Reforms Targeted by the Affordable Care Act - Literature review Example

 Affordable Care Act Social problem Far before the Affordable Care Act materialized, health insurance failed to provide peace of mind to citizens – it only provided panic, anxiety, and dread. About 129 million Americans-about one in two people could face discrimination because of conditions such as cancer, heart disease, diabetes, or even pregnancy or acne. For the other Americans, they were well aware that coming down with an illness got them a letter. This could lead them to miss an affordable coverage, be ensnared in a job or dropped from insurance since they became unwell and had no place to turn to (Richardson & Rivera, 2013). The enactment of the Affordable Care Act (ACA) had the aim of increasing the affordability and quality of health insurance. It will also increase the number of Americans under insurance cover, both public and private, in order to lower the uninsured, and to reduce the costs of healthcare for the government and individuals. The Act introduced some mechanisms-including insurance exchanges, mandates, and subsidies-to increase affordability and coverage. The law informs insurance firms to cover applicants within some minimum standards. The law offers the same rates despite of gender or pre-existing conditions. The Act offers additional reforms targeted to reducing costs and develop healthcare effects by changing the system to quality over quantity by increasing regulation, competition, and incentives to rationalize healthcare delivery. It was projected that the Act will lower both Medicare spending and future deficits. The insurance market before the Act was very discriminative. The insecurity was a deep hindrance to individuals. For a family that lacked coverage, adequate coverage or assured coverage, it was a perpetual worry in their lives, if not a source of financial damage or disaster. Those who thought their health insurance was okay for years suddenly discovered that was a fantasy when serious illnesses happened in their families. The scenario is now changing. No longer should health insurance be a means of doubt or pre-existing materials are unanswerable. If one loses insurance coverage or a job that was covered, there is a way to access care (Segal, 2010). The law is not just for people previously uninsured, or the 50% of Americans who have pre-existing conditions- It is for all Americans that were one illness away from insurance coverage purgatory. As progress is made each day, many Americans are getting enrolled and transitioned into new plans, it is critical to remember America is moving away from a broken system that characterized many Americans before the enactment of ACA (Richardson & Rivera, 2013). Public reaction Two polls showed that when the Supreme Court of the U.S ruled on the much-anticipated ruling on ACA, public reaction was likely to equal views concerning the law itself: Confused, divided, and unhappy. Outcomes from Wall Street Journal poll showed that 37% of Americans said they could be pleased if the Court had overturned the law, 22% said they could be disappointed, while around a 1/3 said they had "mixed feelings." The pollster found the same result when it asked a different question. 35% percent argued that they would become disappointed if the Supreme Court could uphold the law, while 28% said they feel pleased. The results leave many Americans less pleased with the Act (Huffington Post, 2014). A separate survey that was done by the Pew Research Center generated similar results. The pollster asked three questions to find reactions to various scenarios: Supreme Court could uphold the whole law, discard the entire law, or scrap the mandate that compels people to have health insurance. Fewer than half (between 39% and 44%) argued that they would feel happy, while between 48% and 51% said they would feel unhappy. According to the report of Pew Research, the results were along party lines (Huffington Post, 2014). Many Democrats were happy if ACA could be upheld while many Republicans were to be happy if it was thrown out. The likelihood that the Supreme Court could have rejected just the individual, did not satisfy either of the two sides. The views connect to more common opinions of the law. As the case, relatively restrained differences in the format and rewording of questions have produced some responses. Many polls show opposition is higher than support of the law, but the levels have varied, along with the respondents who are still undecided in opinions. The other constant finding is that a portion of opposition comes from the liberal Americans who argue that they were disappointed that the law fails to be more inclusive. The CNN/ORC polls done in the past two years have discovered that between 50% and 59% say that they are opposed to the law since it makes main changes to the health care system of the country. However, the surveys managed to ask a follow-up question, which showed that between 10% and 14% of all Americans were in opposition to the health