Affordable Care Act Components

Large businesses

CON: controversial-pay minimum wage, can't afford money for health care, cut a lot of jobs as result, huge pots of part-time workers, part-time workers wouldn't get extra hours because employer have health benefits. People who want to work more can't because companies don't want to pay health benefits CON: ACA considered large business to be 50 full time employers, but it can still get pretty costly for those "large" businesses with only 50 employees. example: McDonald's would offer coverage to managers, but not to a minimum wage part-timer PRO; more coverage

State health insurance exchanges (the "Health Insurance Marketplace") allows business and individuals to compare plans and enroll for coverage

CONS: honor system, so the government doesn't check this. Not all states are required to participate in this. Several of Republican states don't participate in this. Increased cost because of expansion. PROS: Increased access Bronze: silver gold: high cost, low deductible -this one may be gotten rid of -group insurance, low cost

Medicaid expansion: medicaid eligibility expands to include those earning 133% of the official poverty, including adults without dependents in participating states

CONS; more expensive for government to cover more people, reduce incentive to work, if its easier to qualify for medicaid, less people will try to get higher income Pros; increased access, pushing that those are unmotivated to get a job and work out of poverty level state exchange: Only states in state exchange can do this. Kentucky and Indiana, to get medicaid, must get 80 hours of work every month

Dependents may be covered may be covered by their parents' insurance plans until 26

PROS: Gives young adults more coverage options, increases access, extend coverage CONS: did increase premium costs

Insurers may not cancel policies when policy holders become sick

PROS: Makes it illegal for health insurance companies to cancel your health insurance just because you get sick CONS: for insurance companies, they want to be able to drop people to keep rates low. State agencies that needed to regulate this are no longer needed, less jobs. Before this, it was common for insurance company to drop an individuals because they got sick, and there were state agencies to watch over this.

Pre-Existing conditions: insurers may not deny coverage to individuals for pre-existing conditions, and must offer the same premiums within the same age and geographical group regardless of gender and pre-existing conditions, except tobacco use.

PROS: good for people with pre-existing conditions because now they can get coverage. Once you're enrolled, the plan can't deny you coverage or raise your rates based only on your health. If you're pregnant when you apply, an insurance plan can't reject you or charge you more because of your pregnancy. CONS: insurance companies wouldn't like this because they can't charge higher premiums to individuals with higher risk. Other individuals have to pay higher premiums to cover other individuals with high risk. "Everyone's premiums are going up"

Individual mandate takes effect, requiring individuals (with some limited exceptions) to carry health insurance or pay a tax penalty. Subsidies will help low-income people comply with this mandate

PROs: all people recieve coverage by requirement lowering costs, young healthy people paying premiums for insurance offset the costs of premiums (they don't need a lot of healthcare), CON: no penalty for young, healthy people with no insurance already been repealed, go away in 2019.

Insurers may not place a lifetime limit on hospital stays or other benefits deemed "essential" in new policies

PROs: people with chronic diseases can be covered for life, but there are exceptions CONs: would make it more expensive for everyone because there are only a few individuals that need this kind of coverage

Minimum standards

all insurance plans that are offered have to cover a certain range of care and treatment options. Before insurance plans could offer whatever treatments they wanted. Expanded the number of minimum things PROS: annual wellness visits, vaccinations, maternity care. With insurance you get the same price. Before, insurance was more expensive for women because they had to separately buy maternity care in insurance. Increased access to care, even with cheaper insurance, can still get these treatments CONS: premiums went up because the minimum standards are increased. Some individuals pay for treatments that they can't use or don't like (maternity care/birth control) upper-middle class ended up paying for most of the insurance. Doctors have to treat more, lower quality Example; hobby lobby fought this component, with birth control

90 days

employees get benefits earlier. Employers have to file their benefits without 90 days, prevents lapse in coverage when you go from job to job. less gaps of people that are uninsured when they are changing jobs, they don't get benfits cons: companies have to pay more for the health benefits, increase costs, increases risk of employees abandoning jobs once they recieve health benefits

Subsidies (in the form of refundable tax credits) available on the state health

people who qualify, low-income, government will pay for some of health insurance pros: less expensive to buy health care, access to health care, more people who can buy it, more affordable than before, more screenings are covered, small businesses also get subsidies cons: doesn't decrease the cost of health insurance for everyone, cost is less for people who can't afford it, estimate the amount of money you make, but if you overestimate, than you have to give back some of the money in subsidies that government gave you

Small businesses:

small employers the option to offer health insurance to employees. employers can have employees choose between bronze silver gold platinum business must have 25 of fewer full time employees. Not required for small businesses to cover their employees, this just gives them an opportunity to cover their employees, makes it easier. Can receive up to 50% tax credit if they use this plan cons: Premiums go up