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The passage of the 2010 Patient Protection and Affordable Care Act was one of the most controversial pieces of legislation to move through Congress since President Obama was elected. Going into the 2012 presidential election season, key parts of the legislation are up for review by the U.S. Supreme Court. Those arguments, and the ongoing rhetoric from the candidates keep health care front and center in the American political debate. Unfortunately, misinformation and myths about what the law has really accomplished are common.

The point of the legislation has been, since its inception, to make healthcare affordable for all consumers and to give them access to fair, cost-effective insurance benefits. Key segments of the population, like people with pre-existing conditions, have been unable to get coverage for years, or, if coverage has been offered, the rates have been priced out of reason. Healthcare costs in the U.S. are higher than anywhere else in the world, yet America lags behind other, less-developed nations in terms of life expectancy and the overall health of its citizenry.

Three in five Americans are overweight, the nation is addicted to fast food, and there is little if any emphasis on preventive care in the prevailing healthcare model. Federal assistance programs like Medicare and Medicaid have been stretched to the breaking point, and more than 40 million Americans continue to live with no health insurance benefits. Consequently, medical debt is the leading cause of personal bankruptcy in the country, accounting for approximately 60 percent of all filings.

Ambitious in its scope, the Affordable Care Act continues to implement reforms to level the playing field, holding insurance companies to more equitable practices like an elimination of all exclusions for pre-existing conditions by 2014. Adult children under the age of 26 may remain on their parents’ policies until age 26, regardless of age or marital status, a vital reform for a young generation also saddled with the highest student loan debt in the nation’s history.

Public attention, however, has tended to focus on one detail of the Affordable Care Act’s reforms, the individual mandate requiring all Americans to carry health insurance by 2014 or face a fine. It is that specific provision at which the Supreme Court is currently looking. If the justices strike down that single provision, it could doom a package that, when taken as a whole, has made significant improvements in the state of healthcare in America.

Content provided by Affordable Health Insurance. You can find the original article at Obama Health Care – what does it really mean?.

On Tuesday, March 27, 2012 Republican presidential candidate Mitt Romney appeared on NBC’s Tonight Show hosted by Jay Leno. During the interview, the candidate advocated overturning the 2010 Patient Protection and Affordable Care Act, and said he was in favor of denying health insurance coverage to people with pre-existing conditions who had not previously held coverage.

Using the popular pejorative, “Obamacare,” Romney engaged in give and take with Leno who expressed his support for covering children and people with pre-existing conditions. As the conversation progressed, Romney said those who were uninsured and then sought coverage once their illness was discovered should not be entitled to insurance protection.

Candidate Distinguishes Pre-Existing Coverage by Timing

“Well, if they’re 45 years old, and they show up, and they say, I want insurance, because I’ve got a heart disease, it’s like, `Hey guys, we can’t play the game like that. You’ve got to get insurance when you’re well, and if you get ill, then you’re going to be covered.”

“But people who have had the chance to be insured — if you’re working in an auto business for instance, the companies carry insurance, they insure all their employees — you look at the circumstances that exist,” said Romney. “But you don’t want everyone saying, `I’m going to sit back until I get sick and then go buy insurance.’ That doesn’t make sense. But you have to find rules that get people in that are playing by the rules.”

Romney Catering to Arch Conservatives to Win Nomination

In dissecting the exchange, columnists and political pundits have pointed out how far to the conservative right Romney has moved since the days when he served as governor of Massachusetts. Because he is running for the presidency in a highly conservative climate, he’s distancing himself from the universal health care reforms he supported and passed as governor.

Currently the U.S. Supreme Court is reviewing the individual mandate clause of the Affordable Care Act. The mandate would require all Americans to carry health insurance by 2014 or be forced to pay a fine. The justices have the option of declaring only the single clause unconstitutional or voiding the entire piece of legislation.

The Implications of Repealing the Affordable Care Act

The question front and center in the debate over the health care law is what will happen if the entire reform package is repealed. The law has already made it illegal for insurers to exclude children from coverage due to the presence of a pre-existing conditions, and under the Affordable Care Act’s terms, adults will receive the same protection in 2014.

