Fast Facts about the Affordable Care Act

In addition to insurance reform, the law includes changes in health care delivery, addresses chronic disease, and strengthens primary care. Each of the 10 sections of the law is dedicated to a different part of the health care system.

Title I: Quality Affordable Health Care for All Americans

  1. No one can be turned down for coverage because of existing conditions.
  2. Health insurance coverage is mandatory – that increases the premium pool and makes coverage of all viable .
  3. Based on income, many will receive subsidies to help pay insurance premiums. This is also true for those who receive insurance through their workplace. If the employee’s insurance share is more than 9.5 percent of their household income, they may receive subsidies.
  4. Those with incomes under the 133 percent of federal poverty level will receive Medicaid. (This isn’t accurate in this state because the General Assembly refused to accept the federal money to pay for it. The State also refused to allow the North Carolina Insurance Commissioner to set up the insurance exchange, thus the federal government set up the exchange and the result is that there is almost no competition.)

Title II: Role of Public Programs

  1. This provision guides the development of medical care homes which moves healthcare from a paternalistic model of medicine to a team-based approach.
  2.  It also moves toward home-based care for the chronically ill.

Title III: Improving Quality and Efficiency of Health Care

Moves healthcare industry from a fee-for-service system toward payments based on quality of delivery beginning with Medicare. What Medicare does is usually followed by private insurance.  This is anticipated to help control costs.

Title IV: Prevention of Chronic Disease and Improving Health

This addresses the costly problem of chronic illness. The provision aims to do a better job of preventing disease or treating it very early before expensive complications arise.

Title V: Health Care Workforce

This addresses the shortage of primary care. Most illnesses don’t require specialists. Countries with strong primary care systems have healthier populations with lower costs.

Title VI: Transparency and Program Integrity

This section is dedicated to reducing fraud and abuse.

Title VII: Improving Access to Innovative Therapy

This is dedicated to improving access to generic drugs.

Title VIII: Community Living Assistance Services and Support

This is a bill that instituted a federally run long-term care insurance program.

This was the late Sen. Ted Kennedy’s proposal but was quashed because the US Health and Human Services’ analysis revealed problems with implementation.  This illustrates that portions of laws can be changed without repealing the entirety of provisions.

Title IX: Revenue Provisions

This sets out how the Affordable Care Act will be funded.

Title X: Strengthening Quality Affordable Health Care for All Americans

This section includes innovative pilot programs designed to identify beneficial changes in health care delivery.

Adapted in part from a Forbes Magazine article written by Carolyn McLanahan