The three layer-cake of the Affordable Care Act, click image for Obamacare 101: Overview.
Last week we took a
brief look at the Affordable Care Act, better known as Obamacare. Here we survey the United States Department of Health and Human Services. The HHS is currently under the purview of Secretary Kathleen Sebelius and Deputy Secretary Bill Corr. Their mission statement reads "improving the health, safety, and well-being of America," meaning they are charged with the
daunting task of managing a wide array of public programs and offices such as Medicare, the Surgeon General, public health and federally funded medical research.
There are roughly 70,000 full-time civil servants working at the HHS organized into about a dozen large divisions, including the Center for Disease Control, the Food & Drug Administration and the National Institutes of Health just to name a few. With the passage of the ACA in 2010, we can add the development and implementation of Obamacare to that long list of critical responsibilities. To learn more about the HHS/ACA and see if you are subject to the insurance mandate, join us below.
The HHS is tasked with implementing the Affordable Care Act, a direct descendant of an idea originally proposed the conservative Heritage Foundation in 1989, touted as a free market approach and alternative to single-payer healthcare. It should therefore come as no surprise that it was initially championed by a number of GOP lawmakers and first implemented in Massachusetts by the state's republican governor, Mitt Romney, in 2006. It was only after the idea was adopted as the centerpiece of the federal solution to the nation's healthcare crisis that those same lawmakers begin criticizing it bitterly and gave it the pejorative nick-name of Obamacare. A name since appropriated by proponents in a rather neat turning of the tables.
Obamacare is a massive undertaking between the HHS, state officials, industry experts and IT professionals to make make health care far more affordable and available to millions of Americans not currently covered, millions more paying exorbitant rates, and to reign in spiraling costs of healthcare administered to the uninsured currently fobbed off on state and regional tax bases. It utilizes private insurers and private medical facilities as well as existing programs like Medicaid as the primary insurers and providers respectively. Two key features the HHS must oversee are the insurance mandate and the creation of Health Insurance Exchanges (HIX).
The mandate was formally lauded by conservative lawmakers as an example of "personal responsibility," but has since been criticized by the same partisan operatives. It was adopted for two important reasons: 1) to get make sure as many as possible get health care coverage and 2) to insure viability for the insurers offering coverage. The Kaiser Family Foundation has created this flow chart to help you navigate that aspect of the ACA, click the image to go to the KFF homepage with a larger, easier to read version of the flow chart:
The gist of it those of us who are poor or have health insurance already are not affected. A single person who
is subject to the penalty for choosing
not to buy insurance will pay only $95 for all of 2014 or one percent of family income, whichever is greater, which would be significantly less than the premium cost for most wage earners. The idea is to give potential enrollees an entire year to navigate the new system as bugs are worked out or states now dragging their feet get their exchange up and running.
Which brings up another important feature overseen by the HHS: the state-run health insurance exchange being set up, the default for those seeking care in states that refused to create an exchange, and the policies themselves. But those are all meaty subjects, and we'll have more posts today and next week covering them!