Conservatives who hotly call for the repeal of the law in its entirety have not clearly addressed what will happen to Americans who cannot access health coverage in a nation where health care costs have increased eight-fold over the past decade.

Although known as a health care advocate, Romney is apparently catering to the right with obfuscation of his own beliefs to get the nomination. What the election of a conservative to the White House in November actually portends for health care reform is unclear, as is the decision of the Supreme Court justices. However, it is clear that neither the problem of health care reform nor its solution have been conclusively determined, while costs continue to climb.

Content provided by Affordable Health Insurance. You can find the original article at Romney’s Real Position on Pre-Existing Conditions Unclear.

With the U.S. Supreme Court set to begin hearing oral arguments about the “individual mandate” provision of the 2010 Patient Protection and Affordable Care Act the week of March 26, 2012, correspondent Matt Negrin reviewed the health care debate in the U.S. for ABC News in “Public Options and Death Panels: How the Health Care Debate Evolved.”

Where the Health Care Debate Began

The Negrin article, published on March 23, 2012, traced the issue to a single question in the 2008 presidential campaign. Negrin identified the moment when the health care reform controversy began, as the answer to a question put to candidates Barack Obama and John McCain at a town hall debate. Asked to define health care as a privilege, right, or responsibility, Obama said, “I think it should be a right for every American.”

The subsequent national argument that culminated in the passage in 2010 of the Affordable Care Act has not only split national opinion, but is forming one of the hottest party dividing lines in the current 2012 presidential election. A major complication has been a failure on the part of the general public to actually understand the reform law, with unfounded rumors and misconceptions flying wildly online, particularly on social networking sites like Facebook.

When CBS News conducted a poll in 2010, at the height of the debate when the most information should have been accessible to the American public, 54 percent of Americans said they did not understand how health care reform would affect them or their families. Gallup polls conducted in the same period never found a higher approval rating for the reform effort than 51 percent in October. At the time of the bill’s passage, only about 45 percent of Americans were in favor of the measure.

How the “Death Panel” Furor Began

One of the most prevalent and pervasive rumors about what conservative critics derisively call “Obamacare” is the notion of “death panels.” In August 2008, Republican vice-presidential candidate Sarah Palin wrote a post on her Facebook page using the phrase “death panel” for the first time, and the inflammatory misperception of “end of life counseling” went viral.

The truth of the matter is that although the counseling measure was actually stripped from the health care reform law itself, Medicare will now pay benefits for voluntary end-of-life counseling as part of annual physicals for seniors. Rather than an attempt to cut costs by “killing off” the elderly by denying them medical care, the benefit policy is a recognition of the graying of the American population. More than a fifth of the U.S. population will be over age 65 within the next two decades.

Rising Health Insurance Costs Are the Real Cause for Concern

It is perhaps a more relevant point of debate for most Americans coming out of the Great Recession that the aggregate affect of health care reform has been an 8-9 percent increase in insurance rates for most Americans. Employers say their healthcare costs are up 2-5 percent. An additional complication is that less than 30 percent of employers have been able to keep grandfathered status for their health care plans, a rate far lower than that estimated by the Obama administration, which suggested a figure closer to 78 percent at the end of 2011.

The recent Willis Report of Employers said, “The accelerated loss of grandfathered status suggests that employers have had to make many plan changes to offset cost increases, and perhaps employers have been more willing to give up grandfathered status in order to take other steps to control costs.”

Controversy and Heel-Dragging Creates Sense of Limbo

This situation, combined with the reluctance of most states to move forward with the required health care exchanges, has largely created a sense of limbo over the progress of the overall health care reform effort. Most Americans feel no progress will be made in this arena until after the November elections, and many are hoping a Republican will be moving into the White House who will dismantle the entire system. At this point, that would certainly lead to even greater confusion, and likely to higher costs. And it would do little to change the fact that more than 50 million Americans still have no insurance coverage whatsoever two years after the passage of the Affordable Care Act.

In addition to being considerably less successful than first envisioned, a fact largely attributable to the Great Recession, health care reform has become an election year headache for President Obama. Not only is he in a position of defending rising insurance costs in the midst of a recession, but he is also being forced to defend statements he made during the 2008 campaign including his initial opposition to the individual mandate the Supreme Court will be reviewing next week.

