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The Affordable Care Act
The Affordable Care Act (ACA), formally known as the Patient Protection and Affordable Care Act and colloquially known as Obamacare, is a landmark U.S. federal statute enacted by the 111th United States Congress and signed into law by President Barack Obama on March 23, 2010. Together with the Health Care and Education Reconciliation Act of 2010 amendment, it represents the U.S. healthcare system's most significant regulatory overhaul and expansion of coverage since the enactment of Medicare and Medicaid in 1965. The ACA's major provisions came into force in 2014. By 2016, the uninsured share of the population had roughly halved, with estimates ranging from 20 to 24 million additional people covered. The law also enacted a host of delivery system reforms intended to constrain healthcare costs and improve quality. After it went into effect, increases in overall healthcare spending slowed, including premiums for employer-based insurance plans. The increased coverage was d ... [...More Info...] [...Related Items...] OR: [Wikipedia] [Google] [Baidu] |
Charles Rangel
Charles Bernard Rangel (, ; born June 11, 1930) is an American politician who was a U.S. representative for districts in New York from 1971 to 2017. A member of the Democratic Party, he was the second-longest serving incumbent member of the House of Representatives at the time of his retirement, serving continuously since 1971. As its most senior member, he was also the Dean of New York's congressional delegation. Rangel was the first African American Chair of the influential House Ways and Means Committee. He is also a founding member of the Congressional Black Caucus. Rangel was born in Harlem in Upper Manhattan and lives there to this day. He earned a Purple Heart and a Bronze Star for his service in the U.S. Army during the Korean War, where he led a group of soldiers out of a deadly Chinese army encirclement during the Battle of Kunu-ri in 1950. Rangel graduated from New York University in 1957 and St. John's University School of Law in 1960. He worked as a private lawye ... [...More Info...] [...Related Items...] OR: [Wikipedia] [Google] [Baidu] |
Medicare (United States)
Medicare is a government national health insurance program in the United States, begun in 1965 under the Social Security Administration (SSA) and now administered by the Centers for Medicare and Medicaid Services (CMS). It primarily provides health insurance for Americans aged 65 and older, but also for some younger people with disability status as determined by the SSA, including people with end stage renal disease and amyotrophic lateral sclerosis (ALS or Lou Gehrig's disease). In 2018, according to the 2019 Medicare Trustees Report, Medicare provided health insurance for over 59.9 million individuals—more than 52 million people aged 65 and older and about 8 million younger people. According to annual Medicare Trustees reports and research by the government's MedPAC group, Medicare covers about half of healthcare expenses of those enrolled. Enrollees almost always cover most of the remaining costs by taking additional private insurance and/or by joining a public Part C or P ... [...More Info...] [...Related Items...] OR: [Wikipedia] [Google] [Baidu] |
Essential Health Benefits
In the United States, essential health benefits (EHBs) are a set of ten benefits, defined under the Affordable Care Act (ACA) of 2010, that must be covered by individually-purchased health insurance and plans in small-group markets both inside and outside of health insurance marketplaces. Large-group health plans, self-insured ERISA plans, and ERISA-governed multi-employer welfare arrangements that are not subject to state insurance law are exempted from the requirement.Sara Rosenbaum, Joel Teitelbaum & Katherine HayesThe Essential Health Benefits Provisions of the Affordable Care Act: Implications for People with Disabilities Commonwealth Fund (March 2011). Definition The Affordable Care Act (ACA) set forth the following ten categories of essential health benefits,Alexandra Ernst10 Essential Health Benefits Insurance Plans Must Cover Starting in 2014 FamiliesUSA (March 28, 2013). at Section 1302(b)(1) of the ACA, codified at 42 U.S.C. § 18022(b): Health insurance plans must ... [...More Info...] [...Related Items...] OR: [Wikipedia] [Google] [Baidu] |
Individual Shared Responsibility Provision
The individual shared responsibility provision, less formally known as the individual mandate, was the health insurance mandate imposed on individuals by the Affordable Care Act in the United States until tax year 2019. This individual mandate required most individuals and their families to have a certain minimal amount of health insurance, with certain exemptions. Otherwise, they were required to pay the individual shared responsibility payment as a fine. It was one of the many Affordable Care Act tax provisions. The federal tax penalty for violating the mandate was eliminated by the Tax Cuts and Jobs Act of 2017, starting in 2019. (In order to pass the Senate under reconciliation rules with only 50 votes, the requirement itself is still in effect). Summary Starting January 2014, individuals and their families must have at least minimum essential coverage. Individuals may be exempt from health insurance coverage in some cases: * The minimum amount that they must pay for annual ... [...More Info...] [...Related Items...] OR: [Wikipedia] [Google] [Baidu] |
Adverse Selection
In economics, insurance, and risk management, adverse selection is a market situation where buyers and sellers have different information. The result is that participants with key information might participate selectively in trades at the expense of other parties who do not have the same information. In an ideal world, buyers should pay a price which reflects their willingness to pay and the value to them of the product or service, and sellers should sell at a price which reflects the quality of their goods and services. For example, a poor quality product should be inexpensive and a high quality product should have a high price. However, when one party holds information that the other party does not have, they have the opportunity to damage the other party by maximising self-utility, concealing relevant information, and perhaps even lying. Taking advantage of undisclosed information in an economic contract or trade of possession is known as adverse selection. This opportunity ... [...More Info...] [...Related Items...] OR: [Wikipedia] [Google] [Baidu] |
Preexisting Condition
In the context of healthcare in the United States, a pre-existing condition is a medical condition that started before a person's health insurance went into effect. Before 2014, some insurance policies would not cover expenses due to pre-existing conditions. These exclusions by the insurance industry were meant to cope with adverse selection by potential customers. Such exclusions have been prohibited since January 1, 2014, by the Patient Protection and Affordable Care Act. According to the Kaiser Family Foundation, more than a quarter of adults below the age of 65 (approximately 52 million people) had pre-existing conditions in 2016. Definitions The University of Pittsburgh Medical Center defines a pre-existing condition as a "medical condition that occurred before a program of health benefits went into effect". J. James Rohack, president of the American Medical Association, has stated on a ''Fox News Sunday'' interview that exclusions, based upon these conditions, function ... [...More Info...] [...Related Items...] OR: [Wikipedia] [Google] [Baidu] |
