Aspects of Affordable Care Act
Introduction
The Affordable Care Act was introduced by the Obama administration to address the inequality of healthcare access in the American healthcare system. Before the law was enacted, uninsured persons in the US received approximately 50% of the healthcare that individuals who had insurance did in the whole year. Today, nearly 50 million Americans do not have insurance coverage and have difficulty accessing health care (Commonwealth Fund, 2013). However, the Affordable Care Act had the objective of ensuring near-universal health coverage for the American people through a series of reforms and expansions. The Act expanded Medicaid and led to the development of state health insurance exchanges that allowed individuals to purchase private insurance plans that were subsidized. Furthermore, it also availed affordable coverage to people whose incomes were modest, who are the majority of the uninsured population.
This Act was a comprehensive healthcare reform law that had three main objectives, including,
- Â Making affordable health insurance accessible to more people by offering them subsidies or premium tax credits that reduce the costs for people with incomes ranging from 100%-400% of the federal poverty level.
- Individuals with an income above 400% federal poverty level were also eligible for the premium tax credits provided by the Act.
- Individuals with 150% income below the federal poverty level qualified to be enlisted in Change Marketplace coverage using the Special Enrollment Period.
- Expanding the Medicaid program also to include adults with incomes below 138% of the federal poverty level.
- Supporting new technologies in medical care delivery methods aimed at lowering the cost of healthcare.
Obamacare contains comprehensive healthcare insurance reforms, including tax provisions affecting families, individuals, insurers, businesses, government, and tax-exempt organizations. These provisions bring with them many reforms in the health insurance sector, including how people are required to file taxes. Moreover, it also contains responsibilities and benefits that organizations and employers can accrue from the program. The Act banned the many demotivating practices by health insurance companies which included instituting high insurance changes for consumers, denying people coverage due to various reasons, or the exclusion of certain benefits from an insurance package based on preexisting conditions (UHHS, 2017). The new Act was able to improve and expand health insurance coverage which helped to reduce medical bills and improve access to care and the overall health of the American people.
Expand Insurance Coverage
The Act aimed at extending health insurance to an estimated 30 million uninsured Americans by broadening public and private insurance. It required everybody to have insurance by helping them purchase insurance through public insurance exchanges that provided subsidies. Employers were obligated to cover their employees or pay penalties. It also provided tax credits for small businesses covering certain health insurance costs for their workers.
Increase Insurance Protections
Among the notable reforms that Obamacare enacted included the broadening of insurance protections for consumers. It provided that there should be no lifetime monetary limits on insurance coverage to increase insurance protection for the consumer. It also covered children and preexisting conditions in its provisions and ensured they enjoyed health insurance coverage without any discrimination (Weatherspoon, 2020). Furthermore, it also did away with canceling insurance plans and reviewing unreasonable increases in insurance premiums by the state. These measures were designed to increase and broaden insurance coverage to assist individuals that were discriminated against by health insurance companies for various reasons.
Enhance Wellness and Prevention
This Act provided measures that aimed to prevent diseases by establishing a Prevention and Public Health Fund that was to be used to fund the state in preventative activities such as immunizations and screenings. Its activities also covered efforts to address physical inactivity, tobacco use, and poor nutrition, among others. Moreover, it also increased Medicaid payments by the federal government for certain preventative services. Finally, it established a national home-visiting initiative to enhance health for families living in risk communities.
Promote the Development of the Health Workforce
The ACA has provisions that deal with workforce issues which include scholarship increases in the health profession, reforms in the training of medical staff, supporting nurse training and new primary care models, including team management of chronic diseases, medical homes, and more funding for community health centers.
Deal with Increasing Health Costs
The Affordable Care Act had many vital provisions that addressed the high cost of health care. They included strict supervision of health insurance premiums and practices, emphasizing primary care and effective treatment, reducing abuse and fraud in health care, reducing uncompensated care, and implementing Medicare and Medicaid reforms. Other measures included enhancing comparison shopping to increase price transparency and competition and testing new payment and delivery system models in Medicare and Medicaid.
Additional Provisions
The Affordable Care Act had many other provisions tailored to improve access to health care. These provisions include:
- The implementation of coverage standards to curb the discrimination of insurance applicants by insurers, including charging higher premiums based on gender or preexisting conditions
- The elimination of waiting periods rampart in employer-sponsored plans
- Guaranteed the issue of health policies irrespective of an applicant’s health status. Income or gender
References
Commonwealth Fund. (2013). New Video: How the Affordable Care Act Expands Health Insurance Coverage. Web.
US Department Of Health and Human Services. (2017). What is the affordable Care Act?. Web.
Weatherspoon, D. (2020). The Affordable Care Act: An update. Medical News Today. Web.