The Patient Protection and Affordable Health Care Act is a US federal statute which President Barack Obama signed into law in 2010.
Its main objective is to decrease the number of uninsured people in USA. It also aims to reduce health care costs. In order to increase the rate of coverage, there are various mechanisms like subsidies, tax cuts and mandates which are provided in the statute. In order to improve healthcare outcome and to streamline the delivery of health care there have been additional reforms written.
PPACA has multiple provisions that would become effective over the following years. With guaranteed provision, policies will need to be issued irrespective of the medical condition of the policy holder. Insurers will also need everyone to pay the same amount of premium. This should not vary because of age, gender, geographical conditions or any pre-existing medical or health conditions.
Individual mandates require shared responsibility between the insurer and the insured. This requires all individuals who are do not have coverage under public health insurance programs to purchase a secure private insurance. If not, they would need to pay a fine. This penalty can be waived for Individuals belonging to religious sections of the society that are exempted by IRS or if they are financially exempt due to hardships. Most states will start operating health insurance exchange programs where individuals can compare premium amounts across public and private health insurance and then choose the one that they can afford. Individuals from low income families can receive subsidies if they purchase insurance through the exchange. Certain states have also chosen to turn down Medicaid insurance plans. Medical insurance policies will need to establish minimal standards. There will be no caps for lifetime coverage. Any organization where fifty or more people are employed can pay shared responsibilities requirement if they do not offer health insurance and if the subsidized health care is being provided by the government to its employees. Similar to individuals, small businesses can also get subsidies if they buy health insurance through the exchange program.
The policy also has implemented changes that allow Medicare reimbursement forms to be restructured. Individuals can either pay fee per service or they can provide bundled payment packages. Single payments are paid to hospitals and physicians. Individual payments can be paid to individual physicians. PPACA has been divided into multiple titles as well as various provisions that either become effective immediately or after six months or provisions that have been phased all the way through 2020.
Effective immediately, FDA is authorized to provide generic versions of biological drugs. They are also expected to grant manufacturers of biological drugs 12 years of exclusivity before generic drugs can be developed. Medicaid drug rebate for some states has also been increased. This rebate has also been extended to managed care plans. Effectiveness research is to be undertaken by a non-profit outcomes research institute. Task forces have been set up to develop, analyze, update and distribute recommendations on how to use clinics and community prevention services. Restaurant chains and fast food vendors having 20 or more branches have to display caloric content of foods on menus, drive-by windows as well as vending machines.
It is estimated that the change in healthcare policies would reduce the number of uninsured individuals by 30 million. Among the uninsured, would be illegal immigrants, citizens who have not enrolled in Medicaid, citizens who are not covered and who refuse to pay penalties and such.
For specific types of insurance funded by employers, certain regulations have been put into place. These provide insurance to the employers at low cost. The employers buy insurance for their employees. However, coverage is very low. Such plans are usually only availed for low cost, part time workers.