We need the ACA

After repeated relentless attempts to “repeal and replace Obamacare” have failed, the Affordable Care Act continues to provide health care for millions of Americans. Like it or not, it is currently the law of the land, and the reality is, we all need it. The ACA provides many provisions that improve health and wellness for everyone across the country.

According to Mona Shattal, Ph.D., RN, FAAN, the Affordable Care Act has three main goals: leveling off rising health care costs, focusing on the quality of health care services rather than the quantity of services provided, and improving access to health care by reducing the number of uninsured Americans. The Affordable Care Act has achieved these goals. It started as the first critical step in national health care reform as no major federal legislation regarding health care had passed for nearly 50 years prior to the ACA.

Numerous benefits have been attributed to the legislation. The ACA ensures affordable coverage for more middle income families. The act provides billions of additional federal dollars for residents of states like West Virginia that participate in Medicaid expansion.  The ACA ensures coverage for those with chronic or serious illnesses by eliminating limits on the amount of lifetime benefits people can receive.

The ACA also provides no-cost coverage for preventive health services, such as immunizations, smoking cessation and cancer screenings like mammograms and PAP smears. The ACA makes prescription drug coverage more affordable for senior citizens and allows young adults to remain on their parents’ health plans until they are 26. The ACA also provides funding for grants for programs to reduce childhood obesity and to combat the drug problem that is ruining lives.

Despite the benefits of the ACA, there are admittedly some flaws. The legislation is meant to be the first step in health care reform. Continued work is necessary for the programs to be fully functioning and benefit all Americans, especially small business owners and those who are self-employed. It is not and has not been purported to be a perfect plan right from the start. However, the benefits far outweigh the faults.

Sadly, the Trump administration has taken striking steps to sabotage and dismantle the Affordable Care Act. Simon Rosenburg writes in U.S. News and World Report that the enrollment period was cut from 12 weeks to six weeks. Spending for marketing to the public was slashed from $100 million to $10 million. And perhaps worst of all, regional directors in the Department of Health and Human Services “were told not to participate in outreach events” and administrators took down healthcare.gov on Sunday mornings during the shortened six-week period.

Here are the facts. The enrollment period runs from Nov. 1 through Dec. 15. People who are already enrolled in the ACA who do not participate in open enrollment will be placed into the same or a similar plan for next year. Some things will remain the same. Consumers may sign up on the federal exchange at healthcare.gov or their state marketplaces. People who qualify can still obtain subsidies to offset some costs and help lower premiums or reduce deductibles and copays. They can still compare coverage options of various available health care plans.

There have been some major changes to the ACA for 2018.  Silver plans are more expensive. According to Tami Luhby for CNN Money, premiums for the “benchmark silver Obamacare plan will soar 37 percent on average,” depending on the state. Many insurers raised the rates of the silver plan to make up for the cost-sharing subsidies the Trump administration cut for 2018.

Gold policies are more affordable for some consumers. The average premium for “the lowest cost gold plan is rising only 19 percent.” The plan has a much lower deductible than other plans. Other policies may also be more affordable. An expanded bronze plan can offer greater savings on health insurance. This plan has lower premiums, but pays less for out-of-pocket costs, which may be more attractive to those who have less expenditures for health care overall. Many enrollees may be able to obtain much more affordable coverage, and some for no monthly costs. For example, a 48-year old with an annual income of $30,000 may find a bronze plan with a zero-premium policy.

Enrollees may also skip healthcare.gov. Third-party websites now offer enrollment directly. Consumers can shop for various plans and receive guidance from insurance agents and brokers. Help in completing applications can also be obtained through the open market. It is important to compare the many options and to make an informed decision based on individual needs. Assistance in finding the best possible plan can be obtained online at healthcare.gov or individual insurance websites, by phone with the Marketplace Call Center, or in person through individual insurance agents in local areas.

As of today, there are 37 days left to enroll. We all need to take advantage of the changes that have occurred and ensure that we receive the best possible health care coverage to meet our needs. Currently about 1 in 12 Americans receive their health insurance and health care through provisions of the ACA.  It is up to us, the citizens of American, to make sure that people understand and take advantage of the enrollment period and to make the Affordable Care Act even better to keep improving health care in America.

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