The Affordale Care Act - What Floridians Need to Know

Written by Collett P. Small, Esq. on . Posted in Blog

In 2010, President Obama signed the comprehensive health reform, the Patient Protection and
Affordable Care Act (ACA), also known as Obama Care, into law. The ACA makes preventive
care, including family planning and related services, more accessible and affordable for many
Americans. Some provisions of the law have already taken effect; many more provisions will
be implemented in the coming years. Nationwide ACA enrollment began October 1, 2013 and
insurance coverage will begin January 1, 2014.

Many Floridians including our seniors and disabled citizens will benefit from the implementation
of the ACA. Some of the highlights of the ACA are: no penalties for preexisting conditions,
no more lifetime dollar limits on health benefits and the elimination of deductibles for many
preventative care treatments and screenings. There are approximately 3,509,167 Floridians who
do not currently have health insurance and who are qualified for coverage under the ACA.

Prior to the implementation of the ACA thousands of Floridians were unable to purchase
health insurance because of a preexisting health condition. Prior to the ACA insurance
companies would either deny coverage outright or charge higher premiums to individuals
with certain preexisting health conditions. Consequently, Floridians, who needed health
insurance the most, were often unable to obtain much needed health insurance and ultimately
unable to obtain much needed sometimes lifesaving medical care. Included in the number
of Floridians with preexisting health conditions were almost 1 million children. Under the
ACA, Floridians with preexisting health conditions will no longer be denied coverage as the
ACA ends the discrimination for preexisting conditions.

Under the ACA, insurance companies can no longer impose lifetime dollar limits on health
benefits. This allows very ill patients, such as cancer patients and individuals suffering from
other chronic diseases, to not worry about going without treatment because of their lifetime
limits.

In addition, insurance companies will now have to cover the full cost of preventative services
such as pap smears for cervical cancer, colonoscopy for colon cancer, mammograms, annual well
visit checkups, and flu shots without an insurance deductible or co-pay.

The ACA provides for an increase in funding to Florida community health centers. In
Florida, 49 health centers operate 426 sites, providing preventive and primary health care
services to 1,080,695 people. Health Center grantees in Florida have received increased
funding under the ACA. This money is slated to be used to support ongoing health center
operations, to establish new health center sites, and expand services to Floridians. Florida
health centers are expected to hire 163 additional workers, who will assist 158,160 Floridians
with enrollment into affordable health insurance coverage.

As an Elder Law attorney, I am especially concerned with the impact of the ACA on our seniors.
So far the ACA promises to provide Floridians with a stronger Medicare Program. Under
the ACA prescription drugs should be more affordable for our seniors. According to the U.S.
Department of Health and Human Services, Floridians with Medicare saved nearly $464 million
on prescription drugs because of the ACA. In 2012 alone, 237,344 individuals in Florida saved
over $161 million, or an average of $678 per beneficiary. In 2012, people with Medicare in
the "donut hole" received a 50 percent discount on covered brand name drugs and 14 percent
discount on generic drugs. Coverage for both brand name and generic drugs will continue to
increase over time until the coverage gap is closed.

Florida seniors will also benefit from being able to receive preventative services with no
deductible or co-pay. This elimination of an insurance deductible for preventive services
removes the cost barrier for seniors and people with disabilities who want to stay healthy by
detecting and treating health problems early. In 2012 alone, an estimated 34.1 million people
benefited from Medicare's coverage of preventive services with no cost-sharing. 1,823,396
Floridians with traditional Medicare used one or more free preventive service in 2012.

The ACA promises to protect Medicaid solvency by extending the life of the Medicare Trust
Fund by ten years. According to the US department of Health and Human Services, from
2010 to 2012, Medicare spending per beneficiary grew at 1.7 percent annually, substantially
more slowly than the per capita rate of growth in the economy. In addition the ACA helps
stop fraud with tougher screening procedures, stronger penalties, and new technology. For
more information please visit the health insurance market place in Florida at HealthCare.gov
and select Florida.