Despite all the information disseminated by the government about ObamaCare, many Americans are still confused between this Act and Medicaid. With all the jargon about insurance and the different health plans, it is not surprising that many people are at a loss to fully comprehend the difference between the two.
To begin with, ObamaCare is the colloquial term for the Affordable Care Act (CCA) or the Patient Protection and Affordable Care Act (PPACA). It is a health care reform law signed by President Barack Obama on March 23, 2010. It basically exists to make certain changes in the health care system in America to make it more affordable to the citizens.
Medicaid, on the other hand, is a health care insurance coverage funded by the government to Americans who are low-income earners whose percentage of earnings fit a category determined by the government that makes them eligible to be under Medicaid. Before we differentiate ObamaCare from Medicaid, it’s best to understand what the Affordable Care Act is all about.
ObamaCare: Bits and Pieces
1. Under the Affordable Care Act, most Americans will be required to get basic health care insurance coverage or the minimum essential coverage annually unless they are exempted, depending on the criteria or they will have to pay the “shared responsibility fee”.
2. There are certain dates assigned by the government termed as open enrollment wherein individuals can only sign up for a health care insurance coverage unless they are eligible for special enrollment. If the enrollment dates are over, those who will not be able to get coverage will be penalized. However, they can still get short-term health coverage although this is not categorized under minimum essential coverage.
3. For health insurance providers, policy holders can choose among companies under what is called the Health Insurance Marketplace. Some states have their own marketplace.
4. People can enroll with Healthcare.gov and for those who live in states that have their own marketplace, they will have to sign up with the state marketplace.
ObamaCare and Medicaid at a Glance
Insurance Providers are Private.
Under ObamaCare, insurance providers are private companies like Aetna, Humana, Blue Cross, UnitedHealthCare, among others. Medicaid, along with Medicare is managed by Centers for Medicare and Medicaid Services (CMS) is a social protection program of the government wherein private health care providers of Medicaid enrollees are paid by Medicaid and is funded by both the federal government and states with Medicaid expansion.
Services May Vary
Services offered under Medicaid also include dental as well preventive services such as screenings, vaccines and check-ups. Health care organizations belonging to Managed Care Organizations (MCOs) also provide care and services to the elderly and people with disabilities. As for ObamaCare, health insurance providers also provide these services depending on the health care plan or scheme of the policyholder.
Made to Imitate ‘Romney Care’
The Affordable Care Act (ACA) or ObamaCare was signed on March 23, 2010. It was patterned after “Romney Care”, also a health care reform law which was the brainchild of Republican Governor Mitt Romney of Massachussetts. Conversely, Medicaid was an amendment of the Social Security Act and signed by then President Lyndon B. Johnson on July 30, 1965.
Care is Dictated by your Health Care Plan
Benefits under ObamaCare depend on the type of health care plan paid for by the enrollee while Medicaid enrollees get different benefits which rely on the state of residence. States with Medicaid are given control to administer their own Medicaid program, set fees for the services and set the criteria for eligibility. They can also sign up with private health insurance providers or directly hire doctors and nurses if they prefer. Enrollees for ObamaCare can choose from metal plans such as Plantinum, Gold, Silver and Bronze, depending on the coverage they need and can afford to pay.
Restricted to Open Enrollment Dates
Americans who are required to get insurance policies under ObamaCare have to enroll within the open enrollment dates which usually run for a period of two to three months depending on what was decided on by the government. On the other hand, individuals who are eligible for the Medicaid program can enroll any day of the year. Once an individual is qualified and has enrolled, coverage is activated at once while under ObamaCare, coverage usually starts a month after enrollment. This is why people who wish to enroll during open enrollment are advised to do so the earliest time possible.
Serves Different Needs
ObamaCare aims to make health care more affordable to most American people while Medicaid exists to give health care services to people with low incomes who meet a certain criteria. Individuals who are required to enroll within open enrollment are those who not eligible for Medicaid, Medicare, who get job-based health insurance and who do not have health insurance coverage but can afford to have one.
Income Dictates Eligibility
Families with a household income of or below 133% of the Federal poverty level (FPL) are eligible for Medicaid, including children below 6 years old as well as children born after September 30, 1983, under 19 years of age and pregnant women who belong in a family with an income below the given federal poverty level. Eligibility under Medicaid can also include the elderly who are 65 years of age and disabled people. However, not all poor people can enroll under Medicaid. In fact, records say that around 60% of Americans who are considered poor do not have Medicaid.
Funding and Expansion
One of the provisions under ObamaCare is full funding of the coverage of new eligible adults for Medicaid starting 2014 and will last for three years. Funding will decrease to 90% by the year 2020. Along with other provisions, Obamacare aims to expand the Medicaid and Medicare.
Health insurance coverage under ObamaCare is paid for by the individual or the employer with employees over 50 in number while health insurance providers and services given to people with Medicaid are funded by the federal government and the different states.
In conclusion, ObamaCare and Medicaid are not one and the same. The former is a health care reform law with the goal of improving the health insurance system to ensure most Americans can afford health care services while the latter is a program that is geared to providing health care services to eligible Americans for low or no cost at all.