Friday, February 13, 2015

Health Reform--What's In it For Me ?

The quick answer is, that depends.

February 15, 2015 Open enrollment ends for 2015

The Affordable Care Act has raised questions that were unforeseen for patients and providers.  It's stated goal was to provide affordable care for all.

In 2010 the conventional wisdom was there were 40 million Americans (according to HHS)who were uninsured and the plan would more or less provide an avenue for people to find suitable and obtainable insurance coverage for themselves and their families.   According to a recent statement at Whitehouse.gove/healthreform about 10 million Americans have been added to the insurance pool.  

The affordable care act is not socialized medicine. Term is often used in a pejorative manner in the U.S.

It utilizes a multitude of private insurers, establishing a rigid set of requirements to be eligible to participate in the new system. Many of the changes involve standard and requirements for eligiblity. It is built upon an already complex system, chaotic in many ways which can be compared to a Gordian knot.  I compare it to a golf ball with an inner core of elastic material wound into the shape of a ball.  Upon that core is now another layer of material made up of composite and plastic material.

Federal and State Health Information Exchanges provide the portal into health insurance for the unemployed, disabled and other persons who are uninsured due to previous limitations of prior existing conditions. It also eliminated the 'cap' on maximum coverage, and reimbursement exclusions for certain type of healthcare, some of which are .

 Health insurance marketplace In the United States, health insurance marketplaces,[1] also called health insurance exchanges, are organizations set up to facilitate the purchase of health insurance in each state in accordance with Patient Protection and Affordable Care Act (ACA, known colloquially as "Obamacare"). Marketplaces provide a set of government-regulated and standardized health care plans from which individuals may purchase health insurance policies eligible for federal subsidies.

The HIX uses a complex set of algorithms to determine the amount of subsidy an applicant can expect for a plan  There are tiers using different insurance companies, medicaid, and levels of deductibles, and co-pays. Initially the HIX online was UNUSABLE for prospective enrollees. The re-design is  better. 

For more information see..... Health Care That Works

2015 is the second iteration for HIX enrollment. The target audience is smaller, and more difficult to enroll. These are the people who  cannot afford the premiums even with the subsidy. The site offers a question / answer format with animation. It is well designed for consumers with attention-getting design.

Post a Comment