Introduction
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ACA Medicaid Plan
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Calculating Subsidies and Premiums
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State Medicaid Expansion
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Conclusion
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This module has two sections, each of which focuses primarily on how we pay for medical care.
- The first section provides an introduction to the Patient Protection and Affordable Care Act of 2010 (ACA), which went into effect in January 2014. At that time the "individual mandate" went into effect (with some caveats), coverage from the state exchanges began, Medicaid coverage began in the states choosing Medicaid expansion, and other consumer protections went into effect (guaranteed issue for adults, caps on out of pocket costs). These changes will have significant impact on access, cost, and equity however there will be inequities between states, especially for low income groups. This initial section will look at the major provisions, and more of the details will emerge in subsequent modules.
- The second part looks at how we fund and reimburse for medical care with emphasis on insurance coverage. This section will briefly examine the four major sources of health insurance coverage in the United States today:
- employer-sponsored insurance (ESI),
- Medicare,
- Medicaid, and
- individual plans.
For individual plans we will focus on the newly created Exchanges.