It is impossible to predict where the status of health care reform will be in 2014 when the bulk of the Affordable Care Act’s provisions will be in place, but now the only fair assessment is to say the measure has elevated costs and contributed to a political stalemate. The losers in that scenario are cash-strapped consumers who, given the astronomical costs of health care in this country, live one major medical crisis away from financial ruin.

Fully 60 percent of the personal bankruptcy proceedings filed in this country are directly attributable to medical debt. And those are the people who will be going to the polls in November. Whether they will be voting for a candidate or against health care reform may not be a matter of semantics so much as a realistic assessment of the current political climate in the nation.

Content provided by Affordable Health Insurance. You can find the original article at Evolution of the Health Care Debate Culminates in Pre-Election Limbo.

With many states lagging behind on the creation of the health insurance exchanges mandated under the 2010 Patient Protection and Affordable Care Act, the Obama administration has announced it will be issuing the standards by which the exchanges are to operate. If any state fails to or refuses to set up an exchange, the federal government will assume responsibility for the project and move forward.

The health insurance exchanges are to serve as a competitive marketplace where small businesses and consumers can buy private coverage plans. The intent is to drive down rates and to make policies more affordable. While the states will be given broad operational latitude, the establishment of the exchanges will proceed, under federal control if necessary.

States Openly Lag on Exchange Creation

Many states have openly said they will not move forward with the implementation of the required exchange pending the outcome of the Supreme Court’s review of the individual health insurance mandate contained in the Affordable Care Act. Others are waiting for the outcome of the 2012 presidential election.

The move to issue the exchange standards makes it clear the Obama administration is continuing with the scheduled implementation of the provisions of the Affordable Care Act, regardless of conservative critics or the current political climate in the nation.

Administration Officials Defend Exchanges

Testifying at a Senate hearing on Wednesday, March 7, Health and Human Services Secretary Kathleen Sebelius described the exchanges as a one-stop-shop for price and benefit comparison. If insurers want to be competitive in the marketplace, they will have to set their rates accordingly, which will be to the advantage of consumers.

On Thursday, Timothy B. Hill, a senior HHSS official, speaking at a conference held by the trade group America’s Health Insurance Plans said, “We want states to be successful in establishing their own exchanges. We are doing everything we can to help states get ready. But we are not naive. There is a likelihood that some states won’t be ready.”

Overview of the Exchange Rules

Under the rules, each exchange will certify given plans, and must establish a web site that provides cost and benefit comparisons, as well as other assistance for consumers who want to enroll. The exchange will be responsible for determining eligibility for federal subsidies, which are an option for people with annual incomes of as much as four times the federal poverty level. Currently that would be approximately $92,000 for a family of four.

States can, however, choose to operate the exchange through either a new non-profit entity or through an existing department. The marketplace can be open to all insurers and plans, or to a limited number. The role of brokers and agents can be determined by the state, and larger employers with as many as 100 employees an be allowed to participate.

Currently the implementation of state-based exchanges is spotty, with states like Connecticut, California, and Washington virtually ready to proceed, while other states, including Florida and Texas, have taken no action whatsoever.

Content provided by Affordable Health Insurance. You can find the original article at Obama Administration Announces Release of Standards for Health Care Exchanges.

According to a report released by the Department of Health and Human Services in March, more than 105 million Americans are currently enrolled in health insurance plans that, prior to the passage of the 2010 Patient Protection and Affordable Care Act, would have imposed lifetime coverage limits on their benefits.

In a press release accompanying the report, HHS Secretary Kathleen Sebelius said, “For years, Americans with lifetime caps imposed on their health insurance benefits have had to live with the fear that if an illness or accident happened, they could max out their health coverage when they needed it the most. Now, because of the health care law, they no longer have to live in fear of that happening.”

According to The American Journal of Medicine, approximately 60 percent of the personal bankruptcy actions filed in the U.S. are directly attributable to unresolved medical debt. About 75% of those individuals who file for bankruptcy actually do have health insurance. The cost of health care is so high in the U.S., however, that a major illness can easily generate medical bills in excess of $1 million, and it is estimated that annually, hospitals in this country overcharge patients by as much as $10 billion.

