Case study Response on Key Feature of the Affordable Care Act
Successful implementation of healthcare policies requires the development and enforcement of rules and regulations governing the circumstances in which healthcare is provided to the citizens. Americans have championed for the development and implementation of universal health care to all citizens to achieve the primary objectives of healthcare which is to increase access to quality and affordable health care, improve the quality and lower the costs and enhance consumer protection from healthcare providers (Rak & Janis Coffin DO, 2013). The development of the affordable healthcare act (AHA) and the implementation provides a unique framework to address the critical issues or challenges towards the achievement of the goals and objectives of an affordable healthcare system. The implementation of the 2010 to 2015 Acts on affordable healthcare will contribute to increased efficiency in healthcare systems and hence enhancing the quality of healthcare services provided to Americans. The government has the responsibility of protecting its citizens from the healthcare consumers from any discriminatory behavior that will interfere with the provision of quality and affordable healthcare to every citizen.
I believe one of the most critical elements of healthcare that has been addressed by the Act is the development of new consumer protections. In most cases, insurance companies have become a barrier towards the provision of affordable healthcare and have contributed to increased disparities in healthcare. Regulation of the annual limit on insurance coverage will, for instance, improve the access to health care services at any time for the citizens (Heintzman et al., 2017). Ensuring that the insurance companies develop a website where consumers will get any information related to health insurance cover such as the age options will help the consumers to develop an understanding of the best healthcare cover policies for them. Most of the insurance companies were discriminatory of children based on their pre-existing conditions. Prohibiting denying coverage to children under the bases of their preexisting conditions enhances increased access to affordable health care.
With increased demand for quality healthcare in the states, most of the citizens have not been able to access affordable healthcare due to increased healthcare costs and especially the socially disadvantaged groups in society. The implementation of the Affordable Healthcare Act provides an opportunity to improve the quality of the health care provided to the citizens as well as lowering the costs. The 2010 Act provides the government will provide small business with tax incentives to facilitate them with an opportunity to provide insurance benefits to their workers ((Nikpay, Buchmueller & Levy, 2016). The act also provides that the government will ensure that citizens are able to receive free preventive care as well as support healthcare programs aimed at preventing disease and illness. The 2011 Act also provides for the introduction of new innovations to reduce the healthcare costs as well as providing for free preventive care for seniors which were not provided under the previous healthcare acts.
Access to quality and affordable healthcare has become a primary challenge in the United States of America with a larger population of socially disadvantaged groups unable to access quality health care due to increased healthcare costs, lack of equity in distribution of healthcare systems as well as increased regional marginalization (Shartzer, Long & Anderson, 2015). The implementation of these Acts will contribute to increased efficiency in the distribution of healthcare resources, reduction of the cost burden to the socially disadvantaged groups and hence providing them with an opportunity to access affordable and quality healthcare. Extending coverage to young adults up to the age of 26 years as well as extending coverage for the early retirees is one of the most important contributions of the 2010 Act and will play a critical role in increasing access to affordable care and reducing cost burdens to the citizens. Lastly, most of the insurance firms have been found guilty of healthcare offenses which by limiting consumers from access to affordable healthcare. The 2011 Act provides an opportunity to hold the insurance companies accountable for their actions or behavior by bringing down the healthcare premiums (Act, 2017). Therefore I believe the future of America healthcare and the ability of the government to improve the existing healthcare systems and improve the quality of healthcare provided to the citizens while increasing access to affordable healthcare will depend on the successful implementation of the Affordable Healthcare Act.
Case Summary
The case study on the Affordable Healthcare Act provides the Obama Administration presented an understanding of the critical issues facing the American Healthcare system as it. The study focuses on the need to develop and implement an affordable healthcare system and reduce healthcare disparities by providing each citizen with an opportunity to access quality and affordable healthcare as it is the responsibility to grant citizens their healthcare rights. The study has been able to highlight some of the key facts on American healthcare systems such as the limited coverage of healthcare insurances and its effectiveness in improving access to affordable healthcare (Sommers, Gunja, Finegold & Musco, 2015). The existing healthcare insurance covers such as the Medicaid do not provide the citizens with an opportunity to access quality healthcare services. the restrictions prevalent in most insurance covers such as annual limits, lifetime limits as well as coverage of children based on their pre-existing conditions have been some the common barriers to access to affordable healthcare.
