US ready to usher in 'Obamacare'

by Ivan Couronne

President Barack Obama's landmark health care reforms take effect on Wednesday, granting coverage to millions of previously uninsured Americans after nearly four years of bitter wrangling that has loomed large over the US political landscape.

Since the Affordable Care Act, or "Obamacare", was passed in 2010, the legislation has survived multiple repeal attempts by Republican lawmakers, a US Supreme Court hearing, and a disastrous rollout of the website set up to assist the launch of the legislation.

But as of January 1, 2014, it will be illegal for insurers to deny coverage because of pre-existing conditions or to limit the level of annual reimbursements for essential services—practices in the past which had left some patients facing financial ruin.

Under the Affordable Care Act, it will now be mandatory for any US resident to enroll in a plan.

Failure to do so will be punishable by a $95 fine, a figure that will rise to $695 in 2014.

The economic reasoning of the legislation is that if everyone contributes to the system the premiums paid by healthy people should offset the additional costs associated with the US citizens who are the most costly to insure.

In a significant first, the new legislation defines treatments that insurers must cover. All insurance must now include cover for hospitalizations, including emergencies.

And preventative care—such as screenings for diabetes or cancer, vaccines or contraception—should also be fully reimbursed.

"The new law is transformational for our entire ," Health Secretary Kathleen Sebelius said Tuesday.

For the estimated 150 million Americans who are insured through their employers in the United States, where only the poorest and those over 65 are insured through Social Security, there will be little or no change.

However around 25 million people insured individually through private insurers without the benefit of group rates stand to benefit.

From now on, they will be able to browse and choose different plans from the federal government website, which is being used in 36 states.

Fourteen other states have created their own versions of the site.

The government has set a target enrolment figure of seven million people by the end of March 2014. So far 2.1 million individuals have signed up for insurance through the web portals.

The figure is way down on initial projections, something officials have blamed on the disastrous problems which paralyzed after its launch in October.

December witnessed a sharp acceleration in registrations as the system improved. Added to the 2.1 million who have registered are a further 3.9 million who are eligible for programs for the poor, including Medicaid.

The US government has not disclosed how many of the six million beneficiaries of the new system were previously uninsured—a key number that will determine the success of the reforms.

In total, around 50 million Americans are living without .

Observers are also waiting to see if young adults will enrol in the scheme, something which is crucial to its success.

Tony Carrk, of the left-leaning Center for American Progress think tank, said he expected young people would sign up as the March 31 deadline loomed.

"What we know from prior experiences with Massachusetts, the are most likely going to wait until March to sign up, toward the end," Carrk told AFP, referring to a universal introduced in 2006.

Despite the ushering in of the legislation on Wednesday, Republicans remain violently opposed to the reforms, which have led to higher premiums for some middle-class voters who are too well off to qualify for available tax credits. The issue is already looming large in the build-up to mid-term elections later in 2014.

Meanwhile, government officials acknowledge that the opening days of the new health care era could be marked by confusion in medical offices and hospitals with some policyholders still awaiting insurance cards and computer systems not yet fully operational.

"We have to work very hard to make sure the next few days go well," senior White House advisor Phil Schiliro said during Tuesday's conference call.

add to favorites email to friend print save as pdf

Related Stories

Help offered for people who miss Obamacare deadline

Dec 25, 2013

The US government Tuesday offered help for people who were unable to sign up for health insurance through the federal website by the deadline as part of the president's controversial health care reform legislation.

Obama symbolically signs up for Obamacare

Dec 23, 2013

US President Barack Obama has symbolically signed up for health insurance to promote his own controversial health care reform legislation, a White House official said Monday.

Curtain rises Wednesday on 'Obamacare'

Dec 31, 2013

(HealthDay)—It survived a U.S. Supreme Court challenge, multiple repeal attempts, delays of key provisions and a disastrous rollout, and now the Affordable Care Act, also known as "Obamacare," marks a major ...

Republicans stake out new attacks on 'Obamacare'

Dec 04, 2013

With President Barack Obama mounting a weeks-long offensive supporting the rebooted health care website, Republicans are lining up their own pre-election campaigns attacking the controversial law as disastrous for Americans.

Recommended for you

Low Vitamin D may not be a culprit in menopause symptoms

27 minutes ago

A new study from the Women's Health Initiative (WHI) shows no significant connection between vitamin D levels and menopause symptoms. The study was published online today in Menopause, the journal of The North American Menopa ...

Internists favor public policy to reduce gun violence

6 hours ago

(HealthDay)—Most internists believe that firearm-related violence is a public health issue and favor policy initiatives aimed at reducing it, according to research published online April 10 in the Annals of ...

iPLEDGE isotretinoin counseling may need updating

6 hours ago

(HealthDay)—The iPLEDGE program needs to provide women with information about more contraceptive choices, including reversible contraceptives, according to research published in the April issue of JAMA De ...

User comments