State’s Safety Nets for the Proper Implementation of ACA

Despite the current onslaught of the Republicans against the Affordable Care Act (ACA), the administration is determined to open the enrollment to the program this coming October. The new healthcare reform act was signed into law last 2010 and since then, the American citizens haven’t grasped the benefits which led to its minority approval. To regain the public’s trust and support for the act, the administration takes serious approach to properly implement it as they struggle to meet the deadline.

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The Affordable Care Act aims in securing affordable, quality and accessible healthcare as a right, not a privilege, for every American citizen. The reformation attached with the new healthcare requires citizens to avail of a private healthcare plan or pay a 1%-2.5% tax.

For those who cannot afford the health insurance, they will either qualify for Medicare/Medicaid or get assistance in the form of tax credits, tax breaks or assistance with up-front costs on the Health Insurance Exchanges. This simply means that health insurance will now be available to most uninsured individuals with low and middle income. With its promising benefits, the people behind this law must not only keep their eyes on how to put it into action but must also carry out safety nets to avoid further complications.

To properly implement the act, the administration is conducting several outreach programs and seminars to spread the news and benefits that the act brings with it. These ventures aim to educate the public in order to avoid misinterpretations. This also answered the different concerns ranging from seniors, women, young adults, small businesses, and the patients’ bill of rights.

The administration also launched the Navigator Program, which aims to help consumers and small businesses understand their new coverage options and find affordable coverage that meets their health care needs. These programs are permanent and once up and running, the funding for it will come from the Marketplaces’ operating funds. The Navigators’ services are the following:

  • Raise awareness about the marketplace
  • Provide unbiased information about enrollment
  • Help consumer understand health plan differences and help submit consumers’ choices to the marketplace
  • Provide culturally and linguistically appropriate information
  • Provide referrals to any Consumer Assistance Program or other health insurance ombudsman program in the state

To avoid some conflict of interests:

  • Navigators may not receive consideration directly or indirectly from issuers or subsidiaries for enrolling people in a health plan inside or outside the marketplace
  • Issuers of stop loss insurance and subsidiaries cannot serve as navigators
  • Navigators must submit a plan for ensuring they remain free from conflict of interest

Another safety net that the administration has come up with is to verify the incomes of those who wish to apply for these insurance subsidies. The administration hired a credit reporting agency namely Equifax Workforce Solutions, to provide information that is more current than what is available on the federal income tax returns. The agency shall provide the information in real time, which means that it updates automatically within seconds of the receiving a query from the federal government. With these, the consumers will be ensured that they’ll get the health care and tax credits that they are entitled to.

Paper wise, the ACA is no doubt a historical reform to the American’s health care system but without proper safety nets to seal its loopholes, it will also become a historical failure. With the near deadline, more safety nets are expected to be established in the coming months to further back it up. But whatever these back-up plans are, ACA is in its road of implementation.

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