The What, When, Why and Where of the Affordable Care Act (Part 1 of 3)

By: Mark S. Vass

The Affordable Care Act (ACA), ObamaCare, The Patient Care Act; It really doesn’t matter what you call it.  Add them up however, and what do they spell? Health Care Progress.

Realize that progress is not defined as being in any one direction.  So let me reiterate—the ACA is healthcare progress.  Progress not measured by politicians, healthcare agencies, or multi-million dollar medical entities, but by the most crucial entities—you and I.  The patients.  The consumers. The ones who are affected the most.  You’re what’s most important.

This new law has been one of the most fiercely debated issues in years.

This isn’t an op ed piece and won’t lean politically from one side to another.  This is much more important.  It’s written from and for the perspective of the health care consumer.  The patient and the patient-to-be.

Although I’ve been writing for over 15 years, I can attest to the fact that this is one of the most complicated and confusing topics I’ve ever researched.  The ACA Bill alone is a whopping 906 pages in length.

I’ll start at the beginning.

On March 23, 2010, President Obama signed the Affordable Care Act.  This new law was written to put in place health insurance reforms that were to roll out over the next five years and beyond.  When the law was signed, most of us saw that it was [at the time] being touted as the Patient’s Bill of Rights. This was because The Patient’s Bill of Rights was the first reform to be put into place.

When this happened, millions of patients were clapping their collective hands.  “Finally we’re going to have some rights . . . any rights.”  Personally, by then I had already been disabled for ten-years and had gone through a half dozen surgeries.  As a patient, I was excited.  This was something that we needed.  This first reform to roll out was important to a lot of people. It wasn’t until a few years later when politicians really got a hold of it, that it’s real name (ACA) stuck.

Let’s look at the first four years.

As mentioned, in March of 2010 a new and important chapter in the healthcare world began.  The Affordable Care Act was first aimed toward protecting healthcare consumers from abuses that’ve been perpetrated by our Nation’s health insurance industry.  First, insurance companies were being prohibited from denying coverage for Americans having any pre-existing conditions.  This was always crucial and one of those “chicken or the egg” dilemmas.  No insurance with a pre-existing condition, but no healthcare to fix the condition because of no insurance coverage.  No more.  The first year of the ACA would also see the elimination of lifetime limits, and regulation of annual limits.  These two were biggies when it came to out-of-pocket expenses.  Also, we got some help with being able to appeal insurance company decisions not in our favor, along with not having our coverage rescinded because we made a mistake on our original applications.  For Medicare recipients, relief was being felt by those finding themselves in the prescription drug donut-hole.  Finally, consumer assistance programs were being established in states across the Country.

What a year.

The ball kept rolling in 2011, especially for seniors and the disabled covered under Medicare.  There were prescription drug discount cards beginning to show up everywhere, and seniors were beginning to receive free preventative care.

The next year, entities called Accountable Care Organizations (ACO’s) were organized to [in theory] work with not only doctors, but all healthcare providers to show them how to work better as a “team” with the patient for our better care.

Last year was a memorable one regarding the ACA.  Things got extremely political.  Congress, opposed to some of the changes mentioned thus far attempted to shut down the government, and after three and a half long and sometimes very contentious years, open enrollment for the “new” Affordable Care Act” and all its new insurance plans was to begin on October 1, 2013.

Many of you reading this are undoubtedly thinking, “I didn’t know about that program or this program over those four years.”  Don’t feel bad, I was acting as a patient advocate, a freelance journalist, and a patient myself (making things very personal), and as I performed research for this article, was surprised a time or two myself.

This means one thing.  You have a little work in front of you—education.  Get on the Internet, read newspaper and magazines, and watch the news.  You need to act as your own best Patient Advocate.

Next week I’ll review the ACA present day and future.  Then, in part three of this three part series, I’ll discuss how and where to get what you need and deserve from this new law, along with who to contact, how to do it, and what to do if you don’t receive what—by law—you should.

Until next week, good luck and good health.