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Four groups who will benefit from the Affordable Care Act

Jun 12th, 2013

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who will benefit from the Affordable Care Act

Credit: Genevieve via Flickr

When the major provisions of the Affordable Care Act go into effect next year all of America will be seeing some changes when it comes to health insurance. But there are a few groups who will being seeing some undeniably positive changes next year because of the law. Changes like the elimination pre-existing conditions, and the implementation of tax credits to make insurance more affordable.

Let’s take a deeper look, here are four groups who will benefit from the Affordable Care Act.

1. Mental Health Patients and others with pre-existing conditions

For years before the Affordable Care Act came into being,  those diagnosed with a mental illness suffered disproportionately at the hands of insurers. This is because mental illness in the eyes of an insurance company is a pre-existing condition.

Michael Moore’s 2007 documentary “Sicko” shed a lot of light on this practice. If a patient had previously been sick, or was currently suffering from a diagnosed disease then they were said to have a pre-existing condition. Naturally if you have a health history you’d like to seek insurance coverage to continue your treatments without risking bankruptcy.

But because of their pre-existing condition, mental illness sufferers were often denied health insurance coverage. Or if they were approved for coverage then they could expect to be charged exorbitant premium rates.

Now though after next year it will be illegal for insurers to deny coverage because of pre-existing conditions. They will also not be allowed to charge people more for insurance based on their health history.

When combined with the planned expansion of Medicaid, and mandated coverage for mental health services built into plans sold at the state health insurance marketplace, the Care Act is great news for many suffering from mental illness.

2. Chronic disease sufferers

America suffers from a chronic disease problem, this is a plain fact. What do I mean by chronic diseases?  Well I mean diseases like obesity, heart disease, and diabetes. These diseases cost the American health care system billions of dollars every year. The news is though that these diseases could easily be easily managed and prevented through better lifestyle choices.

The Affordable Care Act mandates that insurance plans cover preventive care in the form of regular checkups and health screenings with no cost sharing. The roots of America’s chronic disease problems are likely buried deep in socio-economic trends somewhere, so the ACA won’t fix that.

However, having access to regular doctor’s appointments without the fear of copays certainly couldn’t hurt the problem. It will no doubt help some people get back on track to manage their chronic conditions.

3. Small businesses with less than 25 full-time employees

There’s been a lot a talk in the media saying that the Affordable Care Act will destroy jobs and hurt the economy. Many of the pundits making this claim focus on the group of small businesses that are in the 50 full-time employee range and don’t offer their workers health insurance.

In case you didn’t know, next year the Affordable Care Act will mandate that businesses with at least 50 full-time employees offer those employees a health insurance option. An analysis by CNN found that the actual number of small businesses not already offering insurance that will be impacted by the mandate is relatively small.

What gets skipped over by a lot of pundits is that there will be large health insurance tax credits available to businesses with 25 or fewer full-time employees. The credits have been available since 2010 and currently cover up to 35 percent of the cost of health insurance. Smaller is better for this credit, the smaller the company the bigger the tax break.

Next year the credit increases to cover up to 50 percent of health insurance costs. But the catch is that the credit will only be available if the business purchases their insurance plan at one of the state marketplaces.

4. Poor uninsured Americans

Arguably the group that will be benefiting the most from the Affordable Care Act are those poor uninsured Americans. These are the people whose jobs don’t offer insurance, but they also don’t make enough to afford an individual insurance plan.

Firstly they’ll likely receive a tax credit to help them pay for their insurance premiums which will be based on their income. The lower the income, the greater the tax credit. Check out our health care reform calculators to see if you qualify for tax credit.

Poor Americans will benefit from the planned Medicaid expansion for those living in the states that chose to expand the program. With the expansion, you can make up to 133 percent of the federal poverty line and still be eligible for Medicaid benefits. Also for the first time, single, childless adults will be eligible for Medicaid under the expansion.


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