In California, acupuncture providers are preparing for a surge in
patients following implementation of the Affordable Care Act,
HealthyCal reports (Bookwalter, HealthyCal, 6/18).
Under the ACA, health plans in state health insurance exchanges
must provide coverage for 10 broad categories of benefits, such
as maternity care, prescription drugs and preventive care
(California Healthline, 2/21)
Global consulting firm Accenture predicted that the number of
facilities located in retail stores will rise to nearly 3,000
by 2015. The clinics are expected to account for 10 percent of
non-primary care outpatient visits within three years.
On March 23, 2010, the federal healthcare reform legislation,
known as the Affordable Care Act, became law. The law is being
implemented in phases between now and 2014, and some provisions
are already in effect for Californians.
Benefits Available Today
The law creates a voluntary long-term care insurance
program–called CLASS–to provide cash benefits to adults who
Seniors who reach the coverage gap will receive a 50 percent
discount when buying Medicare Part D covered brand-name
prescription drugs. Over the next 10 years, seniors will receive
additional savings on brand-name and generic drugs until the
coverage gap is closed in 2020.
The law provides certain free preventive services, such as
annual wellness visits and personalized prevention plans for
seniors on Medicare.
The Community Care Transitions Program will help high-risk
Medicare beneficiaries who are hospitalized avoid unnecessary
readmissions by coordinating care and connecting patients to
services in their communities.
Californians age 19-26 can now stay on their parents’ health
Children under age 19 can no longer be denied health coverage
due to a pre-exisitng condition.
New health insurance policies can no longer impose lifetime
limits on new benefits.
Most young people feel like they have years of good health in the
bank. They are, as a group, so unlikely to buy insurance that
insurance companies dubbed them the young invincibles and in some
cases gave up on trying to enroll them in health care plans.
Some young adults, inevitably, will be proven wrong in their
optimistic evaluations of their health.
“We’re not invincible—no one’s invincible,” said California
organizer Tamika Butler. It’s not that people of her generation
don’t want insurance, Butler said, it’s that they can’t afford
Butler works for the Young Invincibles, an organization created
in 2009 by two millennials who wanted to reclaim the term and
advocate for health coverage for their generation.
Many advocates and experts wonder if the Affordable Care Act will
actually make care more affordable for young people – or if the
young will simply end up paying the price of lowering costs for
everyone else. The “age-rating” provision of the ACA prevents
insurers from charging an older client more than three times the
amount they charge a younger client. In most states, the rate
stands at 5 to 1. To make up for charging older people less,
insurers are expected to start chargine younger people more once
the provision goes into effect in 2014.
Right now, young people are generally benefiting from protective
changes ushered in by Obama care.
Possibly the most popular provision of Obamacare was the
expansion of dependent coverage so that young people can stay on
their parents insurance until age 26. Even those who want to
repeal the legislation want to keep that provision intact. As one
of the first provisions enacted, it’s also one of the first
indicators to be evaluated.
The data suggests the change was a success in increasing the
number of Americans with insurance. “The total enrollment
exceeded original expectations,” said Harvard assistant professor
and senior advisor to the Department of Health and Human Services
More than 3 million young people gained insurance between
September 2010 and December 2011 because of the change, Sommers
found. In his analysis, youth of all socioeconomic and racial
backgrounds benefited from the provision.
“It’s hard to see whether it narrowed disparities,” Sommers said.
“But we’ve really seen broad benefits in coverage.”
Those who it helped the most were single, male and out of school.
“The biggest gains tended to be in kinds of people who had fewer
options,” Sommers said.
In the past, married young adults have had more health-care
possibilities through a spouse, so the legislation helped to
provide single young adults with another option through their
parents. Women were also more likely to be insured, so Sommers
said that the provision helped men catch up. Before the change,
many insurers allowed young people to stay on their parent’s
insurance while in college, so the provision also provided a new
option for those no longer in school.
Sommers also found that young adults with poor health were most
likely to get coverage in the first few months of the provision.
Because of the provision, 23-year-old Kurt Henlin was able to
stay on his parents insurance after he graduated from Temple
University last May. His mother has insurance through her job as
an administrator at Bronx Community College.