Guaranteed Issue
Guaranteed issue is a term used in health insurance to describe a situation where a policy is offered to any eligible applicant without regard to health status. Often this is the result of guaranteed issue statutes regarding how health insurance may be sold, or to provide a means for people with pre-existing conditions the ability to obtain health insurance of some kind. Under the Patient Protection and Affordable Care Act (ACA), all health insurance policies must be sold on a guaranteed issue basis. Prior to the ACA, a small number of states required insurers to sell all coverage on this basis in the individual health insurance market. In addition, the "creditable coverage" provisions of the Health Insurance Portability and Accountability Act of 1996 are often considered to be a federal guaranteed issue regulation which some states fulfilled using a high-risk pool program. References See also *Community rating Community rating is a concept usually associated with health insura ... [...More Info...] [...Related Items...] OR: [Wikipedia] [Google] [Baidu] |
Health Insurance In The United States
Health insurance in the United States is any program that helps pay for medical expenses, whether through privately purchased insurance, social insurance, or a social welfare program funded by the government. Synonyms for this usage include "health coverage", "health care coverage", and "health benefits". In a more technical sense, the term "health insurance" is used to describe any form of insurance providing protection against the costs of medical services. This usage includes both private insurance programs and social insurance programs such as Medicare, which pools resources and spreads the financial risk associated with major medical expenses across the entire population to protect everyone, as well as social welfare programs like Medicaid and the Children's Health Insurance Program, which both provide assistance to people who cannot afford health coverage. In addition to medical expense insurance, "health insurance" may also refer to insurance covering disability or l ... [...More Info...] [...Related Items...] OR: [Wikipedia] [Google] [Baidu] |
Government Budget Balance
The government budget balance, also alternatively referred to as general government balance, public budget balance, or public fiscal balance, is the overall difference between government revenues and spending. A positive balance is called a ''government budget surplus'', and a negative balance is a ''government budget deficit''. A government budget is a financial statement presenting the government's proposed revenues and spending for a financial year. A budget is prepared for each level of government (from national to local) and takes into account public social security obligations. The government budget balance can be broken down into the ''primary balance'' and interest payments on accumulated government debt; the two together give the budget balance. Furthermore, the budget balance can be broken down into the ''structural balance'' (also known as ''cyclically-adjusted balance'') and the cyclical component: the structural budget balance attempts to adjust for the impact of ... [...More Info...] [...Related Items...] OR: [Wikipedia] [Google] [Baidu] |
Congressional Budget Office
The Congressional Budget Office (CBO) is a federal agency within the legislative branch of the United States government that provides budget and economic information to Congress. Inspired by California's Legislative Analyst's Office that manages the state budget in a strictly nonpartisan fashion, the CBO was created as a nonpartisan agency by the Congressional Budget and Impoundment Control Act of 1974. Whereas politicians on both sides of the aisle have criticized the CBO when its estimates have been politically inconvenient, economists and other academics overwhelmingly reject that the CBO is partisan or that it fails to produce credible forecasts. There is a consensus among economists that "adjusting for legal restrictions on what the CBO can assume about future legislation and events, the CBO has historically issued credible forecasts of the effects of both Democratic and Republican legislative proposals." History The Congressional Budget Office was created by Title II of th ... [...More Info...] [...Related Items...] OR: [Wikipedia] [Google] [Baidu] |
Medicare Advantage
Medicare Advantage (Medicare Part C, MA) is a capitated program for providing Medicare benefits in the United States. Under Part C, Medicare pays a private-sector health insurer a fixed payment. The insurer then pays for the health care expenses of enrollees. Insurers are allowed to vary the benefits from those provided by Medicare's other parts. Part C plans are required to offer coverage that meets or exceeds the standards set by the other parts, but they do not have to cover every benefit in the same way (actuarial equivalence is required). Plans must be approved by the Centers for Medicare and Medicaid Services (CMS). If a MA plan reduces some benefits, the savings may be passed along to consumers by lowering co-payments for doctor visits (or any other plus or minus aggregation approved by CMS). Coverage must include inpatient hospital (Part A) and outpatient (Part B) services. Typically, the plan also includes prescription drug (Part D) coverage. Many plans also offer add ... [...More Info...] [...Related Items...] OR: [Wikipedia] [Google] [Baidu] |
Individually Purchased Health Insurance
In the United States, individually purchased health insurance is health insurance purchased directly by individuals, and not those provided through employers. Self-employed individuals receive a tax deduction for their health insurance and can buy health insurance with additional tax benefits. According to the US Census Bureau, about 9% of Americans are covered under individual health insurance. In the individual market, consumers pay the entire premium without an employer contribution, and most do not receive any tax benefit. The range of products available is similar to those provided through employers. However, average out-of-pocket spending is higher in the individual market, with higher deductibles, co-payments and other cost-sharing provisions. Major medical is the most commonly purchased form of individual health insurance. Economics Premiums can vary significantly by age. In states that allow medical underwriting, an individual's health information may be used in determin ... [...More Info...] [...Related Items...] OR: [Wikipedia] [Google] [Baidu] |
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