ObamaCare Features

The backbone of Obamacare are several Obamacare features that improve on standard health insurance while keeping costs in check. Here’s a partial list:

  • Insurance companies can no longer deny coverage or increase your premiums based on your health.  Many had difficulty buying insurance because of pre-existing conditions.  Insurance companies only wanted to insure healthy people that had a lower probability of needing services.  It was better for the companies, but it left many people uninsured.
  • Insurers also had economic incentive to get rid of anyone that got sick using any contractual reason or excuse that they could.  Many people had insurance dropped because of honest errors on applications, things like forgetting to list minor surgeries that you may have had as a child.  Pre-existing conditions and most application errors are no longer a factor.
  • Gender discrimination is no longer tolerated.  Previously, insurers avoided insuring, or charged more for women in their child bearing years.
  • Unjustified rate hikes have been eliminated.  Yeah, I know some will snicker at this because rates still keep on going up, but at least now they’re based on actual medical expense ratios.  As a personal example, I once had health insurance through a small business group.  Rates were great for a while, but soon started to climb drastically.  The group had other plans that were less expensive but I didn’t qualify because of high blood pressure.  My rates went up and up as the healthy people in the group moved to the new plan leaving only us less healthy individuals that the insurer wanted to dump.
  • Lifetime dollar limits were eliminated.  This was a sneaky part of some policies that limited the amount that insurance companies needed to pay.  Sometimes it was a cap on all coverage, sometimes it was on certain conditions.  Medical costs build up real quick with major illnesses.  Many people who thought they were insured found that their plan limits left them only partially covered.
  • Young adults often had difficulty finding insurance on their own.  Entry level jobs often didn’t provide insurance and those going to school were left stranded.  One of the Obamacare benefits is that they can now stay on their parent’s plan until they reach 26.
  • Insurance companies always had an appeal mechanism for disagreements, but they were often slow and difficult.  Appeal rights have been standardized so they are streamlined and accelerated.
  • Finding coverage has become easier.  You can still buy coverage through your personal insurance agent but a key feature of Obamacare is in expanding coverage to tens of millions by subsidizing health insurance costs through the Health Insurance Marketplaces (HealthCare.Gov and the state-run Marketplaces).  Millions of people are currently taking advantage of this subsidy.
  • Regulations requiring most businesses with over 50 employees are required to provide health insurance coverage are being phased in.  There are some tax benefits to offset part of the cost.
  •  All plans need to meet set of minimum benefits.  This caused some controversy when President Obama mistakenly said that “you can keep your old policy”.   Policies that didn’t include what is considered as the 10 essential benefits had to be updated.   These essentials include free preventative care,OB-GYN services with no referrals, free birth control, and coverage for emergency room visits out-of-network.
  • CHIP Insurance (Children’s Health Insurance Program) was expanded and coverage has been made easier to get.
  • And there were some improvements to Medicare, even though seniors on Medicare don’t participate in the Affordable Care Act.