The study has also highlighted the increased costs of healthcare through which only the wealthy people can access quality healthcare. The provisions of the Acts advocates for improvement on the quality of healthcare and lowering the costs which means that the present costs of acquiring or accessing quality healthcare are very high (Barbaresco, Courtemanche & Qi, 2015). There are still citizens who cannot access preventive care in the country and hence the need to offer free preventive healthcare. There is increased healthcare fraud in the current healthcare systems and especially through the insurance firms who search for any errors or technical mistakes in consumer’s healthcare policies with the motive of denying them payment for the services. They have also been found the culprit of increased charges so that they can gain maximum benefits from healthcare consumers of their insurance policies (Blumenthal & Collins, 2014). The insurance firms have not been accountable for their activities and hence the increased demand or concerns to hold them accountable to enhance the quality of healthcare services provided to the citizens.
The study has also addressed critical issues in American Healthcare System which is the poor pay of healthcare practitioners in rural and marginalized areas. The 2013 Act provides that the government should increase Medicaid payments for primary care doctors to motivate them to offer quality healthcare services and especially in the most marginalized regions. The study has also focused on increasing coverage of individuals through healthcare insurance policies to ensure increased access to affordable healthcare (Uberoi, Finegold & Gee, 2016). The study has therefore successfully addressed the issues of consumer protection, access to quality and affordable healthcare as well as improving the quality of Healthcare services while lowering the costs to the citizens (Heim, Lurie & Simon, 2015). These are the critical issues or challenges which are currently facing the American Healthcare systems and implementation of Affordable Healthcare Acts as provided under the Obama administration will play a critical role towards the development of affordable healthcare services in the country and reduce healthcare disparities through equitable distribution of healthcare resources.
Case Analysis
The material presented under the case study was provided under the Obama Administration on healthcare website. I believe that the issues presented under the affordable healthcare act have fairly represented the key issues in the law. This is because the existing healthcare law has been insufficient in addressing the healthcare concerns of the citizens and hence increasing health disparities in the economy as well as denying the citizens an opportunity to access quality affordable. The issues of consumer protection are very critical in law and it is the responsibility of the government to protect its consumers and especially on health-related cases to enhance the provision of quality healthcare (Wallace & Sommers, 2015). The healthcare systems are very complicated and it is very possible for consumers to be exploited or discriminated against through insurance firms. Developing regulations to control and protect consumers from any activity which would limit them from accessing affordable and quality healthcare is very essential (Nikpay, Buchmueller & Levy, 2016). Inequality and health disparities have also been critical issues of concern in healthcare systems in the country and therefore developing regulations to increase access to affordable healthcare are essential in ensuring Equity in the distribution of Healthcare resources in the country. Poor health services and increased costs of healthcare have been fairly represented in the law in that they have become a challenge to an effective provision of quality healthcare. Improving the quality and lowering the healthcare costs will contribute to improvement in overall healthcare standards in the country.
I believe the passing of the particular provision in the law was guided by the overall impact and necessity of the issues in the healthcare systems. For instance, the passing of the consumer protection laws was as a result of the increased need to protect consumers from exploitation and discrimination in their pursuit to access quality and affordable healthcare services. The passing of the laws regarding increased access to affordable healthcare was due to the increased health disparities in the country and the government vision to implement universal healthcare systems as required through the 2030 national development healthcare goals as provided by the World Health Organization (Dorner, Jacobs & Sommers, 2016). The provision of law regarding the improvement of the quality and reduction of healthcare costs I believe was passed as a result of the increased demand for quality healthcare services to fight and help in the prevention of diseases such as chronic diseases which have rapidly increased with majority of the population unable to access the care due to increased costs. I would not have faced them differently as I believe they have been fairly represented to address the critical issues in the current healthcare system.
The provisions provided in the Affordable health care have fairly represented the three visions of how a health policy should work. An effective health policy should contribute to equitable access to high quality and consumer-friendly services (Shartzer, Long & Anderson, 2015). The provisions in the act have therefore enhanced equity in the distribution of healthcare information or knowledge, opportunities as well as services. The provisions are also centered on improving consumer services and therefore developed to address consumer healthcare needs. Lastly, the provisions have also contributed to high-quality health care services as well as promoting accountability from government and healthcare services providers perspective.
