Question

Examine repercussions and implications for different population groups (Health policy)

Answer 1

6 Government health care programs provide services to about one-third of Americans

• Medi-care
• Medi-caid
• Children's Health Education programs
• Tri-care
• Veterans Health Administration

The ACA ( Affordable Care Act) requires the following health benefits to be included in a health insurance plan

1. Wellbaby and well child care for children younger than 21 years of age
2. Oral health and vision services for children
3. Preventive services and immunization
4. Ambulatory patient services including laboratory services
5. Chronic disease management
6. Mental Health and substance abuse coverage at parity with physical ailment coverage
7. Hospital/emergency services
8. Rehabilitative and habilitative services and devices
9. Prescription drug coverage
10. Maternity care
11. No cost sharing for these services

Federal subsidies are available to individuals pay for a qualified health-plan. There are two kinds of subsidaries:

1. Advance Tax payment : which help individuals to pay health insurance premiums each month for people with incomes 100-400% of the Federal Poverty Level (FPL)
2. Cost sharing: helps pay all other health costs such as co-payments,deductables, and co-insurance for families with income 100-250% of the FPL who are enrolling in the silver level plan in the market place

The subsidy is based on the initial application based on individual's /family's projected income. There is no penalty for good faith estimates that are lower than the actual income at year-end.

The ACA requires citizens and legal immigrants to pay a penalty if they do not have a qualified health plan. The mandate for a qualified health plan can be met if an individual has public health insurance coverage, employer sponsered health insurance or an individulal health plan purchased from either the HIX market or the private insurance market.

The penalty for not having the health insurance is amended by the US department of The Health and human service or congress

Exemptions from penalities

1. Those who have to pay more than 8% of their income for the lowest cost premium
2. People who do not pay taxes because of low-income
3. People with certain religious exemptions
4. Prisoners while incarcerated
5. Those experiencing a hardship( eg: victims of domestic violence, persons being evicted from their place of residence)
6. Native Americans and Alaskan natives
7. People who have been covered had their state of residence elected to expand Medicaid
8. Mixed status families (documented and undocumented immigrants with one nuclear family)