You receive a phone message that, because of the recent Supreme
Court decision to uphold the Affordable Health Care Act, you have
an opportunity to get health care at substantially discounted
rates. You call the 800-number, and the salesperson offers
“superior” health insurance at “group” rates with savings of 50
percent or more.
However, be aware of several scams that boast a special affinity
to this federal act.
The healthcare law’s $2,500 annual cap on flexible spending
accounts will amount to a tax on older and sicker Americans.The
central provisions of the Affordable Care Act require younger and
healthier Americans to buy insurance policies that will, in
essence, subsidize the healthcare of older and sicker Americans.
But one of Obamacare’s hidden taxes — a new limit on
contributions to health flexible spending accounts, or FSAs —
will hit older and chronically ill individuals hardest.
Covered California™ is
the official website for California’s new marketplace for
affordable, private health insurance under the new healthcare
reform law, the Affordable Care Act. Covered California’s mission
is to increase the number of Californians with health insurance,
improve the quality of health care for all of us, reduce health
care coverage costs and make sure California’s diverse population
has fair and equal access to quality health care. You will have
the ability to choose the health plan that offers the best
services at the greatest value for you – insurance that can’t be
dropped or denied if you have a pre-existing medical condition
(any illness or condition a patient has prior to obtaining
Confused about how the new health reform law really works? This
short, animated movie –
featuring the “YouToons” — explains the problems with the
current health care system, the changes that are happening now,
and the big changes coming in 2014. Learn more about how the
health reform law will affect the health insurance coverage
options for individuals, families and businesses with the
interactive feature “Illustrating Health Reform: How Health
Insurance Coverage Will Work.”
Creation of worksite wellness programs is promoted by parts of
the Affordable Care Act. If your office doesn’t have a gym, it
soon might — out of the company’s interest.
Ever since Karen Straub had her thyroid removed because of cancer
in 1999, she has struggled with her weight. She became diabetic
and suffered from terrible acid reflux. So when her boss,
California State Controller John Chiang, started a worksite
wellness program for his staff, Straub decided to give it a try.
She joined new Weight Watchers at Work meetings during lunch on
Thursdays. She beams activity data from her accelerometer to the
Healthrageous website, which allows her to track her activity and
interact with her co-workers through a social media platform.
Three years after Congress passed the Affordable Care Act, the
landmark law now known as Obamacare is finally nearing full
implementation. This week, veteran health care writer Emily Bazar
presents the second of her question-and-answer columns to help
answer questions. “Ask Emily” runs twice a month.
Central Coast small-business owners and employees soon will have
an opportunity to learn firsthand how the Affordable Care Act
will affect them.The Governor’s Office of Business and Economic
Development (Go-Biz) is presenting a working lunch for small
businesses on the new federal health-care law. It will be held
from 11:30 a.m. to 1:30 p.m. Friday, June 7 in the cafeteria at
Santa Barbara City College, East Campus, 721 Cliff Drive in Santa
Michael Lujan of Covered California, formerly known as the
California Health Benefit Exchange, will explain how the
Affordable Care Act will affect small businesses in California.
Health-care coverage under the Affordable Care Act begins Jan. 1,
2014; the act provides financial assistance to help small
businesses pay for health insurance.
Beginning next year, nearly 5 million uninsured Californians will
rapidly gain health coverage thanks to the Affordable Care
Act. This is wonderful news, especially for those who need
it most– the 1.4 million newly eligible for Medical.
However, the reality is that coverage does not necessarily mean
access to care. Simply having insurance doesn’t
guarantee Californians can actually receive attention if there is
a shortage of caregivers, namely primary care physicians
(PCPs). Even with health care reform, California does not
have enough of these doctors; this is partly due to the shortage
of primary care physicians and the lure of higher pay in
specialty practice. Medical students entering family practice
medicine as a specialty is on the decrease as well.
Not to mention, clinics in rural and urban areas will receive a
flood of millions of newly insured patients. Training physicians
can take up to 10 years and frankly, patients can’t afford to