Affordable Care Act

Affordable Care Act

Introduction

Healthcare has always been considered as one of the fundamental pillars of any country. It is well acknowledged that the health of a people is a fundamental determinant of the health of the economy especially considering that only healthy individuals have the capacity to generate wealth. In the recent times, the United States government has made numerous legislations that have changed the healthcare sector, the most fundamental of which is the Affordable Care Act. Popularly known as “Obamacare”, the Affordable Care Act is considered the most sweeping and reformative legislation since the passage of Medicare and Medicaid in 1965. It is aimed at giving all Americans the capacity to obtain medical coverage at an affordable rate. While there may be differing opinions as to the utility of the Affordable Care Act, the law comes as extremely beneficial to the country.

First, the legislation would allow for increased health insurance coverage in the country. Research shows that currently, there are about 32 million Americans who are yet to be under a health insurance cover (Hill, (2011). This piece of legislation will allow for these people to be covered at least by 2014 when the bill comes fully into force. This includes the 3.1 million Americans aged between 19 and 25, who are under their parents’ plans since they cannot afford to pay for their own plans (Tate, 2012). In addition, insurance companies will no longer have the capacity to deny individuals who have pre-existing conditions insurance coverage or even drop plan members when they become sick (Hill, (2011). For many years, applicants for health insurance in the Family or Individual market were required to complete an application and pass the approval of the underwriting guidelines. This was extremely frustrating to individuals who had their applications declined or even their premiums increased simply because of the preexisting health conditions (Tate, 2012). In essence, the Affordable Care Act comes as a relief to these people, as well as for individuals who are unable to afford their health insurance as they will be added to the Medicaid’s program in the states with the federal government paying the states for the addition (Tate, 2012).

On the same note, the bill comes as extremely beneficial to the low-middle income families and individuals. Scholars note that Medicaid program will be expanded so as to cover individuals in the low income brackets (Pipes, 2010). It is worth noting that individuals who have low income will obtain subsidies from the United States government, which will be catering for up to 100% of the monthly premiums (McCaughey, 2012). In addition, subsidies will be availed up to 400 per cent of the Federal Poverty Level. The determination of the subsidies is based on the family’s annual income, as well as the total number of dependants in that family. This ensures that individuals in the low-middle income bracket can access healthcare services if and when they need it, which goes a long way in enhancing the health of the country (McCaughey, 2012).

In addition, the Affordable Care Act reduces the healthcare costs (Murdock, 2012). The Congressional Budget Office noted that there would be a reduction in the healthcare costs in the country especially considering that the Act ensures that 95% of Americans obtain health insurance in which case there will be increased accessibility of preventative healthcare (McCaughey, 2012). It is noted that the newly insured individuals will not be waiting until their health problems become extreme to the extent of becoming an emergency, which is a relatively costly avenue (Murdock, 2012).

In addition, the Affordable Care Act would result in a reduction of the budget gaps or deficit in the country (Tate, 2012). It is estimated that by 2019, the Affordable Care Act would lower the deficit in the national budget by about $143 billion thanks to the Act’s associated fees and taxes (McCaughey, 2012). On the same note, the Congressional Budget Office opines that, by 2020, the Act would result in the elimination of the Medicare “donut hole” gap in its coverage. The donut hole is essentially a temporary limit on the things that the drug plan covers for drugs (Boehner, 2011). Once a beneficiary of Medicare has exited the initial coverage pertaining to the prescription drug plan, he or she would financially responsible for a considerably higher cost of the prescription drugs up to the time when he or she attains the catastrophic coverage threshold (Tate, 2012). This gap, however, will be eliminated by the bill thereby reducing the amounts that a beneficiary uses out of pocket for his medication.

