Opinion: Your Guide to ObamaCare

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America’s Favorite Nurse, Alice Benjamin, shares her views on how the Affordable Care Act, aka Obamacare, will impact you.


October 1 is right around the corner, but for many Americans they are just now beginning to learn about changes expected with the Health Care Law. The Affordable Care Act, also known as the Health Care Law and passionately referred to as ObamaCare, became law in June 2010.

Since that time, it has embodied numerous silent victories each year since its roll out. Primarily focused on the opening of the Health Insurance Marketplace on October 1, not many people knew it would take 10 years to fully enact the law.

Things in Effect Now Thanks to the Affordable Care Act

Children can’t be denied health insurance because of a pre-existing condition

Young adults up to age 26, can remain on their family’s health insurance plan

Health insurance plans must cover more preventative services

Insurance companies can no longer drop your coverage if you get sick, nor can they place lifetime dollar limits on health coverage

Medicare covers more wellness and preventive care

People with Medicare get discounts of 52.5 percent on brand-name prescription drugs and 21 percent on generic prescription drugs while in the doughnut hole. (Discounts increase over time with the doughnut hole completely closing by 2020)

For African Americans, the law has and continues to address inequities and will increase access to quality, affordable health coverage, invest in prevention and wellness, and give individuals and families more control over their care. By understanding what’s in the law, African Americas can make better health care choices for themselves and their families.

Beginning in 2014, the Affordable Care Act will provide 6.8 million uninsured African Americans an opportunity to get affordable health insurance coverage. This is significant as African Americans are disproportionally dying largely from preventable and manageable diseases.  The leading causes of death in African Americans include heart disease, cancer, stroke and diabetes.

African Americans also have higher prevalence rates of infant mortality, asthma, high blood pressure, overweight and obesity, high cholesterol and HIV/AIDS when compared to other groups. With the opportunity to have health insurance coverage, no longer will people have to ignore the early warning signs and forgo care.

Here are four things you need to know.

1. If you currently have health insurance now and like it – KEEP IT.

You don’t have to change it. But know that the Affordable Care Act has still helped you. Health care insurance plans are now required to cover more preventative services. Insurance companies will also no longer be able to limit how much they pay for your care annually (effective 2014) and over your lifetime (effective now). Women no longer have to pay more than men for the same insurance coverage. And older consumers now have better protections from increased insurance rates as they age.

2.  If you don’t have health insurance available through your employer or purchase your own coverage, you may now purchase insurance through the Health Insurance Marketplace.

The Health Insurance Marketplace, aka the Health Exchange is a resource where individuals, families, and small businesses can learn about their health coverage options; compare health insurance plans based on costs, benefits, and other important features; choose a plan; and enroll in coverage.

Private insurance companies within the Marketplace will compete for your business. This provides consumers options for quality comprehensive plans at lower competitive group rates. There are also federal tax credits and subsidies available for those whose incomes qualify to offset rates to ensure insurance is affordable. All Marketplace plans include 10 Essential Benefits which include access to vaccines and checkups, hospital and doctor visits, maternity care, mental health care and prescription drugs. Many preventive services including annual wellness visits are also covered at no cost to you.

Open enrollment runs from October 1, 2013, through March 31, 2014. However for coverage to be effective January 1, 2014, you need to register by December 7, 2013. For those who register in December but after that date, coverage will not begin until February 1, 2014.

3.  Medicare is strengthened.

The Affordable Care Act protects and improves Medicare with guaranteed benefits and cracking down on waste and fraud. It also identifies savings that will keep Medicare financially stable for at least a decade longer than if the law had not been passed.

4.  More people than ever will qualify for Medicaid starting in 2014.

If you’re eligible, you can get free or low-cost care and don’t need to buy health insurance through the Marketplace. Under the health care law, Medicaid eligibility is expanding in many states. Even if you were told you didn’t qualify in the past, you may qualify under the new rules. All U.S. citizens and legal residents with income up to 133 percent of the poverty line including adults without dependent children may qualify for coverage in any state that participates in the Medicaid program.

About Nurse Alice Benjamin:

Nurse Alice Benjamin is a nationally board certified Cardiac Clinical Nurse at world renowned Cedar-Sinai Medical Center in West Hollywood, California with over 15 years of experience. She is an American Heart Association spokesperson. She is the first African-American nurse elected to the American Nurses Association/California Board of Directors. Benjamin is also a freelance on-air health expert and writer. She has appeared on various national radio shows and TV shows including “Tom Joyner Morning Show”, “The Doctors” and HLN’s “News Now” and more. You can follow her on Twitter at @AskNurseAlice.