The Affordable Heath Care Act (ACA), commonly known as ObamaCare, is the new national health care law that was signed into law on March, 2010. Since becoming the law, the Patient Protection and Affordable Care Act (ACA) has altered insurance industry practices, expanded certain Medicare benefits, and initiated new payment and service delivery models. This law went into full effect on January 1, 2014. As of October 1, 2013 consumers looking for health insurance were able to turn to state-based health care exchanges. The exchanges are the centerpiece of the Affordable Care Act intended to help the uninsured and small businesses find affordable coverage. Many people who have had to put off seeking medical care because they could not afford it may finally get the care they need. Additionally, doctors may get paid for services that they have provided for free to uninsured patients. On the other hand, ObamaCare has resulted in the increase in Insurance premiums, an increase hiring of part-time workers and incentivizing businesses to scale back benefits. While it is debatable whether this law is positive or negative, Obama Care is the future of healthcare and it is here to stay. The healthcare law is over 2,500 pages and the complete details of this law are beyond the scope of this chapter. This chapter, will however, tell you the pluses and minuses of this law and how this affects you and your kidney stone.

There are many questions regarding the ACA. What is the impact of ObamaCare on you and your family? How will the ACA influence the health insurance industry over the next few years? What are the different plans? What kind of health care does a patient receive? Should individuals comply with the new federal mandate to purchase health insurance starting January 1, 2014, or pay the tax instead? This chapter will provide insight to help to answer some of these important questions.

There are ten health services that must be covered by every plan sold to patients. This includes:

Most health insurers will offer plans for individuals in five separate categories: This includes catastrophic coverage and four metal tier programs. The metal tiers are associated with the costs of how much a patient will pay in out of pocket expense vs. monthly premiums.

Choosing a tier that best suits your medical needs depends on what the individual can afford as well as the patient’s medical needs. If a patient is relatively healthy, the bronze plan with lower monthly premiums and higher out of pocket cost may make the most sense. However, for a patient with recurrent kidney stones requiring multiple procedures and preventive care, then the platinum plan with the high premiums but least costly deductibles may make the most logic.