Ashira Vantrees, JD of Aimed Alliance explains what the Affordable Care Act entails and also what it does not cover.
Okay, thinking of the Affordable Care Act, can you briefly describe what the Affordable Care Act or ACA is, and what are the goals of this law? And what does it cover?
Absolutely. So, the ACA formal name is the Patient Protection and Affordable Care Act, and it was passed in 2010, and what it’s intended to do is to expand access to healthcare from many Americans. And so, the ACA has been able to do this in a number of ways. So for example, the ACA created tax credit for individuals living between 100% to 400%, below the federal poverty line to help provide them some financial assistance to ensure they could be able to get healthcare coverage, and it also created really important protections that require health plans cover the cost of preventative services like cancer screenings for free, and it also requires health plans, or it also prohibits health plans from charging a higher cost for healthcare coverage if they have a pre-existing condition like cancer.
Wow. Is there anything the Affordable Care Act does not cover?
Yeah. So, there are limits to what the affordable care act does cover. I should mention that the Affordable Care Act does have what it calls the 10 essential health benefits, and so these 10 essential health benefits are things that health plans that are on with a federal exchange are required to include. That includes coverage for things like prescription drugs, maternity and newborn care, hospitalization costs and other really important things that are really just at the core of our healthcare, but those do have limits. So, the ACA does not cover the cost of long-term care such as living in an assisted living facility or home health care, and it also doesn’t cover the cost of things like cosmetic surgery, weight loss surgery, infertility treatments, or dental and vision for adults.