12 msfocusmagazine.org Gaps Remain Despite ACA Legislation Help is available if you are un- or underinsured It is said a lot, but multiple sclerosis is unpredictable. The disease causes symptoms that may change from day to day, but that mayalso change orworsen overlongerperiods of time. Forthese reasons and others, treatment can be complicated, individualized, and unfortunately, expensive. A 2015 study found that MS treatment can cost $60,000 or more annually. Healthcare costs that high can be a serious burden, even for those with health insurance. For those facing MS without insurance, getting proper medical care can seem impossible. There has been some good news in recent years, though. In 2014, with the passing of the Affordable Care Act (ACA), many beneficial changes affecting medical insurance were enacted. TheACAhelped lift millions out of medical distress, with people below or near the poverty line receiving the most benefit from the legislation. In 2013, before the ACAwent into effect, more than 44 million nonelderly Americans were without health insurance. By the end of 2016, that number had fallen considerably, to less than 28 million. As insuranceratesrose,peoplesawimprovements in their ability to pay for prescriptions and care. Despite providing much needed health benefits, the ACA didn’t solve all the problems that were built into the healthcare system. There are two major problems still hurting people who need healthcare. One of them remains uninsurance,while the otheris under- insurance. Addressing the needs of the uninsured Because of the ACA, many of those who didn’t have insurance became eligible to receive it through either Medicaid expansion or the newly established Health Insurance Marketplace. A study found that those who remained vulnerable were low-income families. In spite of the ACA’s creation of a Health Insurance Marketplace, and its efforts to expand Medicaid, tens of millions of people remain uninsured for a variety of reasons: Cost – If you do not qualify for free or subsidized coverage, the required costs, such as monthly premiums or out-of- pocket expenses, could be too high for you to reasonably afford. Confusion – The current insurance system is complex, constantly in flux, and can be incrediblyconfusingtonavigate.Thismeans that some people who may be eligible for certain benefits are simplyunaware of their options. Circumstances – As your personal circum- stances change, your insurance coverage may, as well. Marriage, divorce, job change or loss, the birth of children, or the death of a family member are just a few of the situations that could affect your insurance status. Employer – Not all jobs provide access to MS treatment can cost $60,000 or more annually Hot Topics