PPACA Business Analysis

The Patient Protection and Affordable Care Act (PPACA), also known as the Affordable Care Act (ACA) or, more commonly, Obamacare, is a United States federal statute signed into law by President Barack Obama on March 23, 2010. The law mandates United States citizens to obtain health insurance coverage and businesses of 50 or more full time employees) to provide health insurance to its’ employees. Should you not be covered, a penalty will be imposed.

One of the cons of the PPACA could be the tax penalty for not carrying insurance coverage. The penalty starts at $95 or 1% of income, whichever is greatest. If the family or individual still chooses not to carry insurance, the penalty will rise each year. It doesn’t seem fair to make people choose between carrying medical coverage or getting penalized for not wanting health care

The Patient Protection and Affordable Care Act of 2010 (PPACA) was designed to decrease health care costs and require health care access to all U.S. citizens. The Act has the potential for reducing the cost of health care in the United States; however, with many risks which could possibly strain the health care system, increase debt, and decrease the quality of care many are concerned.

A series of events has recently occurred to cause the passage of PPACA. Economics are explicitly linked to health care. In the United States, health care coverage is provided primarily through an employer-based system. This system began in the depression era when pay was federally frozen. Companies, in an attempt to lure scarce workers, used benefits packages including health care as bait. Described as a “uniquely American” “private social security” health care system, the employer-sponsored system is the “cornerstone” of United States health care system (Blumenthal, 2006). This system has left many un- or under-insured. Blumenthal states (2006), “The United States’ dependence on employer-sponsored insurance means that the protection of its citizens against the costs of illness depends directly on the ability of private businesses to manage and absorb health care expenses that have defied all efforts to contain them.” Recently, economic downturn and the need to reduce expenses to better compete on the global market has caused many companies to both reduce their insurance benefits package and their work force causing many to lose their health care coverage. The employer-based system merged with the economic downturn, unaffordable health care costs for businesses, and

The act has an advantage or disadvantage. The PPACA promises to reshape the U.S. healthcare system by improving quality, lowering costs and increasing access to affordable healthcare. One way the PPACA seeks to increase access to care is by offering federal matching funds to states allowing them to cover more low-income patients on Medicaid. Individuals with pre-existing conditions who had previously been denied coverage will now have access to new coverage options. Beginning January, 2014, insurance companies will be prohibited from denying coverage to those with pre-existing conditions. The law also makes it illegal for insurance companies to rescind coverage after a patient becomes sick and it eliminates the lifetime limits on insurance

The basic standards that was signed in law by President Obama that The Patient Protection and Affordable Care Act (PPACA) will cover all Americans to quality and affordable access care and necessary transformation within the health care system to cover costs. The Congressional Budget Office (CBO) has established that the Patient Protection and Affordable Care Act is completely paid for and provides coverage for the American population. The primary transformation required by health insurances are shared responsibilities that the universal insurance market uses to eliminate discrimination practices in pre-existing condition, and having all Americans gaining coverage and affordable health care. Additionally, PPACA established health outcome improvement

The new law also provides some benefits to businesses. “The Obama Administration issued information about this law to small businesses across the country to help cut down the price of their health coverage to their employees.” (FDCH Regulatory Intelligence Database) The administration considers doing this a step to even the playing field between the large and small businesses. With this help almost four million small businesses can apply for relief from the otherwise high health insurance premiums. Potentially, this has the opportunity to save the smaller businesses almost $40 billion dollars by 2019. The Administration feels this is a tremendous idea because small businesses have been the engine to our economy for ages. The PPACA provides competitive health insurance markets that are referred to as Exchanges that will begin in 2014.This will provide the small and large businesses to come together and get a fairer deal from the bigger insurance companies. Business people in the physician assisted profession are positively affected by this new law. The American Academy of Physician Assistants states that this act offers tremendous promise in improving health care for all Americans. The Academy states, “The

