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How Will The Affordable Care Act Help The Disabled?
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How Will The Affordable Care Act Help The Disabled?

The Affordable Care Act, otherwise known as Obamacare, which was enacted in 2010, will maybe not help the disabled as much as initially hoped. This is owing to the definition of habilitation for those in wheelchairs, etc, which is currently the focus of political attention due to the implementation of health care reform laws.

Habilitation is basically defined as helping a person to keep, learn or improve skills and abilities to function which they may not be able to develop normally. This is how it differs from rehabilitation, which is helping someone to regain lost skills and functions, walking, talking, etc, following an accident or illness. Whereas habilitation is about providing services for those persons who may never have developed the necessary skills in the first place, such as a child with cerebral palsy who has never learned to talk. This is often the problem for someone applying for health insurance payments for habilitative services, when the coverage often only applies to rehabilitation only.

Habilitation, i.e being taught and helped to do normal everyday tasks, is crucial for disabled people who are seeking more independence, as well as their families and carers. Habilitation can cover a diverse range of services, including basic physical therapy, cognitive training, speech therapy and others. The precise nature of the services required depend upon the individual person: for example someone who is physically impaired may need extensive physical therapy, to help them regain strength and become more coordinated, whilst an autistic child may need speech therapy and training in communications skills. These services can really make the difference between someone suffering from certain disabilities becoming institutionalised in a home, effectively quite helpless, or being as independent and active as possible within their own community.

Disabled rights advocates are consequently delighted that disabled people will now receive habilitaiton under the Affordable Care Act (ACA). It has apparently been mandated that the disabled must receive these services, so that their  health insurers must cover it. It sounds as if it shoud be a win-win situation: that if a doctor examines a disabled patient and diagnoses them as in need of habilation, it should then be possible for this patient to get the treatment they require.    

Unfortunately this is not as easy and clear-cut as it may seem,the main issue being that different US states decide what constitutes “habilitation” and what is and is not covered by this term. So disabled people could receive very different standards of care in different states, with some potentially devastating consequences for patients who need therapies which are not covered in their particular states. An example may be a child with Down’s Syndrome who needs speech therapy, and this may be allowed in Massachussetts but not in North Carolina. The impact of these variations could be devastating for those patients needing services not covered by their States. There is no doubt that a number of states and insurers will face legal challenges about their level of coverage, and this will be neither the first or last litigation over the ACA. It is litigation which is of the greatest import to the disabled community, who are counting on the ACA to address the current failings in the health care system, which leave disabled people vulnerable.

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