The removal of lifetime coverage limits is of significant help to people who are fighting long-term illnesses like cancer, and also facing the accompanying potential for devastating financial disaster. Additionally, about 28 million children will benefit from the changed policy. Health care reform has also made it impossible for children to be excluded from health care coverage due to a pre-existing condition, and they are allowed to remain on their parents insurance policies up to age of 26, regardless of their educational or marital status.

Approximately 70 million of those who no longer face lifetime caps have insurance as part of a large employer plan, 25 million on small employer plans, and 10 million through privately purchased health insurance.

Other data included in the report indicated that 3.5 million Medicare recipients saved $2.1 billion on prescription drugs in 2011 due to aspects of health care reform, with 32.5 million beneficiaries accessing free preventive health care.

Content provided by Affordable Health Insurance. You can find the original article at Lifting of Lifetime Coverage Caps Benefits 105 Million Health Insurance Customers.

The Pennsylvania Senate is poised to vote on a measure drafted by Senate President Pro Tem Joe Scarnati, a Republican, that would amend the state’s constitution, making it illegal for anyone in Pennsylvania to be forced to obtain health insurance or to be fined for failing to do so.

The move is a direct effort to circumvent the personal mandate requirement of the 2010 Patient Protection and Affordable Care Act, a clause currently set to be reviewed by the U.S. Supreme Court. If found to be constitutional, the mandate would take effect in 2014.

For the amendment to pass in Pennsylvania, it must be approved in two back-to-back legislative sessions and then be subject to a state-wide referendum. If the bill is approved in 2012, it could go up for a second vote after the legislature’s new session begins in January, and be on the ballot for the consideration of the citizenry in May 2013.

In speaking with reporters, Scarnati said, “I’m not doing this to debate Obamacare; that’s not really the issue. What this is really about is giving Pennsylvanians the ability to go to the polls and vote how they feel about being mandated by the federal government on this issue. I think that will be a very clear, clear message to the administration, to Congress and to the courts.”

There is a similar measure before the Pennsylvania House put forth by Rep. Matt Baker that would prohibit mandatory health insurance thorough a state law rather than a constitutional amendment. Leaders in both houses have said it will be necessary to meet and decide which approach stands the greatest chance of succeeding.

Health advocates oppose both moves, saying the prohibition would elevate health care costs and limit the choices available to state residents. The personal mandate has become a major point of debate in the lead up to the 2012 presidential election, with conservative Republicans and Tea Party adherents calling for the abolition of “Obamacare.”

Another key provision of the Affordable Care Act is the establishment of health insurance exchanges to create a competitive market for consumers and small businesses. Few states have made any concrete progress in establishing the exchanges, however, with many openly admitting they are awaiting the outcome of the election.

Content provided by Affordable Health Insurance. You can find the original article at Pennsylvania Moves to Outlaw Health Insurance Mandate.

The American political scene is currently fraught with glaring contradictions in the public perception of health care reform. Even Americans who are drawing public benefits from much-debated “entitlement” programs from Social Security and Medicare to Medicaid support candidates calling for the abolition of those programs. In part, this is due to the poor public relations with which health care reform was presented to the American people in 2010 as well as a failure to explain that the real driving issue underlying the reform is personal financial protection.

Medical Debt Drives High Rate of Personal Bankruptcy

It is incredibly easy for someone to be hospitalized for nothing more than “tests,” with no serious injuries or diagnosed infection, and to walk out with medical bills in excess of $50,000. Coming out of what is now being called the “Great Recession,” approximately 62 percent of all personal bankruptcies filed in this country are directly caused by medical debt. A single illness without adequate health insurance coverage can destroy a family’s finances for years to come.

Currently there are some 50 million Americans who have no health insurance of any kind, including the 9.3 million who lost their health benefits during the recession along with their jobs. If the 2010 Patient Protection and Affordable Care Act is allowed to progress to full implementation in 2014, approximately 95 percent of the national population would be covered.

