Discussion 1 Danait
ACA is among the most revolutionary healthcare reforms in American history. The law that was enacted during the Obama administration aims to enhance people’s access to health and also make it less costly. Despite the opposition that the law has faced from people like former President Donald Trump and other conservatives it remains beneficial. ACA was developed and enacted to reduce people’s expenditure on health and ensure that there was equitable access to care in the country. Some of the aspects of the law that have improved healthcare outcomes as well as reduced costs include Medicaid expansion, banning the discrimination of people with preexisting conditions, and the introduction of the market exchange.
Medicaid expansion is the increase of the scope of Medicaid coverage. While initially, the expansion was mandatory after states went to court, it became optional and therefore, states that wanted to expand have expanded while others have refused (Lee & Porell, 2020). The law required that states expand coverage to people who earn up to 138% of the federal poverty level. Medicaid was also to cover people up to 64 years old rather than the previous 65 years of age (Gruber & Sommers, 2019). Also, the federal government provides matching funds to cover up to 90% of the expansion costs. Therefore, unlike before, now more people can afford care. Parents who earn minimal wages have now been relieved of some of the weight of healthcare costs and can now access quality care because of Medicaid coverage. Apart from reducing costs, the expansion also promotes the use of preventive services that people could not afford before.
Another aspect of ACA that has improved care outcomes and also cut care costs to people is the protection of people with pre-existing conditions against losing their coverage or other discrimination like being denied cover. Initially, insurers were allowed to refuse coverage for people they deemed as risky to cut their operational costs (Gruber & Sommers, 2019). For instance, people with cancer, diabetes, and other issues would frequently be denied cover by companies. Such behavior led to poor outcomes because people could not afford the care they need without insurance coverage. However, after ACA, the discrimination was discontinued and therefore healthcare became available to all people despite having conditions at the time of seeking or renewing their covers.
Another part of ACA that reduced costs and allowed people to choose from several opportunities competitively is the Market Exchange (Parys, 2018). The Market Exchange was established to allow for competition among insurers that would allow people to choose premiums that were less costly and efficient for them. The aim of setting up market exchange was to enable people to compare and choose the best covers for them. It was expected that allowing for such competition would allow for reduced costs (Parys, 2018). While the costs of insurance have remained relatively high, the transparency allowed by the market exchange has prevented prices from going even higher.
In conclusion, ACA has been very instrumental in managing healthcare costs. The various provisions of the law have prevented insurance companies from exploiting people and allowed more people to get relief from the government through Medicaid expansion. The market exchange also allows people to compare prices to choose prices that are affordable to them.
Gruber, J., & Sommers, B. D. (2019). The Affordable Care Act’s effects on patients, providers, and the economy: what we’ve learned so far. Journal of Policy Analysis and Management, 38(4), 1028-1052. https://doi.org/10.1002/pam.22158
Discussion 2 Erin
The Affordable Care Act (ACA) was enacted in 2010 with the goal to expand healthcare coverage, improve the cost of healthcare as well as improve the overall quality of healthcare. The goals were to reduce spending that is unnecessary, improve healthcare value, enforce strategic investments in public health and increase access to care (Walker et al., 2020). Some of the positive effects that we have seen is that it requires employers with at least 50 full time employees to offer affordable health insurance coverage for employees that average more than 30 hours per week (Dillender et al., 2022). This can have many positive effects offering more Americans the ability to have insurance benefits that would normally not be able to afford it, but also can become a strain in businesses to be forced to offer these benefits. The ACA helped to substantially expand the Medicaid programs which was adopted eventually by 25 states by 2014 after the Supreme Court decision that states were not required to expand their Medicaid system. Medicaid recipients increased from 57 million from July through September 2013 to 74.8 million in November 2016 (Duggan et al., 2019). This again helped to expand coverage for non-elderly individuals that allowed them to now qualify for benefits that they typically would not have, but also put more strain on the system. As previously said though, one of the goals of the ACA is to expand coverage for patients in America to allow them to seek medical care routinely rather than emergently. This helps to allow patients access to preventative care medicine. When a patient is allowed the opportunity to see a physician prior to there being a problem then it reduces the cost of a hospital stay or even prevents one in the beginning. Chronic health conditions are managed through a primary care provider versus and emergency room visit which ultimately leads to a reduction in healthcare costs. The allowance of primary care visits due to insurance availability leads to improved preventative care measures that help to increase longitudinal health outcomes while decreasing healthcare costs at the same time. With an increase in primary, preventative care visits it shows direct improvements in patient compliance and some select preventative measures (Hostetter et al., 2020). The costs of healthcare seem never ending with their rising costs, but the initial goal behind the ACA is to improve healthcare in the U.S. and the direct health of the country. There are still some things that need to be figured out and improved with the initial thought behind the ACA, but it will come in time as we figure out where there needs to be more adjustments made which lessen the burden financially on the states or country as a whole. The U.S. needs increased healthcare coverage, but the cost is still astronomical or difficult for employers to follow the mandates and not being penalized. The ACA attempted to fill this gap for the citizens of the U.S., but as a whole still requires some work to adjust it to show the benefits. The ACA has had positive effects on highlighting the importance of preventative medicine and the positive outcomes that can be a result, keeping patients out of the hospitals.
Dillender, M., Heinrich, C., & Houseman, S. (2022). Effects of the Affordable Care Act on part-time employment: early evidence. Journal of Human Resources, 57(4), 1–31
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