WEST ORANGE, NJ - On November 14, 2012, the Pleasantdale Elementary School PTA welcomed guest speakers Dr. Lisa Lieberman and Dawn Diamond to present information on the Affordable Care Act and what the public can expect. Ms. Lieberman is a faculty member at Montclair State University in the Department of Health and Nutrition Sciences, and Ms. Diamond is a recent Montclair State graduate of the MSU Master of Public Health Program.
Main points that were stressed in regards to the Affordable Care Act were understanding what it includes and also an explanation of Health Insurance Exchanges. Some features and provisions of the Affordable Health Care Act will include: increased preventive health funds; an allowance for children to remain on their parent’s insurance until age 26; no pre-existing conditions penalties; no lifetime limits; and bundled payments (bundled payments refer to generating one payment to multiple providers within a medical group that will also include incentives to provide more efficient and higher quality care. This would replace, for example, the current method of a single surgical procedure producing multiple claims from multiple providers). The Exchanges would be set up as a marketplace that offers a choice of health plans to meet the needs of consumers, common rules regarding the insurance offering and pricing, and better information. These insurance companies must also meet a minimum requirement of coverage in order to be a part of this marketplace.
According to the Henry J. Kaiser Family Foundation website, Insurance Exchanges are defined:
“Exchanges are new organizations that will be set up to create a more organized and competitive market for buying health insurance. They will offer a choice of different health plans, certifying plans that participate and providing information to help consumers better understand their options.
Beginning in 2014, Exchanges will serve primarily individuals buying insurance on their own and small businesses with up to 100 employees, though states can choose to include larger employers in the future. States are expected to establish Exchanges--which can be a government agency or a non-profit organization--with the federal government stepping in if a state does not set them up. States can create multiple Exchanges, so long as only one serves each geographic area, and can work together to form regional Exchanges. The federal government will offer technical assistance to help states set up Exchanges.”
The greatest fear appears to be is that many believe this is socialized medicine, where the government runs healthcare, but this plan it is regulated by government while an individual’s insurance company is still in charge of their healthcare and their contract is still between them and their insurance company. There will be a penalty tax on those individuals who do not have health insurance. There is also expected to be an expansion of Medicaid.
States must submit their decision to have state designed exchanges by Friday November, 16 2012 and have a detailed plan due by December 14, 2012.
Following the presentation, West Orange Alternative Press spoke to Pleasantdale PTA President Lee Etta Sutton and asked why they chose to have these speakers visit. She said “the health and wellness committee met with the realization that a large amount of our community was either under insured or uninsured. We wanted to provide information on how the new law would affect them and provide them coverage.”
PTA secretary and Chairman of the Health and Wellness Committee, Nina Goodey, added, “I feel fortunate that Professor Lisa Lieberman of Montclair State University was able to come and speak with our PTA membership. The presentation was both accessible, entertaining, detailed, and it provided valuable information to our community.”