Patient Protection and Affordable Care Act
Yolanda Raqueno
HCS/455
April 17, 2013
Patient Protection and Affordable Care Act The goal of this essay is to discuss the health care system in the United States. Another aim of this essay is to discuss the health policy, to improve, and to reduce inequalities. In the United States the private insurance system is a major provider of health care services, health care system is expensive and in many cases not efficient. This essay focuses on the patient Protection and Affordable Care Act, Formulating, Legislative, and Implementation stages. The government has trying to stop the increasing growth of spending on health care and offering different measures by pricing controlling
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The health reform will provide billions dollars in tax relief, and reduces what most people will pay for health care by capping -out of pocket expenses. Americans are allowed to choose their health insurance coverage, and the Affordable Care Act will help to ensure that American will receive a quality health care (Morone, 2008). The small business owner will be able to buy a health insurance for the employees. The small businesses will receive a tax credit for up to 50% of the cost the employees’ health insurance. The health insurance companies cannot reject coverage of pre-existing chronic illness, and the patients have right to appeal if an insurance companies refuse doctor ordered treatments (Morone, 2008). Federal health reform provides more people with access to health insurance coverage, establish legal protection for patients, and set up mechanisms for consumers to shop knowledgeably for health care coverage (Rigby, 2011). The advantages of health care reforms are the following:
• Expanding Medicaid to allow more consumers at the low-income families, or patients levels to qualify for health care insurance (Nichols, 2010).
• Encouraging business employers to offer health care insurance (Nichols, 2010).
• Provides credits to purchase private health coverage to moderate income Americans, especial to those are not qualified for Medicaid (Nichols, 2010).
• Streamline the purchase of health care coverage from the establishment of the
Medicaid is a social health care program that covers nearly 60 million Americans, including children, pregnant women, seniors, parents and individuals suffering with disabilities. Medicaid is the biggest source of funding for health related services and medical needs for the people with low income in the United States. This program is funded jointly by the state and federal level governments, but it is the state’s responsibility to manage this program. The Medicaid program is not a required program that states have to use, but all 50 states have implemented this program. With the introduction of the Affordable Care Act (ACA), and its passing in 2010, the ACA unveiled its plans to expand Medicaid eligibility to nearly all low-income adults as an addition to the other groups that fall into the Medicaid eligibility. The Medicaid program had “many gaps in coverage for adults” because it was only restricted to the low income individuals and other people with needs in their own specific category. In the past, the majority of the states who had adults that did not have children dependent on those parents were not eligible for Medicaid. These low income adults without dependent children would be without medical insurance assistance before the ACA was introduced. Medicaid is now available to all Americans under the age of 65 whose family income is at or below the federal poverty guideline of “133 percent or $14,484 for an individual and $29,726 for a family of four in 2011” (NSCL).
The purpose of The Affordable Care Act (ACA) is to increase access and make it more affordable for all Americans. Unfortunately, the US health care delivery system lacks the ability to plan, direct, and coordinate from a central agency making it difficult for citizens to obtain health coverage. For that reason, The Affordable Care Act in 2010 became the most extensive health care reform in US history with its main objective to reduce the number of uninsured. The ACA permitted some standards in the health care delivery system to achieve universal coverage. Some examples were authorizing health insurances to start covering children and young adults below the age of 26 under their parents’ health insurance plans also allowing the law to lower
For those Americans not covered or find their work coverage too expensive, there is a new way for them to buy insurance on their own called Health Insurance Marketplaces. Some states have named these marketplaces something else. The Health Insurance Marketplace is like a virtual insurance megamall where private insurers compete for American’s business. Americans can pick out how much coverage they want, how much they want to pay for it, from cheaper high deductible plans to more expensive plans. Regardless what plan is chosen, all plans will cover a complete set of services like hospital visits, doctor visits,
It was to be necessitated by the expansion of the community investments and the clinical preventive care. Alternatively, the accessibility of the preventive and primary health care was sought to be expanded and strengthened. The act has led to positive results in the aspect of the health care system. Low-income individuals were previously not able to afford their insurance coverage. It made it difficult for people to get access to good health care. However, the health reform act created a platform for programs such as Medicaid and Medicare. The programs were able to provide minimum coverage to all citizens and individuals who had no form of affordable employer coverage. Insurance companies were also given standards of selling their products. It is essential to note that the act created a bridge between the citizens and the health care system and all the financial disparities that
In recent years, health care has been a huge topic in public debates, legislations, and even in deciding who will become the next president. There have been many acts, legislations, and debates on what the country has to do in regards to health care. According to University of Phoenix Read Me First HCS/235 (n.d.), “How health care is financed influences access to health care, how health care is delivered, the quality of health care provided, and its cost”.
The United States has received a lot of benefits from Obamacare in helping the aid of many American citizens in the last five years. It offers many benefits that have helped people who are struggling in daily lives to get proper care. In the last five years, the health care reform has been providing a skyrocket in people to get insurance. It has also made an impact in the environment lowering any costs related to health.”New data from the Obama administration shows that Medicaid enrollment grew by almost 27 percent in the expansion states, compared to 8 percent in non-expansion states.”
