The major provisions of the Patient Protection and Affordable Care Act (PPACA) took effect on January 1, 2014. What this means to the average individual is that applications for health insurance anywhere in the United States be no longer be determined based on medical history, and that any ongoing health issues must be covered immediately. In Florida, business groups that applied for health insurance in the past were always able to get coverage, however individuals were medically underwritten and could be declined. Those covered by an employer were also subject to a one-year probationary period for pre-existing medical conditions if they did not have prior insurance before joining the health plan.
Some of the other important items now mandated to health insurance include maternity, unisex premium rates, and pediatric dental. The Affordable Care Act also allows people up to the age of 26 to retain coverage on their parents insurance plans if they are unmarried. In the state of Florida, there is added coverage of up to age 30 from a law passed by the legislature in 2008.
As a consequence of the PPACA most insurance commissioners believe insurance costs will most likely rise due to much more use of health care services, and because plans must cover more than they did in the past. With rates now being the same for males and females, there is concern about making sure all young men apply and accept health insurance coverage, as their average rates will now be higher. Most of the old plans were excellent, but they were not mandated to cover all of the items outlined by the PPACA, such as maternity and dental coverage for children. New plans also cannot have an annual out-of-pocket limit that people are responsible for of more than $6250.
The United States is the only industrialized nation that before the PPACA did not have a basic health plan for all citizens. Although costs are expected to rise in the short run, many experts believe that by having a healthier population, in the long run, those costs will stabilize. There are many like me who believe that we have a moral obligation to make sure that everyone has the ability to receive health care regardless of their ability to pay. Part of the Affordable Care Act includes a sliding scale for people earning between 100-400% of the Federal Poverty Level (FPL) to receive a tax credit, which in many cases covers the entire premium for people applying for coverage. In order to receive this tax relief, the insurance must be purchased on www.healthcare.gov. This can be done with assistance by an insurance agent. People who do not qualify for a tax break can buy at the website, directly with an insurance company, or through an insurance agent.
The Affordable Care Act also included a provision to expand Medicaid. Unfortunately, the Supreme Court struck down this provision, making it optional to the states. Florida has not expanded Medicaid. It is an issue that the Florida legislature will discuss again this year, and one that I will be working with other legislators to help make a reality. I encourage all readers to contact members of the legislature and remind them that $50 billion in Federal funds is at stake here, and that all major business groups are in favor of this.
-Richard Stark, Florida State Representative for District 104