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Health Care Reform Lodi- Affordable Care Act

Health Care Reform Lodi

Health Care Reform Lodi

The Affordable Care Act, better known as ObamaCare, was signed into law March 23, 2010. The major components of the law take affect January 1, 2014. This is the largest piece of legislation passed in the United States since Social Security and will affect every American. This law has grown to be bigger the the entire IRS code and it is still growing.


How Will “ObamaCare” Affect Me?

Even though most Americans are familiar with the term “ObamaCare”, few know the name of the legislation; the Affordable Care Act, let alone what is in the law or how health care reform Lodi will affect them. Here are a few of the major components of this new law:

  • Guarantee Issue – This is probably the part of the law that will have the most positive effect on many Americans and that both Republicans and Democrats (and the Insurance Industry) wanted. Health care reform Lodi says that Insurance companies cannot decline coverage to people that have pre-existing or past medical conditions as long as they stay current with their premiums. The problem before the law passed was that insurance companies could, and did, look at current and past medical conditions and would decline coverage or raise the premium if they thought future claims would be greater than the premiums coming in for that situation. This may have been a good business decision, which is why any company is in business, however, some responsible people would get caught in the system and not be able to purchase health insurance after they lost their health insurance from their employer for what ever reason. If health insurance is guarantee issue at any time, then, why would any of us purchase it before we needed it? Wouldn’t we all just go without health insurance until we absolutely needed it, then quickly purchase it. Use it. Then cancel it again until we needed it again? This would defeat the purpose of insurance and turn the plans from insurance plans into utilization plans and dramatically increase the premiums to purchase it. This is the purpose for the next item…
  • Enrollment Periods – To keep people from abusing the system, as mentioned above, Enrollment Periods were established. With a very few exceptions, we can only purchase Individual and Family Health Insurance during the Annual Open Enrollment Period which is from October 15th to December 7th of each year, with the effective date of the policy being January 1st of the following year. If we do not apply for coverage during the Open Enrollment Period then we will have to wait until the following year to purchase Health Insurance.
  • Preventive Care at $0 Copays – Most insurance plans had preventive care built into them, however, on most plans these benefits were subject to Copays, Deductibles and Coinsurance. Now, every plan has to provide Preventive Care benefits with a $0 Copay.
  • Maternity Benefits – Every plan must provide Maternity benefits to every member. Yes, even those of you that are past child rearing years or do not plan on having children or plan on it.
  • Pay or Play – The health care reform Lodi mandates that every American purchase health insurance or pay a tax. The tax is not very high the first year but, it increases over the first three years. This is meant to encourage everyone to purchase health insurance. If everyone purchases health insurance then, the premium should be reduced for everyone as the risks are spread across a greater number of people and younger healthier people, that typically do not purchase because they do not feel like the need it, will purchase it and will help off set those that are sicker.
  • No underwriting – The only questions an insurance company can ask to base the premium on is Age, Geography and the size of the family. Many people that are sick will be happy about this, however, many healthy people complain about this part of the law. They feel that the law lacks accountability for healthy choices or the lack thereof. Healthier people feel that they should pay less for their insurance because they make choices that keep their claims down and that people that do not exercise and keep their weight under control should pay more for their insurance because their claims are statistically higher. You be the judge.


Did you know the ACA laws were written to protect the consumer from insurance company abuse?  Find out more.


These are just a few of the major components of the Affordable Care Act that affect us.


Give McClerkin Insurance a call today to help answer your questions about ObamaCare. We will help you find the plan that is right for your situation and your budget!


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