The Affordable Care Act, aka ObamaCare, is a topic medical schools could ask about in your interviews. But regardless of whether they ask or not, as a future physician, it’s something you should be aware of. Find out the most important points for you to know.
If I told you ObamaCare and the Affordable Care Act (ACA) were two different things, you would more than likely give me a very strange look. Believe it or not, many people in the United States actually believed these were two different programs before the recent ACA roll-out. The current political situation makes it difficult for prospective medical students and the general public to form an informed opinion on this new healthcare program. Sifting through the junk to get to the hard facts of the ACA is a tough task, but a necessary one for those students seeking a career in medicine. Medical schools will gauge your passion for healthcare by asking your opinion on the controversial ACA. You do not want to get caught unprepared for this one. Below I’ve listed some of the most poignant aspects of the ACA that should foster informed conversations with your peers and co-workers about the potential effects of ObamaCare.[Read 10 Questions for a Doctor – Sahil Mehta, MD (interventional radiologist)]
1) Health Insurance Dependents Allowed Until 26 Years
– Under the new healthcare reform, individuals can now stay on their family plans until they turn 26. While benefiting unemployed college graduates who can’t afford an individual healthcare plan, the new law also ensures that younger people remain insured. In the past, the younger demographic would simply opt out of health insurance once they were ineligible for their family plan. It’s a win-win situation because younger individuals remain insured and the healthcare system remains funded by added family members.
2) Government Subsidies Leading to Affordable Premiums
– The biggest cause of bankruptcy in the U.S. is medical debt. One of the main objectives of the Affordable Care Act is to make healthcare more affordable, just as the name suggests. Under the new umbrella of the ACA, government subsidies can now be applied towards health insurance premiums. These subsidies act as a discount of sorts based on the family or individual’s annual income. As long as the appropriate, family-sized income is a certain percentage below the federal poverty line, a subsidy can be given. When that income changes, the amount in subsidies given will also change. To show how big of a difference subsidies can make, compare these two similar plans:
Under Old Employer’s Plan-
For a family of four, 68K Annual Income, an HMO with no deductible= $1,900.00 /month (no subsidies)
Under New Covered California Plan-
For a family of four, 68K Annual Income, an HMO with no deductible= $750.00 /month ($1,184.00 w/out subsidies)
Subsidies can make a big difference and the ACA plans to drive that point home for people looking to switch insurance plans.
3) No Exclusion Based On Pre-existing Conditions
– Quite possibly one of the most important amendments to the healthcare system is the addition of a no-exclusion rule. In the past, health insurance companies could reject someone based on pre-existing health conditions. These pre-existing conditions could arise later on in the patient’s life and further complications from care would make it extremely expensive to insure such a patient. Now, insurance companies can no longer refuse to insure someone based on past medical history. This is fortunate for those with chronic illnesses, but the resulting effect on the healthcare system and healthier individuals remains to be seen.
4) Establishing a Standard of Care
– Above all, this final point might stand as the most controversial change of the new health law. The ACA now outlines a clear standard of care that all health insurance plans must provide. These 10 Essential Health Benefits must be covered by every plan, even those offered at the minimum. For the first time mental health is included in these 10 essential points. Before 2014, there was no mandatory standard of care required by the government. This was convenient for the public because people could pay for only those services that they needed. For younger, healthier individuals, preventative care was a priority. For the elderly or those suffering from chronic illnesses, more acute care was needed. The new law effectively ends this freedom of choice causing mixed reactions at best.
Under the ACA there are still many options available for different types of health care coverage, but some health benefits may seem forced upon people. For example, maternity care is a required health benefit provided by all insurers. There is also an array of 22 different preventative tests that must be provided for all insured females. But, the fact is not all women of child-bearing age want to have children. The question then arises whether women should be required to pay for this type of coverage. The debate is ongoing.
This article is far from a comprehensive list or analysis of the ACA. There are still so many factors to consider. How will premium rates change over the years? What will be the primary demographic of new health insurance adopters? Will there be enough participation? Will healthcare really be more affordable? Experts are speculating daily on the potential outcome of the ACA. The most important thing to remember is that as of now, no one knows. While it is not the greatest advice, it is the truth. Until the public gets a better idea of how widespread the adoption of new healthcare plans is, there is no telling what might happen. The best thing for you to do though is get involved in the debate.
A month ago I was helping my parents pick out healthcare plans. I was so scared that I might pick a catastrophic plan that would lead my entire family to ruin. So, I know it can be intimidating. Still, speculate, talk to first-time adopters, talk to your co-workers and peers, and get an idea of what was different now and then. After that, form your own opinion and continue to evolve it as you learn more and more about the implications of the Affordable Care Act. Stay healthy my friends.
Christopher Yoon is a graduate of UCLA, receiving a B.S. in Biochemistry. In addition to contributing to ProspectiveDoctor.com, Christopher also works as an Emergency Room Technician.