Executive Decisions
The implementation of these provisions has however changed over time since the Supreme Court ruled on the constitutionality of various provisions in the ACA Act 2013. One of the key issues of concern to the court was the constitutionality of mandating all Americans to purchase health insurance failure to which they would pay a penalty. The court ruled the provisions to be constitutional since the penalty imposed was treated as a tax and the Congress had the right to impose a tax (Heintzman et al., 2017). Therefore, this rule has contributed positively to the implementation of provision by increasing the healthcare coverage through healthcare insurance policies or cover. The second issues of concern on the provision were the constitutionality of the expansion of Medicaid in which the court ruled that if the States were to choose to expand the coverage of Medicaid, then they must accept all the federal regulations and cannot choose where to expand. The implementation of this provision has enabled most states to increase the coverage of Medicaid and hence enhancing equitable distribution and access to healthcare resources.
The administration has however faced problems with the computers systems put in place since many consumers have experienced difficulties or challenges logging into the website as well as getting information on their eligibility for Medicaid and subsidies. The systems have been proving incorrect information upon an inquiry which has been misleading the consumers on the eligibility. The health insurance companies have also expressed concerns on the health plan reports which are supposed to be sent after a consumer has used the website to buy health insurance coverage. The insurance companies have reported concerns over production of reports with inaccurate information, with the wrong address as well as duplicated information. The implementation requirements have raised concerns to various groups with some populations voting against the plan and especially the Republicans supported by a section of Democrats. The federal government has also requested to be excluded from the funding some obligations which are supposed to be funded by the Insurance companies. Some Republicans have also voted to re-appeal the implementation of ACA as provided under the Obama care but to advocate for the implementation of America Care Act in which their efforts have not succeeded.
References:
Act, A. C. (2017). Affordable Care Act. Consumer Financial Protection. . Journal of Health Economics, 53, 72-86.
Barbaresco, S., Courtemanche, C. J., & Qi, Y. (2015). Impacts of the Affordable Care Act dependent coverage provision on health-related outcomes of young adults. Journal of health economics, 40, 54-68.
Blumenthal, D., & Collins, S. R. (2014). Health care coverage under the Affordable Care Act Journal of racial and ethnic health disparities, 4(3), 329-336.
Blumenthal, D., Abrams, M., & Nuzum, R. (2015). The affordable care act at 5 years. Tax Policy and Economy, 29(1), 133-157.
Dorner, S. C., Jacobs, D. B., & Sommers, B. D. (2016). Adequacy of outpatient specialty care access in marketplace plans under the Affordable Care Act. Obstetrical & Gynecological Survey, 71(2), 82-83.
Frean, M., Gruber, J., & Sommers, B. D. (2017). Premium subsidies, the mandate, and Medicaid expansion: Coverage effects of the Affordable Care Act. Journal of Health Economics, 53, 72-86.
Heim, B., Lurie, I., & Simon, K. (2015). The impact of the affordable care act young adult provision on labor market outcomes: evidence from tax data. Tax Policy and Economy, 29(1), 133-157.
Heintzman, J., Bailey, S. R., DeVoe, J., Cowburn, S., Kapka, T., Duong, T. V., & Marino, M. (2017). In low-income Latino patients, post-Affordable Care Act Insurance disparities may be reduced even more than broader national estimates: evidence from Oregon. Journal of racial and ethnic health disparities, 4(3), 329-336.
Nikpay, S., Buchmueller, T., & Levy, H. G. (2016). Affordable Care Act Medicaid expansion reduced uninsured hospital stays in 2014. Health Affairs, 35(1), 106-110.
Rak, S., & Janis Coffin DO, F. A. A. F. P. (2013). Affordable care act. The Journal of medical practice management: MPM, 28(5), 317.
Shartzer, A., Long, S. K., & Anderson, N. (2015). Access to care and affordability have improved following Affordable Care Act implementation; problems remain. Health Affairs, 35(1), 161-168.
Sommers, B. D., Gunja, M. Z., Finegold, K., & Musco, T. (2015). Changes in self-reported insurance coverage, access to care, and health under the Affordable Care Act. Jama, 314(4), 366-374.
Uberoi, N., Finegold, K., & Gee, E. (2016). Health insurance coverage and the Affordable Care Act, 2010-2016. Washington (DC): Department of Health and Human Services, Office of the Assistant Secretary for Planning and Evaluation.
Wallace, J., & Sommers, B. D. (2015). Effect of dependent coverage expansion of the Affordable Care Act on health and access to care for young adults. JAMA pediatrics, 169(5), 495-497.
Wherry, L. R., & Miller, S. (2016). Early coverage, access, utilization, and health effects associated with the Affordable Care Act Medicaid expansions: a quasi-experimental study. Annals of internal medicine, 164(12), 795-803.
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