Introduction to Patient Protection and Affordable Care Act
This comprehensive health care reform law has three primary goals:
Make affordable health insurance available to more people. The law provides consumers with subsidies (“premium tax credits”) that lower costs for households with incomes between 100 percent and 400 percent of the federal poverty level.
Expand the Medicaid program to cover all adults with income below 138 percent of the federal poverty level (not all states have expanded their Medicaid programs).
Support innovative medical care delivery methods designed to lower the costs of health care generally.
Health Insurance Marketplace Basics
The Health Insurance Marketplace is a way for Americans to get health care coverage according to their budget and needs. Open enrollment is the yearly period when Americans can enroll in a health insurance plan. Consumers can enroll online at Healthcare.gov, by phone at 1-800-318-2596 or in person at local health centers and other facilities.
Open Enrollment for 2018 is over, but you may still be able to enroll in a Marketplace health insurance plan for 2018 if you qualify for a Special Enrollment Period.
The 2019 Open Enrollment Period runs from Thursday, November 1, 2018, to Saturday, December 15, 2018.
A preliminary analysis of the final Health Care Reform legislation includes: a nondiscrimination provision that includes NPs, recognition of NPs as primary care providers and leaders in public and home care medical home pilots and demonstrations, funding for nurse-managed clinics, funding for graduate nurse education and post graduate experience demonstrations, inclusion in primary care Medicare payment increases and inclusion in Accountable Care Organizations (ACOs). The bill language is replete with provider-neutral language that can help facilitate the utilization of NPs in many venues.
The bill, as passed, protects provider choice of health care provider. It also protects individuals with preexisting conditions, protects against caps and out of pocket requirements by insurance companies, provides for universal coverage, provides protections for small businesses, expands Medicaid and provides funding for health promotion and disease prevention.