Understanding the Affordable Care Act

The Shasta County Health and Human Services Agency is just one of many organizations that will help thousands of uninsured Shasta County residents obtain health coverage through the Affordable Care Act. The goals of the Affordable Care Act (ACA) are threefold: to expand access to high quality medical care; improve health outcomes; and curb rising health care costs.

Since the early 1990s, the cost of health care in the United States has risen dramatically.  Currently, the United States spends 17% of Gross Domestic Product (GDP) on health expenditures – that’s 17 cents for every dollar that changes hands in our economy. This rate is much higher than other industrialized nations like France, Germany, Canada and Japan, which all operate their health care systems for 8-10% of GDP. Unfortunately, this high price tag does not translate into great health outcomes. Although the United States outspends other first-world nations for health care, we trail behind most of them in life expectancy.

In order to expand access to more than 32 million uninsured Americans, 27,500 of whom are Shasta County residents, the ACA will require large employers to provide insurance; offer tax credits for small businesses who insure their employees; require individuals to have insurance; establish insurance exchanges; expand Medicaid; provide federal subsidies to offset costs of coverage for individuals with incomes between 139% to 400% of federal poverty level; create a temporary high-risk pool; and allow young adults to stay on their parents’ policies until age 26.

The ACA also includes many consumer protections to enable people to keep their insurance coverage, including prohibiting lifetime monetary caps on benefits, exclusions for preexisting conditions and cancellation for coverage except for fraud. Cost-saving measures include a state review of premium increases, an office for consumer assistance, and the establishment of minimum medical loss ratios to limit insurance company administrative costs and profits.

In California, consumers can make apples-to-apples coverage comparisons of private health insurance plans at www.coveredcalifornia.com.  Covered California is the state-mandated health exchange and is the only place where Californians can receive income tax credits to offset the cost of their premiums.  All plans will be required to cover a comprehensive package of essential health benefits, including many preventative services and medical screenings.  Four benefit levels are available – bronze, silver, gold and platinum – to provide a range of premiums and coverage options.  Individuals with low incomes and aged 30 years or younger may be eligible for catastrophic coverage.

Local organizations – private, non-profit and government – are also available to provide face-to-face outreach and enrollment assistance to individuals and businesses.  For more information on local resources, visit www.coveredshasta.com.

Donnell Ewert, MPH, is director of  director of  Shasta County’s Health and Human Services Agency. While at Wheaton College, he participated in the Human Needs and Global Resources program, which included a seven-month internship in Honduras – an experience that sparked his interest in public health. He earned his master’s degree from UCLA after evaluating a program that used goats to increase the nutritional intake of malnourished children. He worked briefly as a health educator with migrant farm workers in Virginia before becoming an epidemiologist for the health departments in Los Angeles and the state of Indiana. Donnell came to Shasta County Public Health as an epidemiologist in 1999, after doing humanitarian health work in Kazakhstan. He became Public Health director in 2007, and was promoted to Health and Human Services Agency director in November 2012. He and his wife, Mary, have two teenage daughters.

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, MPH, is director of Shasta County Health and Human Services Agency. While at Wheaton College, he participated in a Human Needs and Global Resources program, which included a seven-month internship in Honduras – an experience that sparked his interest in public health. He worked briefly as a health educator with migrant farm workers in Virginia before becoming an epidemiologist in Los Angeles and Indiana. He came to Shasta County Public Health as an epidemiologist in 1999, and became HHSA Director in November 2012. He and his wife, Mary, have two daughters.
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5 Responses

  1. Avatar Robb says:

    Thanks, Donnell, for laying this out so clearly. There's so much spin on this topic that hearing it straight from an expert in the field is refreshing.

  2. Avatar EasternShastaCounty says:

    It's my understanding that those of us who are old enough for Medicare and also have supplemental insurance, will not need to make any changes. Correct?

  3. That is correct. The Affordable Care Act strengthens existing Medicare coverage by covering more preventative services such as annual wellness exams and screenings like mammograms and colonoscopies, and helps consumers save on prescription drugs. Medicare open enrollment – October 15 through December 7 – is always a good time to double-check that your medical and prescription drug coverage is adequate for your needs. If you would like help reviewing your Medicare coverage, HICAP of Northern California provides free Medicare counseling. Call 223 – 0999 to make an appointment.

  4. Avatar Smith says:

    It is noticeable that the German heath care system pays equal attention towards their natives and the foreigners, when they visit the country. You can get health insurance from Covomo, even if you are paying a visit to Germany only for a few months.

  5. Avatar Alyce-Kay says:

    Thank you for making the important points so much easier to understand. It's hard to wade through and make sense of everything that's said about this. Appreciate your straight-forward approach.