9/5/2023 0 Comments Affordable care act revisions![]() In addition, as a result of the ACA, ∼137 million Americans have health insurance coverage without cost-sharing for certain preventive services ( 8). ![]() ![]() As a result of this rule, health insurers were required to pay back >$330 million in 2013, which averaged a rebate of ∼$80 per covered family ( 7). ![]() If a company does not meet this requirement, it must pay money back to the plan enrollees. For example, the ACA requires health insurance companies to spend at least 80% of the premiums they receive on health care coverage and quality improvement activities. In addition to opening up new avenues for people to purchase and enroll in health insurance, the ACA also made changes improving the affordability and coverage options for all types of health insurance. According to a report from the White House, in states that have already expanded their Medicaid programs, 1 million people have gained a regular source of primary care beneficiaries are able to make an additional 11.6 million physician office visits each year and 5,000 deaths per year can be avoided ( 6). Research conducted by the RAND Corporation estimates that, between 20, 9.6 million Americans gained coverage through the Medicaid program ( 5). The impact of Medicaid expansion varies in each state, depending on the state’s previous Medicaid eligibility rules. The ACA also enabled low-income individuals to gain health care coverage through Medicaid. ADA research has shown that, in addition to the required categories of benefits such as physician office visits and prescription drugs, EHBs in at least 44 states include coverage for diabetes self-management education, and at least 28 states include coverage for medical nutrition therapy. ADA has been working to ensure that each state’s package of EHBs offers comprehensive coverage to meet the health care needs of individuals with or at risk for diabetes and that plans’ benefit provisions do not discriminate against people with diabetes. The ACA has also ensured that the millions of people who have enrolled in a plan through the Marketplaces have access to benefits and services that meet their health care needs. Department of Health and Human Services (HHS) has created and distributed consumer education tools in multiple languages, including a toolkit to help people with new health coverage understand their benefits and connect to primary care and the preventive services that are right for them ( 4). To support the work of Assisters, the U.S. The largest gains in insurance rates occurred for Americans earning 4,400 Assister programs helped an estimated 10.6 million people ( 3). A Gallup survey reports the percentage of American adults lacking health insurance fell from 18% at the end of 2013 to 11.9% in the first quarter of 2015 ( 1). Implementation of the ACA has decreased the number of uninsured Americans. Who Is Benefiting From Implementation of the ACA? Diabetes Advocates from around the country visited with their elected officials to share their stories about how important it was for Congress to end the discrimination that prevented people with diabetes from protecting their health. The American Diabetes Association (ADA) fought hard to ensure that health care reform would benefit people with and at risk for developing diabetes. People with diabetes who had affordable coverage through their employer feared (and rightfully so) there would be few insurance options available to them if they left their job and did not start immediately at another job that offered good health coverage benefits. As a result, many people developed complications of diabetes that could have been prevented had affordable care been available to them. Without access to affordable care, some people with diabetes went without the care they needed by cutting back on-or even forgoing-the doctor visits, medicines, education, and testing supplies necessary to adequately manage diabetes. Even for people who had insurance coverage, their plans did not necessarily cover the most basic diabetes needs, leaving them with large out-of-pocket expenses in addition to the cost of insurance. Under the old health care system, it was legal in most states to deny health insurance to people with diabetes or require them to pay more for insurance coverage simply because they had diabetes. Why Was the ACA Needed for People With Diabetes?
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