reform law since they view that its approach is not liberal (Huffington Post, 2014). The public confusion of the law is constant. The Kaiser Family Foundation discovered that, during the past two years, just less than half of the citizens, between 42% and 55%, with no trend argue that the word "confused" better explains their feelings concerning the health care law. The confusion sense stands in the way of the absence of a personal benefit. The Kaiser Family Foundation poll in May showed that just 23% of Americans survive well under the new law; about 31% thought the new law would make them worse while 31% of the respondents argued that the law would not make any difference. The combination of division and confusion, combined with the absence of a perceived benefit, the majority of Americans would be unhappy about it. Affected populations The law had a primary goal, to reduce the number of the uninsured and increase the availability and affordability of the coverage of health insurance. The ACA fills the existing gaps in coverage by increasing the Medicaid program, increasing employer-based coverage, and provide premium subsidies to allow private insurance to be more affordable. Some of the provisions of ACA went into effect before January 1, 2014 (Richardson & Rivera, 2013). The coverage attempts to target the population of the uninsured. Among the 47 million non-elderly uninsured persons in 2012, about 24 million have incomes below 138% FPL. The group will benefit from the Medicaid expansion in states that decided to implement this expansion. Four out of ten of the non-elderly uninsured has incomes ranging between 139% – 400% FPL, the level targeted by subsidies purchased through Health Insurance Marketplaces.  Uninsured individuals will be benefit from the new requirements and rules (Richardson & Rivera, 2013). Legislative intended impact The Affordable Care Act was signed into law in 2010. It is the government's most comprehensive refurbishment of the nation's health care system in the recent past. The goals of the legislation are; to increase the number of people under health insurance, restructure the health care services delivery, and to reduce the costs of health care for each American by restricting some practices of the insurance companies and providing tax subsidies and credits for businesses and individuals. The legislation will give room for many people to be under an insurance cover. The cost of health care will also be reduced in order to allow low earners to afford insurance. The two primary features of the law that begun in 2014 are: the “employer mandate” and “individual mandate”. The individual mandate requires people not under an employer-sponsored plan or program of public insurance like Medicare, Medicaid, or the TRICARE program of the Department of Defense, to possess a private insurance policy from packages certified by the government, or pay a fine for not conforming to the program. The employer role requires businesses employing more than 50 people to provide health insurance cover for permanent employees or pay a fine of $2,000 for every uninsured worker. The law provides for a penalty of $3,000 for every low-income employee who receives insurance federal subsidy in instances where the employer offers coverage. The law has received huge support from Democrats, while Republicans have come out to condemn the policy (Huffington Post, 2014). Summary The Affordable Care Act, as per projections, will increase health insurance coverage to about 30 to 34 million Americans. However, the coverage expansion may not be an expansion of actual care, and the difference is clear. When the national health law was enacted, it released a potential tsunami of recently insured patients, overworking a delivery system that was fragile and strained. The health care infrastructure has witnessed shortages for many years and is not ready to meet such big number of patients efficiently. Training of new nurses, physicians, and other health professionals may take years. Without enough graduates from medical and nursing schools and innovation in shared responsibilities and roles among nurses, doctors, and other medical professionals, families and individuals may face longer times of waiting, difficulty in accessing providers, short time with providers, costs increase, and frustrations with care delivery. Accessibility to health care is the main goal of ACA, but claim for services will create a bottleneck in accessibility. People on the exchanges will experience limited providers and a narrowing of networks. The negative effect on financial stability and practice decisions is motivating physicians not to contract with health plans. The Obamacare requires some changes that will make it better. The following are proposals to improve them: (Schoen, Doty, Robertson & Collins, 2011). i. Enact medical-malpractice reform. It should be possible to prosecute a doctor or nurse who has been negligent, but such suits standards should be tightened. ii. Make it a real market. It is only the committed