Perspective Online

Attorney Demystifies Affordable Care Act

by Rachel Williams

The Center for Diversity and Inclusion welcomed attorney Amanda Ptashkin, outreach and advocacy director for Georgians for a Healthy Future, to its latest Controversies of Culture series. This free and public event, “Affordable Care Act: How Does This Affect You?,” was held on Thursday, October 10 in room 1303 of the TLC.

Attorney Demystifies Affordable Care Act The event came right on the heels of the October 1 beginning of the nationwide open enrollment period. Amanda’s zeal for clarifying healthcare reform law was obvious as she spoke about the impending changes. “There are a lot of people saying there’s an ‘Obamacare plan,’” says Amanda. “There’s no such thing. There’s no government entity giving you insurance. We have Medicare and Medicaid; those are our public programs. They’ve existed since 1965, and they’ll exist in 2014. That is not what the Affordable Care Act is. The marketplace is a private market for insurers to sell to you. You are going toward a private market product, as opposed to a government product. You’re using a government portal, healthcare.gov, to purchase it. That’s not the same thing as having a government plan.”

While some states have their own marketplace, Georgia has a Federal and Fiscal Marketplace through the federal government. The new healthcare options are tiered bronze, silver, gold and platinum, with bronze offering the lowest premiums but also the highest copays and deductions. The platinum plan requires higher monthly premiums, but customers will only pay a 10 percent copay versus the bronze plan’s 40 percent. In addition to choosing which tier they desire, prospective insurees can choose their provider from the participating companies: Humana, Alliant, Peach State, Kaiser Permanente and Blue Cross/Blue Shield.

While the required monthly premiums may seem daunting for many, Amanda stressed that Americans who make between 100 and 400 percent of the federal poverty level can receive government subsidies to help with their premium payments. “For an individual, that’s $11,500 all the way up to $45,000. So someone making $40,000 a year will get assistance paying for their insurance. For a family of four, it’s $23,000 all the way up to $94,000 a year. That’s well into our middle class. That’s a lot of people that we’re talking about. By our estimates, it’s about 830,000 Georgians who will be eligible for subsidies in the marketplace. Again, we have about 1.9 billion uninsured, so that’s a really large chunk, if everyone who is eligible for the exchange subsidies actually took advantage of it.” Americans making up to 250 percent of federal poverty will also receive subsidies to pay for their out-of-pocket expenses, such as copays. Amanda says that for an individual, 250 percent of the poverty level would mean an annual income of $20,000.

Amanda explained that one of the benefits of the Affordable Care Act is that people with pre-existing conditions can no longer be denied or charged more for insurance. Additionally, all insurance plans, whether through the marketplace or not, must provide “essential health benefits.” These benefits include maternity care, prescription drugs, rehabilitation services, preventive care, kids’ oral and vision care, mental health and substance use disorders and emergency services and hospitalization.

“This is huge from a public health perspective in particular,” shares Amanda. “Seeing a focus on preventive care and on whole health, meaning physical and behavioral, is a huge step forward in policy and in the way that we’re dealing with healthcare, and in the way that we’re treating patients. Having those services available to people, that’s really making a comment about the overall health of the people.”

For more CDI events, visit www.westga.edu/diversity.


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