The Affordable Care Act isn’t a wholesale change in the approach to health care but a revision of specific issues to benefit more people, a federal health administrator says.
In an attempt to separate the chaff from the wheat, Marguerite Salazar, regional director of the U.S. Department of Health and Human Services in Denver, spoke at the Durango Public Library. Her appearance was sponsored by the League of Women Voters, the American Association of University Women and the Citizens Health Advisory Council of La Plata County.
Salazar was executive director of Alamosa-based Valley-Wide Health Systems, which provided primary care in Durango until 2007 when the service proved unprofitable.
Among elements of the Affordable Care Act already in effect, Salazar said, are:
Restrictions on insurers: Since 2010, insurance companies can no longer deny children coverage for pre-existing conditions or put a lifetime limit on how much they will pay. They also must spend at least 80 cents of premium dollars on health care.
Since 2011, people younger than 26 may stay on their parents’ insurance plans. More than 3 million have done so.
Small businesses can get tax credits to help provide health insurance for employees. In 2011, 360,000 business owners with about 2 million workers did so.
Improvements in Medicare allow more than 32 million people to receive free preventive care, including mammograms and colonoscopies; and get a 50 percent discount on brand-name medications. Stronger anti-fraud penalties were put in place.
The law denies health care to illegal immigrants.
In 2014 when all requirements of the Affordable Care Act will take effect, Salazar said other benefits will begin. They will include:
People younger than 65 who earn up to 133 percent of the federal poverty level – $14,000 for an individual, $29,000 for a family of four – will qualify for Medicaid.
States will receive 100 percent federal funding for three years to cover expanded Medicaid services. Funding will drop to 90 percent later.
Discriminating against anyone with a pre-existing condition will be illegal.
Insurance companies won’t be able to charge women more than men for the same service.
State-based Affordable Insurance Exchanges – private insurers – will compete for business.
Salazar’s offices covers Colorado, Wyoming, Montana, Utah, South Dakota and North Dakota. She said before her presentation she has given 300 similar talks and expects to reach 500 by the November election.
Salazar answered questions from the audience, said she’d look for answers to others and invited a couple of people who challenged her assertions to talk after the meeting.