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Laws of The Affordable Care Act

Summary of the Various Sections and Laws of The Affordable Care Act.

To understand the laws of the Affordable Care Act, first, it is pertinent to understand what the law says and what it is actually? To start with let us first define the bill. Rationale or explanation of the bill or law. The Patient Protection and Affordable Care Act (ACA) mainly focus on the healthcare section or segment in the United States of America. The legislation made radical changes across the country. It helped to reconstruct the total medical set up as well as the fiscal scenario of the United States of America. The law is a chunk or fragment from the Federal Legislation generally used or acted under the pseudonym or nickname of ” Obamacare”. It made a remarkable strike in the health insurance sector of the country. Instead, say that the legislation established a drastic measure throughout the country. The law or the Act got signed on March 23, the year 2010. The whole process of the reform and reconstruction of the law took place under the then President Barak Obama. The bill is a kind of landmark reform that passed under the 111th Congress under the guidelines of Obama. The Act or the legislation includes a long list of provisions, rules and regulations stated mainly with an aim to improve the health scenario of the country. The bill has been segregated or separated into many requirements and chapters, and somewhere it has certain complexities mention in its rules. And while reading or going through the whole act, it becomes difficult to understand the law sometimes. The sole motto of the legislation at a glance The Obama care reform was mainly formed or considered for profoundly changing the health and health-related insurance market of the country. The three main objectives instead say the primary aim of the bill is- i) To reconstruct or reform the private insurance market through which especially individuals and small group purchasers or business owners can effectively become beneficial.

  1. ii) It focused on changing the overall structure and scenario of the medical and health-related segment of the United States of America.

iii) To consider the health and medical condition of the poor or people who fall under the lower income group. The bill tried to throw light notably on the situation of the lower income section of the society. The legislation attempted to spread or to bring more people under the purview of Medicaid whose income is generally under 133% of the property level of the federation or federal property level. All these three objectives mainly rely on public choices rather than the government regulations and are subject to exceptions that provide or try to impact on rational decision making. The law in its provision tried to provides subsidies that lower the household costs with income ranging from 100% to 400% of the federal level of the property. The legislation suggested lowering the cost of medical expenses and improving and enhances the medical care and facilities in a modern, innovative way. The critical provisions mentioned in the law states to expand and extend coverage to millions of Americans who before the launching of the reform were not present under the scope of health insurance or to say was uninsured. The legislation also focused on improving system productivity or efficiency in the medical sector and to stop denial by the insurance service provider or to charge an extra premium due to the pre-existing cost of a patient. The law includes the provision of premium subsidies and subsidies based on cost sharing that aimed at reducing the cost of medical expenses for those who qualify for the insurance policy. Due to the expansion program of Medicaid program, many people came under the coverage of medical insurance program. Statistics and research analysis say that millions of Americans gained insurance due to the Medicaid policy achievement. During the Open Enrollment Period or OEP, an observation noted that millions of Americans have enrolled in ACA complied health programs and plans throughout the United States. Although the Affordable Care Act has gone or witnessed a far-sighted goal with the hunch of achieving a striding condition in the health scenario of the country, in reality, the bill does not address many aspects of appropriate mechanisms.


A glimpse of the provisions states in the Affordable Care Act.

The Act focuses on or seeks to curb down and lower the health care cost and ensured that more people could take part or participate in preventive care and healthy medical practices. The law tried to abolish confining practices that were previously observed by insurance service providers. As per the observation of various reports and analysis at the beginning of the year, 2019 Americans will no longer have to cultivate the coverage of their health insurance. Some essential provisions or critical features as stated in the law jotted down below-

  1. i) An insurance service provider prohibited from cancelling of policies when the holder of an insurance policy falls sick. The bill offers certain protections that make coverage more accessible. The law says insurance coverage must extend to people with a pre-existing condition or a pre-existing illness that may also include pregnancy and that extra charges in such case are not applicable.
  2. ii) The law provides young adults with more coverage options than earlier.

iii) It makes insurance providers responsible for increasing rates.

