KHN: ACA repeal could impact these 4 provisions

Eliminating the ACA could also repeal these four key revisions, according to Kaiser Health News reporters Julie Appleby and Mary Agnes Carey.

1. Community needs assessments for nonprofit hospitals. The ACA requires nonprofit hospitals to justify their tax exemptions by showing how they use the money to improve their local community's overall health. Nonprofits have to perform a community needs assessment every three years and devise care strategies based on the assessment.

Following the assessment, the hospitals provide documentation to the Internal Revenue Service or face a $50,000 fine.

2. Patients' rights to select their own gynecologist. Prior to the ACA, some self-insured plans required women to get a primary care physician's referral when choosing their gynecologist. The ACA included provisions that required all health plans to allow women to seek care from a gynecologist without such a referral.

3. Monitoring surprise medical bills from hospital emergency room visits. The ACA mandates all health plans charge patients the same co-payments or co-insurance for out-of-network emergency care as they do for in-network hospitals. The health law also requires nonprofit hospitals to post its written financial assistance policy online, which details whether the facility offers free or discounted care and the eligibility requirements for ER visits. The ACA says hospitals must give lower rates to patients who are eligible for their financial assistance programs.

4. Coverage for autism and other degenerative diseases. President Barack Obama's health law requires payers to cover treatments for habilitative care as part of health benefits in individual and small group plans. Prior to the ACA, some payers would only cover rehabilitation to help patients regain functions they had lost. However, they would not always cover therapy for functions a patient never had, such as providing a child who never learned how to speak speech therapy.

To read more on Ms. Appleby and Ms. Carey's thoughts on how an ACA repeal would impact various provisions, click here.

Copyright © 2024 Becker's Healthcare. All Rights Reserved. Privacy Policy. Cookie Policy. Linking and Reprinting Policy.

 

Featured Webinars

Featured Whitepapers

Featured Podcast