The Affordable Care Act - Case Study Example

The Affordable Care Act The Patient Protection and Affordable Care Act (ACA) was signed into law 23rd March by President Obama. The enacting of the Affordable Care Act (ACA) saw an enormous number of reforms undertaken in the U.S. healthcare system. The act represented the most comprehensive reform since the passing of Medicare and Medicaid 45 years ago. The Affordable Care Act seeks to provide low-income persons with subsidies. These grants are then used to purchase health insurance at affordable rates and increase coverage of people with health insurance. The act contained a number of provisions with their effective dates spread out over ten years from 2010 to 2020. To fulfill the act’s provisions, are a number of mechanisms. These mechanisms are subsidies, insurance exchanges, and government mandates. The Act also imposes tax penalties on the individuals who stay uninsured once reasonable health insurance is available. The over 900 page Act document contains a number of provisions. One key requirement is to make healthcare more affordable. The Act reduces healthcare cost through the 80/20 rule which details the amount insurance companies should dedicate to health care and on administration and profit. Before the Affordable Care Act, most insurers were raising premiums without any explanation. The act also reviews the procedure in increasing healthcare premiums and reduces the cost small business pay for health insurance. Another provision is on the accountability of the health care industry. Patients under the new law are more empowered. Patients cannot be denied coverage on the basis of pre-existing conditions. Also, insurers cannot drop sick patients or deny coverage without appeals. Another provision of the Act is in increasing coverage to affordable healthcare. With the enacting of the Act, millions of Americans have gained more access to more affordable or reasonable health coverage and care (Sommers et al., 868). The law emphasizes the need for access to free preventive services. These include wellness clinics and cancer screenings. Also under the law is allowing for healthcare coverage for individuals with pre-existing conditions or circumstances and increasing investment in primary care. The law provides for the strengthening of Medicare services. This is by making several key improvements. Improvements include lowering the cost of fighting fraud and adding new benefits to Medicare. The act also seeks to extend the Medicare Trust Fund life by eight years. The Affordable Care act introduces new preventive benefits such as reducing the cost of high prescription drugs. Reduced cost enables seniors and people with disabilities to save money. The provision of the Act is in creating avenues for higher quality care. One way to realize this is by cutting the red tape in getting access to affordable healthcare. The law requires health care plans to be simplified. The law also seeks to increase the quality of health care by encouraging innovation. This is by setting up of innovation centers for the testing of new innovative healthcare models that can reduce healthcare costs. The Affordable care Act provides for emphasis on prevention services and increased investment by the government in public health. The act permits the establishment of a Prevention and Public Health Fund, a National Health Service corps and community health centers. The law also allows for public-private initiatives in healthcare. Initiatives such as the Million Hearts Campaign help in preventing strokes and heart diseases. All these efforts have the goal of improving the nations health as well as assuring increased access to quality primary health. The numerous changes in healthcare have had a both positive and negative effect on American citizens. One positive effect of the Affordable care Act is in providing affordable healthcare mainly to the millions of uninsured patients all over America. Healthcare has been made affordable by reducing the amount insurers spend on profit and administration. The Acts benefit is that it prevents cancelation of coverage and denials as a result of a pre-existing condition. Denials and cancellations were a huge problem in the American healthcare system as insurers could not only invalidate coverage, but your coverage due to such a mistake, but require repayment for any given benefits that they paid out under this policy. Another positive effect is a requirement that all health care plans should cover the ten essential health benefits guidelines. In these guidelines is a requirement for free preventive services such as the screenings for diseases such as certain cancers, diabetes, and blood pressure. Also under free preventive services are annual well-woman visits, gynecological exams, immunizations, autism and behavioral screenings, and obesity screening and counseling. Another benefit of the Act is by expanding Medicaid. Medicaid is a state- and federally-funded health care program. Prior to the act, Medicaid only covered the low-income elderly, disabled, children, pregnant women and some parents. With the Act, coverage was expanded to include uninsured adults and the poor (Clancy, Uchendu and Jones, 527). Other benefits of the Acts include banning of lifetime limits on benefits and requiring states to set up insurance exchanges for easier shopping for insurance plans. The Act is also advantageous to the state by lowering the budget deficit over the next ten years through the raising of some taxes and shifting of cost burdens to health care providers and pharmacy companies. With all these advantages lie a number of cons with the Affordable Care Act. One major disadvantage is the increased healthcare costs some people incurred as they end up paying more for health insurance under the act than they did under their previous, private plans. Millions of private plans did not meet the ten essential health benefits were canceled. The costs of replacement insurance might be higher. Another disadvantage of the act is the loss of company-sponsored health care plans as businesses will find it very cost-effective to meet the penalty and let their workers buy their insurance plans. (Blumberg et al., 4) The Affordable Care Act can lead to higher short-term cost due to the high number of receiving preventive care and testing. The rollout of the act was marked by challenges in people shopping for health insurance. Also in the act are provisions for penalties to the uninsured and increased taxation to medical-device manufacturers, pharmaceutical companies and insurance companies. All of these present as cons to the act. States under the Affordable Care Act have the roles of expanding their Medicaid programs and or are involved in implementing provisions. Some states, however, have opted from expanding their Medicaid programs. The result of this is some of the poor in these non-expansion states are left without any assistance. In conclusion, the Affordable Care Act has been largely successful in providing affordable healthcare. Despite critics, it is a key legislation in recent times as it represents a major change in how the American government manages its healthcare system. With a long-term outlook on healthcare, the benefits of the act outweigh its shortfalls and thus more support and collaboration are required to enact all of its provisions effectively within the required period. Work cited Blumberg, Linda J., Buettgens, Mathew, Feder, Judy and Holahan, John. Implication of affordable healthcare for American businesses. The Urbban Insitute, 2012 Carolyn M. Clancy, Uchenna S. Uchendu, Kenneth T. Jones. Excellence and Equality in Health Care. American Journal of Public Health, 104:S4, (2014): S527-S528 Sommers , Benjamin D. , Musco , Thomas , Finegold , Kenneth , Gunja , Munira Z. , Burke , Amy , McDowell and Audrey M., . Health Reform and Changes in Health Insurance Coverage in 2014. New England Journal of Medicine. 371.9, (2014): 867-874 Read More