Patient Protection and Affordable Care Act

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An amendment of this law was made by the Health Care and Education Reconciliation Act in March 2010. It is usually termed as ACA, PPACA, Obamacare or the Affordable Care Act. The law provides many rights and protections making an aspect of health coverage fairer and easier to comprehend, as well as subsidies making it more affordable. The law also expands the Medicaid program to cover more low-income people.

This law required employers with at least 50 full-time equivalent employees to provide health insurance to their employees. Legislation and subsequent initial Internal Revenue Service (IRS) rules did not distinguish between paid and volunteer employees, and there were initial concerns that volunteer fire departments and EMS agencies would be required to provide a health insurance to their volunteers if the entity actually had more than 50 full-time equivalent employees. Volunteer services are known to have notoriously tight or small budgets (which is one of the reasons they volunteer in the first place), and the fear was that this mandate essentially forces some volunteer emergency service organizations to dissolve or reduce their volunteer staff, at a dangerous level. Ultimately, many fire and EMS organizations across the United States came together to petition the Internal Revenue Service  to exempt volunteer agencies from this requirement, which is exactly what happened.

Heart of Patient Protection and Affordable Care Act

  • New insurance rules = no limitation of pre-existing condition
  • People must be covered by health insurance or be penalized.
  • States should set up exchanges.
  • Employers provide coverage or pay penalties