Affordable Care Act: A Marketplace of Opportunity | LFA: Join The Conversation - Public School Insights

Affordable Care Act: A Marketplace of Opportunity | LFA: Join The Conversation - Public School Insights:

Affordable Care Act: A Marketplace of Opportunity

By Tarsi Dunlop on October 1, 2013

Healthy kids come to school better able to focus on classroom learning. Having access to quality affordable health care will only increase the quality of life for the nation’s youth, their families and the surrounding communities. In a time of economic hardship, the Affordable Care Act (ACA) ensures that millions of Americans who lack insurance now have access to affordable care. State-based health care marketplaces (or exchanges) open today and offer significant opportunities for students, parents, teachers and school communities across the country. Themarketplace is a one-stop shop, a site run either by your state or the federal government that allows you to fill out an application and compare health insurance options available in your area. Most Americans will be eligible to participate in the exchange; however, you can opt to remain on your employer’s plan if you already receive coverage.  You can learn more about your options, and eligibility, by going to www.healthcare.gov, and there are informative write-ups here, here, and here.
What does the ACA mean for…
Students?
-          Prohibits insurance companies from refusing coverage to or limiting the benefits to children because of a pre-existing medical condition. Approximately 28 million children will benefit from the removal of benefit limits.
-          Requires insurance plans to cover preventative services with no copayment. These free services include 27 preventative services for children, such as immunization vaccines, behavioral assessments, and substance abuse and depression screening for adolescents.
-          Ensures that students will be allowed to stay on their parents’ health insurance until age 26. Already, 3.1 million previously uninsured young adults have gained coverage through this provision.
Parents and Teachers?
-          Allows parents and teaches to easily compare and purchase high quality health insurance plans starting October 1^st, with coverage set to begin as soon as January 1, 2014.
-          Offers families one-stop shopping to learn about health insurance options and to make apples-to-apples comparisons of private insurance plans.
-          Establishes tax credits to middle-class families to afford health insurance and expands Medicaid, in participating states, to Americans making up to 133 percent of the federal poverty level ($31, 320 for a family of four).
-          Prohibits insurance companies from placing annual or lifetime caps on family plans or denying coverage to parents or teachers with pre-existing medical conditions.
-          Makes health insurance more affordable for small businesses. If you or your spouse own a small business, you may qualify for a tax credit of up to 50% of health expenses, starting in 2014, to help offset the costs of covering your employees.
-          Expands health care access to mothers and female teachers by requiring insurance plans to cover mammograms with no copayment and assures women the right to see an OB-GYN without having to obtain a referral first.
School Communities?
-          Expands and modernizes community health centers across the country to serve up to 20 million more patients.
-          Brings more primary care providers to our neediest school communities by tripling the size of the National Health Service Corps, which offers loan repayment and scholarships for serving in areas that most need health care providers.
-          Improves funding for Area Health Education Centers, which serve the primary care needs of rural and other underserved communities, and expands tele-health services, so more rural Americans can access specialty care
The examples above highlight how the ACA will work on behalf of students, families and school communities. Insurance companies can no longer refuse care for kids based on pre-existing conditions, which will also be true for adults beginning January 1, 2014. Preventative services that are so important in increasing quality of health in the long-term and that reduce the need for serious medical treatment will be available to kids under private plans that have a minimum of 10 essential services they must provide. The ACA helps ensure that mothers receive high-quality prenatal care, ensuring babies get a healthier start in life. And for many rural and low-income communities, often without access to essential services, the law will increase funding to serve primary care needs so that kids and their families can stay healthy.
Policy implementation on any level poses challenges; the ACA is no different, and given the scope of change it seeks to bring about in the provision of health care, there are bound to be some complications. Still, teachers, parents and their children and communities will have advantageous options and a place to find an appropriate and affordable plan that suits their individual needs.