The Affordable Care Act, Section by Section

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Below you will find a brief outline of all 10 Titles of the Affordable Care Act.

Title I. Quality, Affordable Health Care for All Americans

This Act puts individuals, families and small business owners in control of their health care. It reduces premium costs for millions of working families and small businesses by providing hundreds of billions of dollars in tax relief – the largest middle class tax cut for health care in history.  It also reduces what families will have to pay for health care by capping out-of-pocket expenses and requiring preventive care to be fully covered without any out-of-pocket expense. For Americans with insurance coverage who like what they have, they can keep it. Nothing in this act or anywhere in the bill forces anyone to change the insurance they have, period.

Americans without insurance coverage will be able to choose the insurance coverage that works best for them in a new open, competitive insurance market – the same insurance market that every member of Congress will be required to use for their insurance. The insurance exchange will pool buying power and give Americans new affordable choices of private insurance plans that have to compete for their business based on cost and quality. Small business owners will not only be able to choose insurance coverage through this exchange, but will receive a new tax credit to help offset the cost of covering their employees.

It keeps insurance companies honest by setting clear rules that rein in the worst insurance industry abuses.  And it bans insurance companies from denying insurance coverage because of a person’s pre-existing medical conditions while giving consumers new power to appeal insurance company decisions that deny doctor ordered treatments covered by insurance.

Title II. The Role of Public Programs

The Act extends Medicaid while treating all States equally.  It preserves CHIP, the successful children’s insurance plan, and simplifies enrollment for individuals and families.

It enhances community-based care for Americans with disabilities and provides States with opportunities to expand home care services to people with long-term care needs.

The Act gives flexibility to States to adopt innovative strategies to improve care and the coordination of services for Medicare and Medicaid beneficiaries.  And it saves taxpayer money by reducing prescription drug costs and payments to subsidize care for uninsured Americans, as more Americans gain insurance under reform.

Title III. Improving the Quality and Efficiency of Health Care

The Act will protect and preserve Medicare as a commitment to America’s seniors.  It will save thousands of dollars in drug costs for Medicare beneficiaries by closing the coverage gap called the “donut hole.”  Doctors, nurses and hospitals will be incentivized to improve care and reduce unnecessary errors that harm patients.  And beneficiaries in rural America will benefit as the Act enhances access to health care services in underserved areas.

The Act takes important steps to make sure that we can keep the commitment of Medicare for the next generation of seniors by ending massive overpayments to insurance companies that cost American taxpayers tens of billions of dollars per year.  As the numbers of Americans without insurance falls, the Act saves taxpayer dollars by keeping people healthier before they join the program and reducing Medicare’s need to pay hospitals to care for the uninsured. And to make sure that the quality of care for seniors drives all of our decisions, a group of doctors and health care experts, not Members of Congress, will be tasked with coming up with their best ideas to improve quality and reduce costs for Medicare beneficiaries.

Title IV. Prevention of Chronic Disease and Improving Public Health

The Act will promote prevention, wellness, and the public health and provides an unprecedented funding commitment to these areas.  It directs the creation of a national prevention and health promotion strategy that incorporates the most effective and achievable methods to improve the health status of Americans and reduce the incidence of preventable illness and disability in the United States.

The Act empowers families by giving them tools to find the best science-based nutrition information, and it makes prevention and screenings a priority by waiving co-payments for America’s seniors on Medicare.

Title V. Health Care Workforce

The Act funds scholarships and loan repayment programs to increase the number of primary care physicians, nurses, physician assistants, mental health providers, and dentists in the areas of the country that need them most.  With a comprehensive approach focusing on retention and enhanced educational opportunities, the Act combats the critical nursing shortage.  And through new incentives and recruitment, the Act increases the supply of public health professionals so that the United States is prepared for health emergencies.

The Act provides state and local governments flexibility and resources to develop health workforce recruitment strategies.  And it helps to expand critical and timely access to care by funding the expansion, construction, and operation of community health centers throughout the United States.

Title VI. Transparency and Program Integrity

The Act helps patients take more control of their health care decisions by providing more information to help them make decisions that work for them.  And it strengthens the doctor-patient relationship by providing doctors access to cutting edge medical research to help them and their patients make the decisions that work best for them.

It brings greater transparency to nursing homes to help families find the right place for their loved ones and enhances training for nursing home staff so that the quality of care continuously improves.  The Act promotes nursing home safety by encouraging self corrections of errors, requiring background checks for employees who provide direct care and by encouraging innovative programs that prevent and eliminate elder abuse.

Finally, the Act reins in waste, fraud and abuse by imposing tough new disclosure requirements to identify high-risk providers who have defrauded the American taxpayer.  It gives states new authority to prevent providers who have been penalized in one state from setting up in another.  And it gives states flexibility to propose and test tort reforms that address several criteria, including reducing health care errors, enhancing patient safety, encouraging efficient resolution of disputes, and improving access to liability insurance.

Title VII. Improving Access to Innovative Medical Therapies

The Act promotes innovation and saves consumers money. It extends drug discounts to hospitals and communities that serve low-income patients. And it creates a pathway for the creation of generic versions of biological drugs so that doctors and patients have access to effective and lower cost alternatives.

Title VIII. Community Living Assistance Services and Supports Act (CLASS Act)

The Act provides Americans with a new option to finance long-term services and care in the event of a disability.

It is a self-funded and voluntary long-term care insurance choice. Workers will pay in premiums in order to receive a daily cash benefit if they develop a disability. Need will be based on difficulty in performing basic activities such as bathing or dressing.  The benefit is flexible: it could be used for a range of community support services, from respite care to home care.

No taxpayer funds will be used to pay benefits under this provision. The program will actually reduce Medicaid spending, as people are able to continue working and living in their homes and not enter nursing homes. Safeguards will be put in place to ensure its premiums are enough to cover its costs.

Title IX. Revenue Provisions

The Act makes health care more affordable for families and small business owners by providing the largest middle class tax cuts for health care in American history.  Tens of millions of families will benefit from new tax credits which will help them reduce their premium costs and purchase insurance. Families making less than $250,000 will see their taxes cut by hundreds of billions of dollars.

When enacted, health reform is completely paid for and will reduce the deficit by more than one hundred billion dollars in the next ten years.

This title will be implemented by the U.S. Department of the Treasury.

Title X. Reauthorization of the Indian Health Care Improvement Act

The Act reauthorizes the Indian Health Care Improvement Act (ICHIA) which provides health care services to American Indians and Alaskan Natives. It will modernize the Indian health care system and improve health care for 1.9 million American Indians and Alaska Natives.

For the full text of the law, go to:
http://www.hhs.gov/healthcare

 

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