more than any other industrial nation for health care, without better results, is because the incentive structure in our system is wrong. Doctors and hospitals are paid primarily for procedures and tests, not health outcomes. The goal of the health care law is to flip this fee-for-services system (which some insurance companies are emulating) to one where the government pays doctors and hospitals to keep Medicare patients healthy and the services they do render are reimbursed more for their value than volume."

      "To do this, though, doctors and hospitals need instant access to data about patients — diagnoses, medications, test results, procedures and potential gaps in care that need to be addressed. As long as this information was stuffed into manila folders in doctors’ offices and hospitals, and not turned into electronic records, it was difficult to execute these kinds of analyses. That is changing. According to the Obama administration, thanks to incentives in the recovery act there has been nearly a tripling since 2008 of electronic records installed by office-based physicians, and a quadrupling by hospitals." 05-13

  22. President Obama Claims that the Obamacare Website Is Fixed (
      "The administration’s push comes as its “end of November” deadline for fixing the troubled website expired, and the results are mixed. According to CMS, which runs the website, error rates and response times have been significantly reduced, while capacity has been increased to handle 50,000 concurrent visitors and 800,000 visitors per day. More than 400 software fixes have been made as “private sector velocity” in the parlance of the administration. But it is still a work in progress, even as the administration claims they’ve met their goal of having the site work for 80% of users. Core functionality of the site still needs to be built in the coming months, and it is far from a completely stable platform. The site still suffers from long periods of planned downtime as engineers install and test software patches, and hundreds of fixes still need to be made."

      "On Friday, America’s Health Insurance Plans (AHIP) President and CEO Karen Ignagni released a statement saying that while the website is getting better, insurers still have concerns." 11-13

  23. Taxes Related to the Affordable Care Act (Internal Revenue Service)
      Provides the tax-related provisions. 06-12

  24. The Roberts Ruling on the Affordable Health Care Act (Christian Science Monitor)
      "In effect, Roberts and four members of the court’s liberal wing ruled that what Congress called a “penalty” in the ACA was really a 'tax.' "

      "The distinction is huge. It means that Congress intended the payment as an incentive for Americans to buy health insurance, not as punishment for those who failed to obey the federal command."

      "While Congress had never before tried to use its Commerce Clause power to compel Americans to buy a product they did not wish to purchase, there is nothing new about Congress using taxes or tax credits to encourage Americans to buy something they may not want."

      " 'Sustaining the mandate as a tax depends only on whether Congress has properly exercised its taxing power to encourage purchasing health insurance, not whether it can,' Roberts wrote."

      " 'Upholding the individual mandate under the Taxing Clause thus does not recognize any new federal power,' he said."

      "Power was the whole point of the legal challenge to the health-care reform law." 06-12

  25. What Are the Biggest Barriers to Practicing Medicine Today? (
      "What's the biggest barrier to practicing medicine today? That's just the first of 10 questions the MedPage Today staff is asking leading clinicians and researchers to get their personal views on their chosen profession. In this series we share their uncensored responses." 12-13

  1. Quiz on the Affordable Health Care Act (Christian Science Monitor)
      Provides a quiz. 06-12


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