Affordable Health Care Act

On March 23, 2010, the Affordable Care Act  was signed into law, setting off a large-scale reform of the American healthcare system aimed at increasing access to care, expanding health insurance coverage, and reducing health care costs.

Though it was passed in 2010, the actual effects of health care reform will not be felt for years as state and federal government agencies create new rules to shape reform. The primary federal agencies working on reform include the Department of Health and Human Services, the Department of Labor, and the Internal Revenue Service. We’ve provided some common links to these agencies’ pages and documents related to health care reform to the left to help you find information and guidance on health care reform.

State agencies must also take an active role in health care reform.  In Washington State, the Office of the Insurance Commissioner, the Office of the Governor, and the Washington State Health Care Authority all participate in health care reform. If you want to explore how these state agencies are working towards health care reform, you can find links in the box to the left along with other related links.

As change happens, you can come here to get updates on the progress and implementation of health care reform and find out what it means to you. If you want us to cover a particular subject, contact us with your suggestions.

Health Plan Benefits

As health care reform takes effect, every health plan will include coverage for a mandatory set of health care services.  While some services may not be covered and other benefits will be subject to limits, a set of Essential Health Benefits will be covered in every plan, with no annual dollar limits and no cost sharing. Though they have not yet been set, the proposed minimum plan will include mental health care, maternity and newborn care, preventive and wellness care, and rehabilitation – which includes massage, physical therapy, and possibly acupuncture. Because of guaranteed access to coverage and care, insurers can’t rescind coverage because of an injury or visits to a mental health counselor.

Health Programs

As well as minimum private health plan benefits, Medicare and Medicaid will also be changing. One of the most notable examples is the creation of Accountable Care Organizations (ACO).  These are groups of eligible healthcare practitioners who work together to coordinate with each other to improve care quality for certain Medicare patients.  At the moment, nurse practitioners, physicians, and physical therapists can form an ACO, and doctors of chiropractic can join but not establish an ACO. Midwives have not yet been mentioned, but the final decision on which practitioners may join or establish an ACO has not been made.

Other changes to keep in mind:

  • Paperwork and other administration tasks could change in the coming years.
  • Similar to Washington law, patients will have their choice of their primary care practitioner, as long as they are in network.
  • As more people have insurance, higher demand for primary care practitioners could open the door to new opportunities for registered nurses and others qualified to fill the gap.

Within the health care reform law, in is a commitment to nondiscrimination. This means that a health plan may not exclude a licensed health care practitioner by type – if your license allows you to provide a covered service, you may provide it; you don’t have to be a physician.“A group health plan and a health insurance issuer offering group or individual health insurance coverage shall not discriminate with respect to participation under the plan or coverage against any health care provider who is acting within the scope of that provider’s license or certification under applicable State law.” (ACA – Section 2706)