Health Care Reform Paper

The Affordable Care Act is the most significant health care legislation passed in the United States since the formulation of Medicaid and Medicare in 1965. The purpose of the Affordable Care Act comprehensive reforms was designed to improve the affordability, accessibility, and quality of healthcare of the many of the American citizens. However, the effort towards an affordable, accessible, and high-quality healthcare system is not over (Kocher, 2010).

Healthcare Reform Bill 101 (Affordable Care Act)

Before the legislation of Patient Protection and Affordable Care Act (ACA), over 47 million non-elderly individuals were uninsured in the united states. Furthermore, the health care system of the united states was facing numerous complex challenges associated to access to healthcare as well as costs and quality of care. The United States had spent a lot of resources on healthcare provision per capita but has failed to produce better health outcomes. With the increasing demand to cut on spending, improve health care outcomes and increase health insurance coverage, health care reform policy became a priority for President Barack Obama administration. The congressional details of the law were crafted jointly by the Senate, and the House registers back to early 2009. After numerous iterations, the Affordable Care Act was signed into law on March 23, 2010 (Koh & Sebelius, 2010).

The ACA has been an ongoing endeavor to revamp the national health care system. By the year 2010, the Obamacare had increased rebates on drugs through Medicare for the Seniors. Obamacare initiated the process of closing Part D “Donut Hole” or Medicare Coverage Gap which was forcing Seniors to pay drug expenses out of their own pockets. By the start of 2012, new legislation was enacted on private health insurance plans. By the year 2013, Health Insurance Exchanges became available for low and middle-income earners making it possible to shop for health insurance. Reduction of part D coverage gap or “Donut Hole” was enforced. Obamacare laid out new rules about the amount that can be contributed to flexible spending accounts. By the year 2014, coverage of the Obamacare would no longer be denied to patients with pre-existing conditions (Kocher & DeParle, 2010).

The healthcare reform timeline of 2015 required all employers with over 50 full-time employees to provide coverage to all its employees. The Act stipulated that the Doctor’s income will not be based on the quantity of care but will be based on the quality of care serving to protect the American citizen’s protection from the current fee-for-service payment model. By the year 2017, healthcare reform will require the states to be given the flexibility to enable business with over 100 full-time employees to purchase coverage through the SHOP Exchange (Rosenbaum, 2011).

Key features of the Affordable Care Act

The key features of the Affordable Care Act aimed at addressing critical issues affecting healthcare system of the united states include increasing access to health care by providing enhanced funding to support states opting to expand Medicaid to all non-elderly persons below 133 percent of the federal poverty level. Creating a state-based Marketplaces (Exchanges) insurance which offers subsidized health insurance plans. Extending insurance coverage to young adults through the age of 26. Expanding and strengthening the support for school-based health centers, community health centers, and workplace wellness programs (Huntington et al. 2011).

The ACA act was designed to improve the quality of healthcare by promoting integrated health care systems, establishing innovation centers for Medicaid and Medicare to analyze and assess the strategies aimed at reducing costs of healthcare and improving the quality of care. The Act created a value-based purchasing which bound the physicians and hospital payments to improved health outcomes, and supporting patient-centered medical homes (PCMH). The ACA intended to protect consumer rights by prohibiting the discrimination based on gender and pre-existing conditions. Eliminating the annual dollar limits prescribed on the coverage of essential medical benefits and creating an 80/20 directive compelling the insurers to utilize 80 % of the insured premiums on healthcare services and quality improvement (Rosenbaum, 2011).

The ACA Act has the potential to expand the availability and suitability of health insurance options for employers and their workers in small firms. Small and low wage employers in 2010, became eligible for tax credits to assist them in procuring health insurance. By the start of November 2014, all firms with less than 50 employees were able to purchase insurance cover online in the newly established Small Business Health Options (SHOP) Marketplaces. In some instance, the Affordable Care Act required some employers to contribute to the cost of their employees’ health insurance coverage. The requirements are meant to limit the cost of federal subsidies by encouraging employers to provide affordable insurance coverage (Kocher & DeParle, 2010).