There are Currently 32 million people without health insurance in the United States. This means that roughly 83 per cent of citizens have to live day by day hoping they won’t get sick. For this reason, President Obama signed the U.S health reform bill into law. The health reform will make health care more affordable for citizens. Employers with more than 50 employees will be forced to provide coverage for all, or they will have to pay a fine. It will also make health insures more responsible. For example, health insurance carriers are forbidden from placing lifetime dollar limits on policies, from denying coverage to children because of pre-existing conditions, and from canceling policies because someone gets sick. It will also expand
The law prohibits insurance companies from refusing to sell coverage or renew policies because of an individual’s pre-existing conditions. In the individual and small group market, the law prohibits the ability of insurance companies to charge higher rates due to gender or health status (“Medicaid expansion”). The law makes it so that health care policies have to cover screening, treatments, and follow up care for cancer. Medicaid has to cover yearly check-ups which will benefit cancer patients by talking about cancer prevention. Seniors don’t need to pay high cost for prescription drugs anymore. Coverage is now available for people that participate in clinical trials. Insurance companies can’t set yearly or lifetime dollar limits on how much they pay for patient care. Now, cancer patients can receive the care they need no matter what the cost is. Health care policies can’t charge people with illnesses any more than people that are healthy.
The primary goal of the Affordable Care Act was to expand health care access to Americans and subsequently reduce the number of uninsured in the nation. From September 2013 to March 2015, there was a significant reduction in uninsured Americans from 17.6% to 10.1% (Anderson, Hempstead, Karpman, Kenney, Long, Shartzer, Wissoker, Zuckerman , 2015). This was achieved through the new laws affecting private insurance and the expansion of the government’s Medicaid program. The ACA started the process by extending tax credits to an estimated 4 million small businesses that would help them provide insurance for their workers in 2010 (Implementation, 2016). In 2013, a marketplace exchange was finally opened for the American people to compare and purchase
The Affordable Care Act contains various exemptions and drawbacks. One big exception to this rule is for companies that “self-insure,” where they pay for their employees’ medical care (often buying “stop loss” insurance policy plan to secure the business from very high costs) rather than buying health insurance policy plan coverage for their workers. Self-insured plans do not have to offer the “essential health and fitness benefits” that each condition has described, they are exempt from the annually insurance policy plan fee that protected little groups must pay, and they will not enhance (or receive) state-based risk developments for protected little groups and individuals.
The United States “spends 17.6% of the Gross Domestic Product on healthcare” (Niles, 2015, Pg.53). Two programs that are supported by this gross domestic product are Medicare and Medicaid. Medicare is the “federal health insurance program for people who are 65 or older, certain younger people with disabilities, and people with End-Stage Renal Disease” (Centers for Medicare & Medicaid, n.d.). On the other hand, “Medicaid is a program that helps with medical costs for people with limited income and resources” (Centers for Medicare & Medicaid, n.d.). Without these programs the elderly, the disabled, and low income families would not be able to afford medical care or prescriptions. As a result, the health of these individual’s would deteriorate and they could possibly
The reform was created to bring many benefits to the healthcare system in the United States. Some benefits that individuals may see today include insurance coverage for children that have pre-existing conditions. This means that insurance companies will no longer be able to deny children because of pre-existing health conditions. This is very beneficial because these conditions can be chronic and require many medications or treatments that become very expensive. Another advantage is that insurance companies now allow individuals to appeal any denying coverage. This allows healthcare experts to review procedures that may had been denied in the past be approved after review. Preventative healthcare measures will now be covered in requiring no
According to Roy, 2013 the issues of providing the affordable care act will unite both the supporters and offenders of the public policy, but in this current situation where the input costs are rising, it will become impossible for government in managing the public policy related to affordable health care. In order to provide affordable health care, majority of the US government has tried out different policies time to time, but unable to get success in realizing the actual policy goals. By providing the affordable health care to majority of the people who requires more amount as controlling the input cost is not possible (AAMC, 2013). Lack of doctors is one of the primary issue in providing high quality health care to
One strategy is to provide coverage that was segmented into cover the most vulnerable in the population, poor women, children and the elderly. Initially, they were covered by Medicare and Medicaid but, when ACA was introduced additional options for coverage were introduced to the uninsured patients to shop for coverage in the marketplace. The lessons learned were that “increasing health insurance comprehension and designing exchanges to facilitate plan comparison will be critical to ensuring the success of health insurance marketplaces” (Barnes, Hanoch, & Rice, 2015, p.58).
Do we save billions of dollars or do we spend billions of dollars providing long-term care for avoidable chronic diseases. With the implication of the National Health Care Plan, we will no longer use the Band-Aid approach to health care. The emergency room festering with germs and patients will no longer be the Doctor of choice for the uninsured and underinsured. Preventative health care will be available to those in need. For those who chose not to insure a penalty will be paid. The quality of care and life will improve for millions. Clinics for the poor and uninsured will not be the only source of care, with very little and inferior products that more often than not are donated. The National Health Care Plan will allow us the opportunity to remove some of the Band-Aids we have put health. Americans will receive the quality health care they deserve.