Those who support the PPACA are majority Democrats. They claim that the government’s health insurance mandate is constitutional based on the Commerce Clause that allows the federal government to “expand its power in various ways by defining various activities as ‘interstate commerce.’” The government is not claiming an individual’s property, but is providing a compensation for the health premiums paid by each person (health insurance). Therefore, the health insurance requirement does not go against the Fifth Amendment’s Taking Clause that states that the government cannot take a citizen’s property without compensation for it. The supporters of ACA compare the health insurance mandate to minimum wage mandate. Just like the health insurance mandate that requires premiums paid to insurance companies, the minimum wage mandate has private beneficiaries (employees), as well.

The individual mandate was established under the Patient Protection and Affordable Care Act (PPACA), and works together with other ACA provisions to create a platform for affordable insurance for all (especially the poor and sick). The individual mandate requires most individuals to maintain minimum essential coverage for themselves and their dependents. Minimum essential coverage is listed in Section 5000A of the Internal Revenue Code (IRC) along with its regulations. Comprehensive coverage is considered to be the minimum essential coverage, which includes public coverage such as Medicaid and Medicare, and private insurance such as individual insurance, employer-sponsored insurance, and non-group insurance. Those individuals who do not comply

Employer-based health care coverage has been in place for many decades. Employers began offering health care coverage for two main reasons. Providing health care coverage was a way for organizations to gain a competitive advantage. Also, it was a way to add value to an employee’s compensation package without increasing their actual wage amount. Over time, the cost of health care has reached tremendous heights, leading to the government establishing the Patient Protection and Affordable Care Act (PPACA). GMFC is now concerned about the increased costs associated with providing necessary PPACA regulations.

PPACA has touted new benefits without measures to cut cost.1 One should know that in America there are already federal laws and programs to cover the elderly (Medicare), the poor (Medicaid), and uninsured children (CHIPs), In addition there is basically free or low cost care to anyone who needs it and it is available if one looks for it. Examples include: Shriner’s hospitals, free clinics, and providers who do pro bono work. In case that wasn’t enough, there are also laws in place that ban practices of charging more to people with pre-existing conditions in employer-based health insurance. The 60% of Americans who get their healthcare insurance from their employer may actually be hurt by PPACA.

The Patient Protection and Affordable Care Act (PPACA), commonly called Obama care, is a United States federal statute signed into law by President Barack Obama on March 23, 2010. Together with the Health Care and Education Reconciliation Act, it represents the most significant government expansion and regulatory overhaul of the U.S. healthcare system since the passage of Medicare and Medicaid in 1965. Guaranteed issue will require policies to be issued regardless of any medical condition, and partial community rating will require insurers to offer the same premium to all applicants of the same age and geographical location without regard to gender or most pre-existing conditions. It requires that all individuals not covered by an employer sponsored health plan, Medicaid, Medicare or other public insurance programs, secure an approved private-insurance policy or pay a penalty. According to this system, a child would stay under their parents insurance until they turn twenty-six. The non-participating employers/ citizens, health

If the government refuses to sponsor health insurance programs; such as Medicare and Medicaid, under the PPACA, then public consumers; such as ourselves, will otherwise go without medical insurance and perhaps, without necessary medical care.

The PPACA imposes an individual mandate requiring most U.S. citizens and legal residents to have health insurance coverage or pay a penalty. There are exceptions to this requirement for financial hardship, religious objections, American Indians, those without coverage for less than three months, incarcerated individuals, and certain low–income

Additionally, I’m fearful of what the PPACA’s effect will have on the Cadillac tax. Many employers are already cost-shifting and removing value-added items from their medical plan packages to reduce the worth of the plan. To this day I do not understand what the Cadillac tax’s underlying purpose is, why would the government care if an employer can afford to offer an excellent benefits package? Then, charge employers a lot of money for doing so. Presumably plans that are too rich encourage overuse of care, such as unnecessary tests and hospital visits that raise US