The stipulation for mandatory health insurance is, however, one of the most hated aspects of health care reform, and its constitutionality will be reviewed by the Supreme Court this March in the case of Florida v. Department of Health and Human Services, No. 11-400.

Supreme Court Review Spurs Attitude of Delay

The effect of the Supreme Court review, which is happening concurrently with the 2012 presidential election has been a massive delay of key aspects of the Affordable Care Act. Many conservative states that support Republican candidates who vow to see “Obamacare” repealed have tabled any efforts to implement the federally mandated health care exchanges that are designed to create a competitive insurance marketplace by January 1, 2014.

If those states do not meet the 2013 deadline to create exchanges, the U.S. Department of Health and Human Services will be forced to take charge of the process, further increasing the burden on the federal government and setting the stage for even more state-federal power struggles.

Health Care Reform Suffers from Bad Press

Supporters of health care reform say the process is the victim of a vicious smear campaign by radio talk show hosts and conservative political commentators who have convinced Americans that the reforms either have no bearing on their lives or will actually cut them out of responsible health care. A long-standing rumor, for instance, is the idea that the law creates so-called “death panels” that will cut health-care expenses by essentially murdering old people.

Because the act was handled as an “insider” effort elicited to gain the support of the insurance industry, the medical community, and Congress, the legislation lacked a more broad-based and educational effort to build a broader public support base. In truth, health care reform in the wake of the Great Recession is more vital than ever to the financial interests of all Americans who, whether they realize it or not, are likely living one major illness away from financial ruin.

Content provided by Affordable Health Insurance. You can find the original article at Ongoing Debate on Health Care Reform Fails to Consider Financial Perils of Medical Debt.

The recent controversy over requiring faith-based institutions and employers to provide insurance benefits that cover contraception and abortion has a direct bearing on student health insurance policies.

The 2010 Patient Protection and Affordable Care Act left many points of implementation and regulation to be decided by the Department of Health and Human Services (HHS). The agency’s final decision on student health plans is likely to include the provision that birth control be offered to students at no cost.

Improvements Needed in Institutionally-Sponsored Student Insurance

While this is a controversial move for religious schools, there are many needed improvements in the works for institutionally-sponsored insurance thanks to the new health care law. Student health plans have been notorious for their low-level of protection.

Now, student insurance must adhere to the same guidelines that apply to individual insurance plans. Students will not be excluded from coverage for pre-existing conditions, and there will be no life-time limit on policy benefits, which must offer preventive care. A study conducted in New York in 2010 found that many student policies “maxed out” when just $700 in benefits had been paid.

Traditionally, students have paid too much for too little, with no coverage for common illnesses and injuries, and no protection against alcohol-related accidents or suicide attempts. Even in the face of these inequities, however, more than 3 million students rely on institutionally-sponsored insurance annually, and in some cases are required to buy the policies as a condition of their enrollment.

Practices like these will be outlawed thanks to health care reform, starting with the 2012-13 school year. As an additional benefit, when the national requirement for every citizen to carry health insurance becomes effective in 2014, student policies will qualify as acceptable coverage.

Controversial Definition of Birth Control as Preventive Care

However, the Department of Health and Human Services has determined that preventive care for women, which must be covered by individual and employer-sponsored insurance plans, includes all FDA-approved forms of birth control. The argument is simply that a planned pregnancy is safer for a woman’s health and less expensive for insurers to support with benefits.

Since student health policies are to be treated by the same standards as individual coverage, faith-based and religious schools that provide or require institutionally-sponsored health insurance will have to provide free birth control in order to comply with federal law.

The Obama administration has offered a compromise that birth control will actually be paid for by the insurers, not the religious institutions themselves, but this has not quieted the controversy, in part because the discussion has become part of the election-year rhetoric.

And, given the nature of the HHS policy, the same institutions will also be required to provide birth control to employees as a job-related health care benefit. Although the regulation will fundamentally improve the quality of insurance coverage offered, especially for students, the outcry continues and will likely escalate as the November elections draw nearer.

Content provided by Affordable Health Insurance. You can find the original article at Student Insurance to Benefit from Health Care Reform, But Religious Institutions Object.

