As healthcare costs continue to climb, access to affordable health insurance coverage is becoming a more pressing concern for many Americans.

The good news is that updated laws in the healthcare industry can lead to improvements in health insurance options for consumers.

Expansion of Medicaid Coverage

The Affordable Care Act required states to expand Medicaid coverage to individuals with incomes below 138% of the federal poverty level. However, some states opted out of this requirement.

In recent years, some states have changed their minds and expanded coverage to more individuals, meaning that low-income Americans now have access to affordable coverage.

Elimination of Lifetime Maximums

Health insurance policies used to have a lifetime maximum amount that the insurer would pay out for a policyholder.

This meant that individuals with chronic or ongoing health conditions would eventually hit a cap on coverage and be responsible for all additional costs. The Affordable Care Act outlawed this practice.

Pre-Existing Conditions

Prior to the Affordable Care Act, insurance companies could deny coverage or charge higher premiums to individuals with pre-existing conditions. This made it difficult or impossible for many individuals to access coverage.

Now, insurers must cover individuals regardless of pre-existing conditions.

Essential Health Benefits

Insurers must provide coverage in 10 essential health benefit categories, including maternity care, mental health services and emergency care.

This requirement ensures that consumers can access a wide range of important health services without worrying about whether they will be covered by their policy.

Subsidies for Lower-Income Americans

The ACA created subsidies to help lower-income Americans afford health insurance coverage. These subsidies can help cover premiums, co-pays and deductibles.

In addition, some consumers may be eligible for cost-sharing reductions, which help reduce out-of-pocket costs for medical care.

Consumer Protections

Insurance companies are now required to provide clear explanations of coverage options and costs upfront. They cannot limit the amount of coverage provided for essential health benefits.

Insurers must also cover preventative health services at no additional cost to consumers.

Telehealth Services

Virtual healthcare visits have increased in popularity in recent years, and updated legislation has made telehealth services more readily available to consumers.

This means that patients can get medical care from the comfort of their home, improving access to care for individuals who may not be able to easily travel to a doctor’s office.

Increased Mental Health Coverage

The ACA requires insurers to provide the same level of coverage for mental health services as they do for physical health services.

This means that consumers with mental health needs can access care without worrying about whether their policy will cover it.

Increasing Transparency

Laws have been implemented to require insurers and healthcare providers to increase transparency related to the cost of medical care.

Insurers must provide easy-to-understand explanations of coverage networks and costs, while healthcare providers must provide upfront pricing information for medical procedures and services.

Prescription Drug Affordability

Prescription drug costs have been a concern for many Americans, and new laws have been enhancing affordability.

Some states have enacted drug pricing transparency laws, forcing pharmaceutical companies to provide information on drug pricing to the public. The federal government has also taken action to stop price gouging and encourage generic drug development.

Conclusion

Updated laws have enabled significant improvements in healthcare coverage and affordability for Americans.

Medicaid expansion, elimination of lifetime maximums, consumer protections, and increased mental health coverage are just a few of the changes that have been seen in recent years. As the industry continues to evolve, continued focus on these improvements will be essential for ensuring access to quality, affordable healthcare for all Americans.