The Affordable Health Care Act Explained: Part 1a – An Overview

According to the National Federation of Independent Business, small business owners report that the number one problem they face is the rising cost of healthcare.  Hence, one may think that the Affordable Health Care Act would be a positive for business owners, though a negative for the Medical field.  Ironically, few seem to like the provisions and the recent Supreme Court ruling may shed some light on this confusing legislation.  For those interested in medical billing, understanding this bill is vital.

To understand this bill, we will now provide an overview of the case.  Future posts will examine the details more closely.

The purpose of the Act, as stated by the U.S. Supreme Court is,

 “To increase the number of Americans covered by health insurance and decrease the cost of health care.”

 The Court considered the two key provisions of the Act:

  • The Individual Mandate:  This provision requires individuals to either obtain health insurance themselves or pay a penalty to the IRS in the form of a “shared responsibility payment.”
  • The Medicaid Expansion Mandate:  This requires States to provide coverage to more people by raising the income standards and adding single persons without children or lose all Federal Medicaid funding.  The Federal government would provide additional funds to States that comply.

The suit was brought against the Department of Health and Human Services in behalf of members of the National Federation of Independent Business.  This is important to note, for this means that this organization and its members believe this Act to contain provisions that will result in rising costs for small businesses.

We should also note that a “small business” can include private physicians with offices and staffs of several workers.  Hence, this lawsuit affects MOST clients of professional medical billing firms as well as the firms themselves.

In short, this bill and the provisions contained within impact everyone, so understanding the Supreme Court ruling is vital to helping all in the medical field maintain the standards of care that all Americans have come to expect.

In the next segment, we will consider the Courts ruling on the Individual Mandate and why understanding this ruling is useful to medical billing personnel.


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