On February 9, 2012, the Obama administration announced that private health insurance plans will now have to produce a clearly worded summary for consumers of exactly what the policy covers along with concise deals on all costs like deductibles and copays. The summary must be no longer than six pages in length and contain no fine print.

Benefits Summary Akin to Nutritional Labels

Likening the Summary of Benefits and Coverage form to nutritional labels on food products, the administration said the provided information will not include data on premiums, which will be available elsewhere, but will otherwise be a valuable resource for insurance policy holders to derive the full benefit of the coverage for which they are paying. A common complaint is that health care policies are so confusing, and the policy language is so difficult, consumers often pay too much or do not get benefits to which they are entitled.

Medicare Chief Marilyn Tavenner, who is in charge of spearheading the implementation of the 2010 Patient Protection and Affordable Care Act for the administration said, “These documents will allow consumers to compare plans on an apples-apples basis.”

“For too many Americans today, choosing a health plan means reading through a human resources book usually the size of a small phone book, and important information about eligibility and benefits is often buried in the fine print,” said Tavenner. “With these new rules, we’re making it easier for consumers to find the plan that is right for them.”

Summaries Will Be Available This Fall

The summaries will begin to appear with insurance policies offered this fall during the open enrollment period since the provision in the health care law direction their including becomes effective on September 23. The requirement applies to all private insurance including individually purchased employer coverage. The change will affect approximately 150 million Americans.

The complete overhaul of the health care system is a divisive one with Americans, especially in the 2012 election year. The proposed requirement, for instance, for all citizens to carry health insurance by 2014 is greatly disliked and its constitutionality will be reviewed by the Supreme Court in March. Conversely, this provision, for simplified benefits explanations, is viewed favorably by 84% of consumers surveyed.

Forms will Facilitate Comparison Shopping

In particular the summaries should be useful to consumers shopping for new coverage since they will have a standardized means of side-by-side comparison. Although many employers currently give out these kinds of documents when workers join health plans, the government versions will include “coverage examples.” These sections will provide cost estimate scenarios for a common condition, for instance diabetes, in a typical individual. In the future, as many as six of these examples may be included in the summary forms.

Both insurers and employers have complained that generating this paper summaries will add substantially to their costs. The administration will allow for compliance with an online version, but consumers must be given instructions on how to receive a paper copy and those requests must be promptly fulfilled.

Content provided by Affordable Health Insurance. You can find the original article at Health Insurance Policies to Include Plain English Summaries.

A recent study conducted at the University of Memphis looked at the effect of federal health care reform on residents of the state. Approximately 558,044 Tennesseans age 65 and under will benefit from new health care insurance coverage as a consequence of the federal reform measures.

These individuals will either qualify to buy insurance through the state-run health care exchange, will remain on their parents’ coverage through age 26, or will be covered by TennCare (the state’s Medicaid program.)

The effect of this increased level of insurance cover will cut the number of uninsured state residents by 50 percent, and will reduce state debt for uncompensated medical care by approximately $2.3 billion.

Some critics, are concerned, however, about the extent to which the newly insured will place a strain on the state’s medical care facilities. A rush on doctor’s services and available infrastructure could actually create a new barrier to available care.

Currently 44 of the state’s 95 counties are not adequately staffed by primary care physicians. An additional 194 doctors would be required to remedy that deficiency alone, which is particularly prevalent in rural areas where newly graduated physicians do not tend to gravitate.

The Tennessee study reveals the conundrum faced by many states as they attempt to move toward full implementation of the federal reform. Only 12-14 states have actually taken concrete measures toward complying with the provisions of the 2010 Patient Protection and Affordable Care Act.

The remainder of the states are either progressing slowly or openly waiting for the outcome of both the Supreme Court review of the Affordable Care Act in March, and the outcome of the 2012 presidential election.

While health care reform may well extend the degree of insurance coverage for the 50 million Americans currently living with no protection whatsoever, there is serious concern that the health care system in the U.S. will not be able to appropriately handle the resulting load of new patients.

Content provided by Affordable Health Insurance. You can find the original article at Health Care Reform May Create New Gaps in Medical Services.