Affordable Healthcare: Overcoming Diseases Through the Health Exchange Marketplace - Essay Sample

Introduction

Diseases are some of the biggest challenges facing humanity across the world. Individuals, government agencies, and non-governmental organizations are spending a significant amount of resources on ensuring that people live a healthy lifestyle that is free of diseases. Since the biggest problem facing Americans citizens in accessing health facilities is the high cost of healthcare products and services, the government, through the Affordable Care Act, established the health exchange marketplace. Health exchanges, also called the health insurance marketplace, are organizations found in each state in the U.S, where people purchase health insurance (Rajczi, 2019). These organizations have allowed many people to access affordable health insurance in the country. There are several financial opportunities and challenges of caring for the newly insured people in California.

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Covered California was the first health exchange marketplace in the U.S established in 2010. There are four different options of insurance covers that individuals can subscribe to depending on their needs as well as financial abilities. These options are bronze, silver, gold, platinum, and the minimum coverage plan. In October 2013, the first month of Covered California operation, 35,364 people subscribed for the health insurance (Drake, 2020). By the end of November, the same year, over 360,000 people had enrolled for the Covered California health insurance plan (Drake, 2020). The number of subscribers has continued to increase, and by March 2018, 1,437,410 people had enrolled for the insurance. For the year 2020, 1,538,819 people registered for the Covered California health insurance plan (Drake, 2020).

Several financial opportunities are accruing from caring for the newly insured in California. First, freshly insured adults are often linked to regular care. They often seek medical services from regular, affordable medical institutions that serve the poor (Rajczi, 2019). As a result, the cost of medical expenses incurred by the insurer is relatively low. In some instances, the cost of services in those medical services in those facilities is too small that cannot be passed to the insurer (Hunt, 2019). Besides, newly insured individuals are less likely to seek expensive advanced specialized healthcare products and services from both private and public medical facilities (Rajczi, 2019). Besides, the newly insured tend to use preventive healthcare measures that keep them medically healthy, thus less likely to seek medical treatment covered by insurers. As a result, health insurers tend to collect a lot of money from newly insured who hardly claim the amount paid.

Apart from the financial opportunities, there are some financial challenges associated with caring for the newly insured. First, these categories of the insured people are more sensitive to the amount of premium paid for the coverage. As a result, most of them tend to subscribe to the cheapest and the most basic insurance plans. These basic plans often do not cover the essential medical services, such as surgery, yet the newly insured may claim such healthcare products and services (Hunt, 2019). Besides, medical facilities offering services to them may overcharge the insurer because the patients are less likely to conduct price comparison research between different healthcare service providers. As a result, health insurer tends to pay more the medical services whose actual cost is lower.

From the above discussion, it is evident health insurance play critical roles sustaining the health of individuals by meeting the medical experience. Health insurance marketplaces such as Covered California help to meet the far much need medical expenses for patients in each state. The introduction of the health marketplace has dramatically increased the new people purchasing health insurance plans. These newly insured individuals offer great financial opportunities to the insurers because they hardly seek healthcare products and services that require insurance coverage.

References

Drake, C. (2020). Valuation of health plan network breadth: Evidence from Covered California. SSRN Electronic Journal, 3(2), 23-36. https://doi.org/10.2139/ssrn.3157339

Hunt, S. (2019). Resources for the Health Insurance Marketplace. Nursing for Women's Health, 17(5), 448-450. https://doi.org/10.1111/1751-486x.12069

Rajczi, A. (2019). The case for universal health insurance. The Ethics of Universal Health Insurance, 2(2), 233-247. https://doi.org/10.1093/oso/9780190946838.003.0007