In this second part of our two-part series on the Affordable Care Act, we answer some of the common questions consumers may have about how the new law works. For more background on the history of the law and its major provisions, please read Part I of the online series.
Who controls the healthcare exchange?
While the original plan was for each state to control their own healthcare exchange, only 16 states and the District of Columbia are running the programs all on their own. The remaining states are either receiving help from the federal government, or the federal government is completely responsible for the program.
How can I obtain individual insurance?
A website has been set up in every state where individuals who are not insured by their employer or other sources can comparison shop for individual and family plans. Though the launch of the federal website has been marred with glitches and slow load time, the ultimate vision of the site is that individuals will be able to enter information about their specific health care needs and then choose the plan that fits best. States that are running their own healthcare exchange will also run their own website.
How will insurance companies determine rates?
Under the Affordable Healthcare Act, insurance companies may not use gender or current health status as a basis for determining insurance premiums. They may only price packages based on whether it is individual or family coverage, where the person lives, how old they are and whether or not they use tobacco.
What is the downside to covering people pre-existing conditions?
One of the reasons why some people oppose this model is because since insurers cannot charge individuals more money based on pre-existing conditions, they may charge a higher premium to everyone, in order to cover the costs of both sick and healthy people.
How will the Affordable Healthcare Act stop insurance companies from price gauging?
As part of the new law, insurance companies have to spend at least 80 percent of the premium that individuals or small businesses pay on actual healthcare costs, rather than overhead costs. If the company does not meet this standard, they will have to refund the individual or the small business.
What if you can’t afford to purchase health insurance?
Many people, particularly those who used to have bare minimum health insurance coverage, are concerned about the costs of their insurance rising. While it is true that most people will likely see an increase in their premiums, the actual numbers will vary. In an effort to minimize the impact on low-income families, the law includes instructions for subsidies to those individuals.
– By Samantha B. Rivers, Editor