  1. iv) Under Obama care, health reform children can also hold health policies under the supervision of their families.
  2. v) The bill provides preventive care free of cost for the citizens.
  3. vi) The law essentially gives priority to a policyholder’s choice of doctor.

vii) It states that if a health insurance plan does not cover a child who is dependent on their family can come under the purview of their parent’s plan until the age of 26. Viii) The law runs a special program known to be Medicaid that covers people with a lower earning with 133 per cent of the federal poverty level.

  1. ix) The bill remarkably states that insurers can not place a limit on the hospital bills and essential medical requirements.
  2. x) The legislation provides patients with the right to appeal in front of the law if the insurance provider refuses payment for medical services.
  3. xi) The bill ensures and includes a provision that highlights the expenditure of premium dollar gained by the insurance service providers on health care services. It further states that insurance companies should spend around eighty-five per cent of revenues earned from premiums in the healthcare sector and essential medical services.

xii)  The Affordable Care Act provides a patient with Bill of Rights. It gives knowledge to patients about their choices of health-related services. xiii) To help patients in correctly understanding the terms and conditions of a health insurance the law binds insurance providers to issue a brief and proper summary of the insurance policy while they are opting for one. xiv) A provision has been marked that an insurance service provider cannot deny an insurance policy to a child detected with pre-existing illness under the age of 19 years.

  1. xv) The legislation caters to preventive care services primarily for the aged persons with a period of 65 years and above. It offers senior citizens a function of no cost sharing and special discount on drugs, generally termed as “donut hole.”

xvi) A typical situation that is faced by almost every American is that hardly they could visualise their life savings after their retirement because of the high amount or rate of premiums in the individual market condition. To conserve coverage by an employer for those who retire early and to make it more affordable the law has stated special provisions. The law created around five billion dollar programs to that could help assist financially to employment-based programs and plans.

Let us now take a refined look into the various sections of the Affordable Care Act law.

According to Section 277 of ACA, it mentioned that health plan for a group or group health insurance issuer could not limit on the dollar value. Instead, to say that a service provider can set no dollar limit for the lifetime. Section 2712 of the Act, says health plan of a group or an individual cannot be restricted or refrained by any health insurance service provider or company in case of any crisis or recession. Section 2713 states the coverage of preventive health services. It further elaborates that specific type of medical care to be provided to patients at no additional or extra cost. There are generally three sets of preventive medical care meant for women, all adults as well as children. Section 2714 states to extend dependable coverage. It states that a health insurance service provider extending medical insurance coverage to children are liable to provide health insurance benefits to an adult child if he or she is not married and has not yet attained an age of 26 years. According to section 2715, it is mandatory for almost every health insurance service provider or service providing company to present its client or policyholder with standardising documents and statements that clearly defines the definitions, norms as well as practices to be followed under a health policy. Section 2716, states that under no circumstances an employer or health insurance service provider can discriminate with an employee based on their salary. An employer is bound to provide health insurance benefit to any employee who is working full time or over thirty hours in a week. Section 2717, provides a provision that states to provide quality medical treatment and care at an affordable price or an affordable rate to every citizen dwelling in The United States of America. It says that after the launching of Patient Protection and Affordable Care Act healthcare service providers need to maintain quality in reporting case studies, disease management as well as medication to ensure proper medical service to patients. Section 2718, declares to slash down the rate or cost of essential medical care under policy coverage. It provides a provision for providing reimbursement to health policyholders for any clinical or medical related expenses. It further focuses on the improvement of health care quality throughout the nation. As per section 2719 of Patient Protection or Affordable Care Act, a health insurance company or individual issuer providing any group health insurance plan or health insurance coverage to any individual must keep provision for appeal. It means that in case of any loopholes in the policy an insurance holder can report the problem and seek justice in front of the law. According to Section 2793 of Obama care, health insurance application states that information and documentation of every health insurance policyholder should be strictly and. So that in case of any requirement the statements can be processed. As per the sections of the Obama care act, we can witness a noticeable reform in the medical sector of America.

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