However, the legislation has faced opposition especially from the business community. Businesses that have more than 50% full-time employees are required to pay for healthcare insurance for their workers (Boehner, 2011). This may see businesses pass the extra costs to consumers or reduce their full-time workers so as to fit in the less-than-50-fulltime-employees bracket (Atlas, 2012). On the same note, the ideal functioning of the program requires everyone to buy an insurance policy, failure to which he will have to pay “penalty income tax” (Atlas, 2012). While this may be considered a con, it goes a long way in enhancing the health of the nation in general.

In conclusion, the Affordable Care Act has been arguably the most radical program since 1965. It comes as extremely beneficial to the nation as it reduces the cost of insurance, increases coverage and eliminates the “donut hole” in the Medicare program. In addition, it reduces the budget gap thanks to the savings in the healthcare costs, as well as the fees and taxes from the Act.

References

Tate, N. J. (2012). ObamaCare survival guide. West Palm Beach, FL: Humanix Books.

Murdock, K (2012). Affordable Care Act: ObamaCare. New York: GRIN Verlag

Hill, J.W (2011). Obamacare – What’s In It. New York: Primedia E-launch LLC

Pipes, S. (2010). The truth about Obamacare. Washington, DC: Regnery Pub.

McCaughey, B (2012). Decoding the Obama Health Law: What You Need to Know. New York: Paperless Publishing LLC

Atlas, S. W. (2012). Reforming America’s Health Care System: The Flawed Vision of ObamaCare. New York: Hoover Press

Boehner, J (2011). Obamacare: A Budget-Busting, Job-Killing Health Care Law. New York: DIANE Publishing

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Affordable Care Act

Instructions

Imagine you are an office manager for a ten-physician primary care practice. You have been asked by the physician group to research and give a presentation on the new regulations impacting the practice as a result of the Affordable Care Act. Using the resources provided, plus at least two other peer-reviewed articles based on your own research, develop a PowerPoint presentation of 14–16 slides, complete with speaking notes. Address the following:

  • Explain the Affordable Care Act and its impact on the U.S. health care system and on the practice of health care in the United States.
  • Analyze current trends in policy, and predict future reforms as a result of the current state.
  • Explain how regulatory agencies have evolved to address health reform and policy.
  • Explain how health care reform and policy have impacted health care quality and cost.

You might want to (but do not have to) organize your presentation using the following outline:

  • Slide 1: Title of the Presentation.
  • Slide 2: Brief explanation of the purpose of the presentation.
  • Slide 3: The Affordable Care Act.
  • Slide 4: Impact on the U.S. Health Care System.
  • Slide 5: Impact on the Practice of Health Care in the United States.
  • Slides 6–7: Current Trends in Policy.
  • Slide 8: Future Reforms.
  • Slides 10–12: The Role of Regulatory Agencies (one slide per agency you address).
  • Slide 13: Impact to Quality.
  • Slide 14: Impact to Cost.
  • Slide 15: Concluding Summary.

Presentation Requirements

Your presentation should consist of:

  • 14–16 bulleted slides.
  • Speaker notes that fully explain each slide.
  • A minimum of two peer-reviewed references, in addition to resources offered in this course or that you find yourself, including government websites.
  • Appropriate APA citations and peer-reviewed references on each slide, as necessary.

By successfully completing this assessment, you will demonstrate your proficiency in the course competencies through the following assessment scoring guide criteria:

Competency 1: Analyze current health reform, policy, and regulation in U.S. health care.

Explain the Affordable Care Act and its impact on the U.S. health care system and on the practice of health care in the United States.

Analyze current trends in policy and predict future reforms.

Explain how health care reform and policy have impacted health care quality and cost.

Explain how regulatory agencies have evolved to address health reform and policy.

Competency 4: Communicate in a manner that is scholarly, professional, and respectful of the diversity, dignity, and integrity of others.

Produce a presentation that conveys understanding of the topic, its context, and its relevance.

Use academic writing conventions such as APA formatting and citation style, or others as required.

Produce writing that includes minimal grammar, usage, and mechanical errors, including spelling.

 

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