With PPACA/Obamacare, lifetime insurance coverage caps will be banned. Select one
a. true b. false.
The PPACA, also known as Obamacare, refers to the Patient Protection and Affordable Care Act, which is a comprehensive healthcare reform law enacted in the United States in March 2010. The primary goals of the PPACA are to increase access to healthcare, reduce the overall cost of healthcare, and improve the quality of healthcare services. Here are some key components and provisions of the PPACA:
Health Insurance Marketplace: The PPACA established health insurance marketplaces (also known as exchanges) where individuals and small businesses can shop for and purchase private health insurance plans. These marketplaces provide a platform for comparing different insurance options and determining eligibility for subsidies or Medicaid.
Individual Mandate: The law included an individual mandate, which required most Americans to have health insurance coverage or pay a penalty when filing their federal taxes. This mandate was intended to encourage broader participation in the healthcare system and reduce the number of uninsured individuals.
Medicaid Expansion: The PPACA expanded Medicaid eligibility in participating states to cover more low-income individuals and families. This expansion aimed to provide coverage to those who were previously ineligible for Medicaid but couldn't afford private insurance.
Essential Health Benefits: The law defined a set of essential health benefits that insurance plans must cover. These benefits include services like hospitalization, prescription drugs, preventive care, maternity care, and more. Plans sold on the health insurance marketplaces were required to include these benefits.
Pre-existing Conditions: The PPACA prohibited insurance companies from denying coverage or charging higher premiums to individuals with pre-existing medical conditions. This provision aimed to ensure that people with health issues could still obtain affordable insurance.
Coverage for Young Adults: The law allowed children to stay on their parents' health insurance plans until the age of 26, even if they were not living with their parents or financially dependent on them.
Employer Mandate: Large employers (with 50 or more full-time employees) were required to provide affordable health insurance coverage to their employees or face penalties.
Preventive Care: The PPACA mandated that certain preventive services be covered by insurance plans without cost-sharing (e.g., copayments or deductibles). This encouraged individuals to receive essential preventive care without financial barriers.
Cost Assistance: The law provided financial assistance in the form of premium tax credits and subsidies to help lower-income individuals and families afford health insurance premiums purchased through the health insurance marketplaces.
Consumer Protections: It included various consumer protections, such as limits on annual and lifetime coverage caps, prohibitions on rescinding coverage when someone gets sick, and requirements for insurance companies to spend a certain percentage of premium revenue on actual healthcare services (the medical loss ratio).
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