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Jul 1, PPACA and the Reconciliation Act increase funding for anti-fraud .. legislation, the Patient Protection and Affordable Care Act (PPACA; P.L.
Table of contents

The million Americans who get coverage through an employer, as well as the roughly 15 million enrolled in Obamacare and other plans in the individual insurance market, are protected from caps that insurers and employers used to limit how much they had to pay out in coverage each year or over a lifetime. Before the A. While not all health coverage was capped, most companies had some sort of limit in place in The vast majority of people never hit those limits, but some who did were forced into bankruptcy or went without treatment.

About 60 million people are covered under Medicare, the federal insurance program that covers people over 65 years old and people with disabilities.


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Even though the main aim of the A. Medicare beneficiaries would have to pay more for preventive care, like a wellness visit or diabetes check, which are now free. They would also have to pay more toward their prescription drugs.

Affordable Care Act changes to Medicare

About five million people faced the so-called Medicare doughnut hole, or coverage gap, in , which the A. If the law were overturned, that coverage gap would widen again. The law also made other changes, like cutting the amount the federal government paid hospitals and other providers as well as private Medicare Advantage plans. Premiums for as many as 55 million people under the program could go up as a result.

The A. If the groups save Medicare money on the care they provide, they get to keep some of those savings.

Patient Protection & Affordable Care Act Summary

About 12 million people are now enrolled in these Medicare groups, and it is unclear what would happen to these experiments if the law were deemed unconstitutional. Some of Mr.


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If the law were struck down, employers would have to decide if they would continue to offer the coverage. Dorian Smith, a partner at Mercer, a benefits consulting firm, predicted that many companies would most likely continue.

ObamaCare and Associated Costs

Doctors and hospitals could lose a crucial source of revenue, as some people lose insurance. The Urban Institute estimated that nationwide, without the A. Hospitals and other medical providers would incur losses, as many now have higher revenues and reduced costs for uncompensated care in states that expanded Medicaid. The health insurance industry would be upended by the elimination of A. Insurers in many markets could again deny coverage or charge higher premiums to people with pre-existing medical conditions, and they could charge higher rates to women. States could still regulate insurance, but consumers would see more variation from state to state.

Slowing the Growth of Health Care Costs

Insurers would also probably see lower revenues and fewer members in the plans they operate in the individual market and for state Medicaid programs. It created a pathway for federal approval of biosimilars, which are near-copies of biologic drugs, made from living cells. Reed Abelson covers the business of health care, focusing on health insurance and how financial incentives affect the delivery of medical care.


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She has been a reporter for The Times since Abby Goodnough is a national health care correspondent. She has also served as bureau chief in Miami and Boston, and covered education and politics in New York City. She joined The Times in Updated: July 9, The Affordable Care Act was already in peril after a federal judge in Texas invalidated the entire law late last year.

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I am not the first president to take up this cause, but I am determined to be the last. It has now been nearly a century since Theodore Roosevelt first called for health care reform.

The Pros and Cons of Obamacare

And ever since, nearly every President and Congress, whether Democrat or Republican, has attempted to meet this challenge in some way. Legislation was soon introduced, and it became clear that the Democrats in the House of Representatives favoured more sweeping reform than those in the Senate. Thus, Senate majority leader Harry Reid attempted to craft a bill that could gain the support of his caucus as well as some moderate Republican senators, such as Olympia Snowe and Susan Collins of Maine. On November 7 the House of Representatives passed its version of the health care bill, the Affordable Health Care for America Act, by a slim margin of — Aiding passage was a compromise on abortion language, because some conservative pro-life Democrats, including Bart Stupak of Michigan , threatened to withhold support unless language were added restricting coverage of abortion in any health insurance plan that received federal subsidies.

The Senate then proceeded with its debate on health care, with the hope of passing legislation before Christmas. The public option, included in the House version, was jettisoned in early December, as it became clear that such a provision would not pass the Senate. Abortion once again threatened to derail the process. Ben Nelson and Republican Sen. Orrin Hatch , was voted down in the Senate 54—45, and it was unclear if Nelson would support passage without the amendment or without tougher language on abortion. Nevertheless, on December 24, with all Democrats uniting, the Senate passed its version of the legislation 60—39, which would provide health care to more than 30 million uninsured Americans.

Patient Protection and Affordable Care Act.

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