Affordable Care Act and Business Operations

The ACA Act has altered the way business operates and has forced many enterprises to rethink their hiring strategies. The job description between full time and part time workers has affected the human capital strategies of many firms. Many large companies prefer to outsource their HR tasks as it involves working with consultants who are specialized in Human Resources and have an in-depth understanding of the health care reform policies, laws, and regulations. The consultants provide suggestions that best suit the organization in terms cost-effectively streamlining the administrative process. Companies, therefore, will be required to formulate and implement strategic plans to evaluate the ability of the enterprise to contribute to the employee’s healthcare coverage (Koh & Sebelius, 2010).

With the introduction of the new law, employers must quickly evaluate the implications of health care reforms on their workforce strategies and benefits as well as the risks and opportunities which the changes generate. The extent and the type of modification the employers will make will vary by industry and the collective bargaining agreements. However, most employers will create value creating options geared towards making no changes to the current offering and the extent of entirely dropping employee health coverage. Employers must pursue more radical changes intended to modify the existing benefit packages for higher income employees (Huntington et al. 2011).

The reforms in healthcare fundamentally alter how employees value health insurance and the social contract inherent in employer-sponsored medical benefits. The ACA Act has guaranteed all citizens the right to health insurance regardless of an individual’s medical condition. The ACA act has minimized the moral obligation employers may warrant to cover the sickest employee who would have otherwise been neglected in today’s individual health insurance market. Healthcare reforms have preserved the corporate tax advantages associated with the offering of health benefits. The benefits must provide a reasonable level of health coverage as employers will no longer be compelled to offer better benefits to high-income executives than to their hourly employees (Koh & Sebelius, 2010).

Primarily due to the law’s reforms, the Affordable Care Act has made significant progress towards solving the long-standing issues facing the United States health care system related to access, affordability, and quality of care. Since its enactment into law, the uninsured rate declined by 43 percent. This is by far the most significant decline recorded in the uninsured rate since the establishment of Medicaid and Medicare programs five decades ago. The law has dramatically improved health care coverage for Americans who already had it.  The coverage offered on the individual market now includes a set of healthcare services including treatment of mental health, substance use disorders, and maternity care services that were previously not covered in the program (Rosenbaum, 2011).

Policymakers should base on the advancement contrived by the Affordable Care Act by ensuring that the Health Insurance Marketplaces and delivery system reform are properly implemented. Policymakers should advocate for the increase of federal financial assistance for Marketplace enrollees and introduce a public plan option in areas which lack individual market competition and taking appropriate measures to reduce the cost of prescription drugs. Although special interest opposition and partisanship remain, the understanding of the Affordable Care Act depicts that positive change is feasible on some of the nation’s most complex challenges (Huntington et al. 2011).

Conclusion

The Affordable Care Act was signed into law on March 23, 2010. The purpose of this legislation was designed to improve the quality of healthcare, protect consumer rights, increasing access to health care and lower health care costs. The ACA has been an ongoing endeavor to revamp the national health care system and Policymakers should rely on the milestones achieved by the Affordable Care Act to ensure that the delivery system reforms and Health Insurance Marketplaces are implemented.

References

Huntington, W. V., Covington, L. A., Center, P. P., Covington, L. A., & Manchikanti, L. (2011). Patient Protection and Affordable Care Act of 2010: reforming the health care reform for the new decade. Pain physician, 14(1), E35-E67.

Kocher, R., Emanuel, E. J., & DeParle, N. A. M. (2010). The Affordable Care Act and the future of clinical medicine: the opportunities and challenges. Annals of internal medicine, 153(8), 536-539.

Koh, H. K., & Sebelius, K. G. (2010). Promoting prevention through the affordable care act. New England Journal of Medicine, 363(14), 1296-1299.
Rosenbaum, S. (2011). The Patient Protection and Affordable Care Act: implications for public health policy and practice. Public health reports, 126(1), 130-135.