What You Need to Know About the ACA

In the next few weeks and months, big changes will be coming in health insurance. The bulk of these changes won’t affect you if you get health insurance through your employer, as most SEA members do. There are also changes that have gone into place already, and those benefit everyone.

All of these changes are part of the Affordable Care Act (ACA), which was approved by Congress in 2010 and upheld by the Supreme Court in 2012. Over the next few weeks, we’ll attempt to break down some of these changes in a series of articles in the SEA News. While we can’t possibly explain every bit of the ACA, we will try to simplify it a bit and point you in the direction of more information.

You’re probably wondering how all of this will affect you and your family. In short:

  • If you already have insurance, the ACA provides new consumer protections and aims to cut costs.
  • If you don’t have insurance, the ACA provides a streamlined marketplace where you can buy insurance. The marketplace will even quickly let you know if you qualify for Medicare or Medicaid, or if you can save money on insurance.

If you have insurance, you might have friends, family members or co-workers (most part-time state workers don’t qualify) who are uninsured, and in learning more about the ACA you can help make sure they get coverage. As a union, we work together to lift everyone up, and making sure that everyone has access to good, affordable health care is a big part of that.

Change is a key word with the ACA, and we’ll get to the upcoming changes next week. For this week, we’ll focus on changes that have been put into place so far.


ACA changes, so far

A big part of the ACA was installing benefits and protections that consumers didn’t have before. These affect everyone with insurance, regardless of whether you’re insured through work or if you purchase coverage yourself.

Two of the biggest benefits so far affect coverage for young adults and preventive care.

  • Young adults can now stay on their parents’ insurance until they turn 26. Previously, coverage would end when the young adult hit age 19 (or 23 for a full-time student). Earlier this year, the White House said 2.5 million young adults now have coverage because of this change.
  • The ACA has also increased access to free preventive care. Insurers must now provide free access to care such as yearly checkups, cancer screenings and immunizations. According to the White House, 54 million more Americans, are receiving care that will help prevent them from getting sick in the first place.

When it comes to protections, there’s a lot insurers can’t do. For example, insurers can no longer:

  • Impose lifetime limits on coverage: This means someone with a major illness won’t have to go into debt just because his or her coverage has run out.
  • Impose low annual dollar limits on coverage: This year is the last insurers can set an annual limit.
  • Cancel your policy because you’re sick: The practice known as “recission” is now illegal.
  • Deny children due to pre-existing conditions: Starting next year, this will be true for adults, too.
  • Funnel your money into their big salaries and bonuses: Insurers must spend at least 80 percent of premiums on medical care and quality improvements. If too much is spent on overhead, like salaries, bonuses or administrative costs, insurers must issue premium rebates.

That’s a lot of info to take in, so we’ll pick up next week. In the meantime, you can check out this fun, informative video from the Kaiser Family Foundation that will give you a broad overview of the entirety of health reform.

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