Despite the kerfuffle, the Affordable Care Act (ACA), or Obamacare, has arrived. Health care exchanges opened to the public for the first time on October 1, 2013, allowing individuals to sign up for marketplace insurance plans that will begin coverage on January 1, 2014. 不幸的是, many of the men and women seeking health care coverage through their state's health-insurance exchange are still 被律法迷惑 and are uncomfortable making a decision for themselves or their families. 不过, 可以预见收益, though unintended consequences loom with the ACA's implementation.
Allow me to highlight some of the benefits of the ACA. In 2014, when policies sold in the exchanges go live, they must cover 10 essential health benefits: (1) hospitalization, (2)门诊服务, (3)应急服务, (4) maternity and newborn care, (5) mental health and substance-abuse services, (6)处方药, (7)实验室检测, (8) chronic disease management, (9) pediatric services and (10) rehabilitative services. Furthermore, preventative care is free, and out-of-pocket expenses will be limited starting in 2015.
Consumers will find there are four plan options, or "金属层," to choose from: bronze, silver, gold and platinum. It is important to understand that the tiers do not represent quality but the total share of monthly premiums. 例如, a gold plan will pay 80 percent of average health care expenses, and an enrollee will be responsible for 20 percent of expenses through deductibles, 相关费用, 等. Premium subsidies and cost-sharing credits will be available to individuals and families based on their income tax returns.
然而, some part-time workers now covered by employer-paid health insurance may not see the promise fulfilled. If the employer chooses to reduce an employee’s hours to fewer than 30 per week in order to avoid paying for his/her health-care plan, that employee will be on his/her own to choose an adequate plan at a cost s/he may or may not be able afford. Because that person will be shopping as an individual on exchanges, s/he will pay more for reduced benefits. And because s/he will be working fewer hours, his/her weekly pay will be reduced.
News reports of these unanticipated consequences of the ACA have generated heated discussions. Opponents of the ACA will see that voters hear more about the negative effects on part-time workers in the 2014 political campaigns. Unions will focus efforts to make sure that workers will not lose the contracted benefits of health insurance. Only time will tell if the ACA will be a colossal success, a mega failure or another mediocre government program. For now, all we can do is wait and see if the promised benefits of the ACA will become reality.
By Jeremy Howell, MHA, CTU 教师, 医疗保健
Jeremy Howell is a member of CTU’s 医疗保健 教师. A career officer with the U.S. 海军, he is a lieutenant in the 海军's Medical Service Corps, and he currently serves at the Bureau of Medicine and Surgery. He holds a Master’s in Health 政府 from the U.S. Army-Baylor University, and his undergraduate degree from Embry-Riddle Aeronautical University. Opinions expressed herein are solely those of the author and do not necessarily reflect those of his employer(s).