policy wonks who know what the health care exchanges. Perhaps people should call them health care supermarkets. Their role is to reduce premiums by allowing people and small employers to have the same market clout. For the supermarkets to work, they need to have competitive products. iii. Follow Roberts on Medicaid. One aspect of Obamacare is that it moved many people into Medicaid, a troubled program. The government should give states the choice to move recipients of Medicaid into the care supermarket system. iv. Pay doctors’ salaries. The fee-for-service system helps to encourage waste. The system rewards doctors for every test and procedure ordered. It is the driver of cost in the system. Annotated Bibliography Huffington Post. (2014). Obamacare Ruling: Polls Point To Confusion, Unhappiness No Matter What. Retrieved from http://www.huffingtonpost.com/2012/06/26/polls- obamacare-supreme-court-ruling_n_1628561.html on 2nd May 2014. The above article appeared on the Huffington Post. The article was reporting on various opinion polls that indicated the popularity of the Obamacare. The article highlights in detail about how the population thinks about the law. The material is very important for this paper since it offers enough information on how people view the law. Schoen, C., Doty, M. M., Robertson, R. H., & Collins, S. R. (2011). Affordable Care Act reforms could reduce the number of underinsured US adults by 70 percent. Health Affairs, 30 (9), 1762-1771. The journal highlights the benefits of the law. The journal talks about the benefits of the law to the underinsured in the United States. It reviews the possible gains that the law will have on people who are yet to be insured. There are many people without insurance due to the cost that requires somebody to be under insurance. The journal is very critical since it sheds light on the importance of the law. Segal, E. (2010). Social welfare policy and social programs: a values perspective. Australia Belmont, CA: Thomson Brooks/Cole. Providing a perspective of new values, Elizabeth Segal's book takes students and readers beyond just describing, identifying, and analyzing policies of social welfare. The writer demonstrates how the values of different groups in America have managed to influence policies, and helps readers recognize that analysis happen through the lens of opposing values. The themes of critical thinking and evaluation gives the book’s framework, and Segal's attention to different perspectives on social programs and social welfare policies heightens people’s awareness of the implications of social work in the world. The book is important since it provides dependable information about social welfare policy. Richardson, C. & Rivera, J. (2013). Health insurance within the affordable care act: select elements. Hauppauge, N.Y. Lancaster: Nova Science Gazelle distributor. ACA increases accessibility to the coverage of health insurance, expands the requirement of the private health insurance market, and necessitates the making of health insurance exchanges to offer small employers and individuals with access to insurance. The law also expands the coverage of Medicaid. The federal government’s cost of expanding Medicaid coverage and health insurance is projected to be equalized by increased revenues and taxes and reduced spending on federal health programs such as Medicaid. The Richard and Rivera's book provides an outline of main ACA provisions, oversight activities, and implementations. Tate, N. (2013). Obamacare survival guide. West Palm Beach, FL: Humanix Books. When President Obama assented to and signed the Affordable Care Act, he provided a sweeping piece of social legislation in American’s history. Since the Supreme Court upheld ObamaCare, it is vital that the people understand the impact the law will have on people’s lives. Tate’s book provides an excellent guide about the law and the implications it has for Americans. The book is a unique that helps Americans understand the details of ObamaCare. The book will serve as a valuable resource for the insured, the uninsured, and the millions of seniors, business people, youth and others affected by the law. The book is very informative since it explains the law in detail. References Huffington Post. (2014). Obamacare Ruling: Polls Point To Confusion, Unhappiness No Matter What. Retrieved from http://www.huffingtonpost.com/2012/06/26/polls-obamacare supreme-court-ruling_n_1628561. html on 2nd May 2014. Richardson, C. & Rivera, J. (2013). Health insurance within the affordable care act: select elements. Hauppauge, N.Y. Lancaster: Nova Science Gazelle distributor. Schoen, C., Doty, M. M., Robertson, R. H., & Collins, S. R. (2011). Affordable Care Act reforms could reduce the number of underinsured US adults by 70 percent. Health Affairs, 30 (9), 1762-1771. Segal, E. (2010). Social welfare policy and social programs: a values perspective. Australia Belmont, CA: Thomson Brooks/Cole. Tate, N. (2013). Obamacare survival guide. West Palm Beach, FL: Humanix Books. Read More