The cost of health insurance similarly has risen dramatically for many years and is now out of reach for millions of Americans and tens of thousands of Mainers. Many have lost their homes and jobs as a result of cataclysmic health care bills that working and middle class families cannot afford.
As the Senator for Senate District 35 in northern Aroostook County, I feel that the citizens in my district should be provided with some of the details of the Affordable Care Act, and they can determine how the Act impacts them.
The Affordable Care Act:
- Prohibits insurance companies from canceling insurance policies for no reason at all.
- Prohibits insurance companies from charging women more for health insurance coverage than charged to men.
- Prohibits insurance companies from denying health insurance coverage for a pre-existing condition, such as pregnancy, cancer, chronic diseases such as diabetes, or a medical event that occurred many years ago and has never occurred since.
- Prohibits annual and life-time insurance caps on health care benefits.
- Allows children to remain on their parents' health insurance plans until they turn 26 years of age.
- Requires that all individuals not covered by an employer sponsored health plan, Medicaid, or Medicare or other insurance program to purchase insurance. Health insurance exchanges will offer a market place where individuals and small businesses can compare policies and premiums, and buy insurance - with government subsidy if eligible.
- Provides Insurance subsidies and cost sharing for persons with low incomes. Households with incomes above 100 percent and up to 400 percent of the federal poverty level (FPL) will be eligible for federal subsidies on a sliding scale.
- A family of four at 150 percent FPL would pay no more than a $50 per month health insurance premium.
- A small business can get subsidies if it purchases health insurance through an Insurance Exchange. Businesses with less than 50 employees are not required to purchase health insurance for employees.
- Provides tax credits for small businesses with no more than 25 employees to ease the burden of health insurance. If the business pays its employees up to $25,000, the tax credit can be up to 50 percent of their contribution to premiums.
- Closes the Medicare Part D Prescription Drug coverage gap [doughnut hole] for seniors and other citizens. Fifty percent of the gap was eliminated in 2011, and the gap is entirely eliminated in 2020.
- Expands Medicaid coverage to low-income children and parents who do not have Medicaid.
- Reduces out-of-pocket costs for certain preventative health care services.
- Requires insurers selling policies to individuals or small groups to spend at least 80 percent of premiums on direct medical care and efforts to improve the quality of care. For insurers selling to large groups, 85 percent of premiums must be spent on direct medical care. In both situations, insurance companies must provide rebates on premiums if they do not meet the required percentages.