Tuesday, October 15, 2013

Young People And The Affordable Care Act

By Maryl Joop


One group who is among the biggest beneficiaries of the new health care law is those that are considered uninsurable due to preexisting conditions. This is due to the new law found within the Affordable Care Act that states that insurance companies cannot deny you affordable health insurance due to a preexisting condition (PEC).

This expansion of Medicaid is designed to cover millions of more individuals and provide affordable health insurance for those who are considered among the poorest in the country. This expansion of Medicaid is contingent upon the participation of the state.

Previously two programs, run by the federal government, provided this population with health insurance benefits prior to the complete rollout of the Affordable Care Act. These two plans were mutually exclusive-only one could be present in a state at a time.

The fee and tax are based on the income of the individual. Because young people's income tends to be lower, and their health is consistently better, these "invicibles" choose to not get insurance.

For those states who wished to run their own program, using mostly federal dollars, they would have the same program, but under a different name. For example, in the state of Utah, this plan was called the health insurance plan or HIP. These programs were designed by the federal government to create consumer driven health plans in the absence of these plans being found in the private sector.

Consequently, they chose not to participate in the program. Other states who did not participate cited significantly constrained budgets due to the economic downturn from the late 2000s. After running the numbers, these states did not believe they could afford the expansion when the state would shoulder in coming years the financial burden currently borne by the federal government.

The initial design was to allow individuals with preexisting conditions to sign up for PCIP or a state run program and receive benefits until January 1, 2014, to provide no interruption to active coverage. However, due to overwhelming demand, in both quantity of applications and quantity of subsequent claims, these stop-gap programs ran out of money and refused to accept new applicants starting on March 2013.

Those who have enrolled in Medicaid previously have found that the health insurance benefits allow them to access doctors and emergency rooms with great frequency. Studies have shown that those in the same economic class of people will access hospitals and healthcare providers at significantly different levels contingent upon the access to Medicaid. Those with Medicaid use the healthcare system many times more than those without Medicaid, when all other factors are largely held constant.




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