Essay Example on ACA: Revolutionizing US Healthcare System

Introduction

The federal Patient Protection and Affordable Care Act is one of the leading establishments in the USA that has impacted healthcare. ACA is a comprehensive reform in healthcare that was signed into law in 2010 during the reign of the retired president Obama; as a result, it was termed as Obamacare (Kaestner et al. 2017. The government has made changes to reframe the role of ACA in society and how it affects individuals and the government financially. ACA expanded the functionality of Medicaid and created insurance policies that prevent insurance providers from charging more or denying coverage due to preexisting conditions. This paper, therefore, identifies significant changes in ACA and describes how these changes have impacted healthcare since.

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ACA was essentially an expansion of the Medicaid, a public health insurance program in the USA that used to cover low- income individuals or families. Medicaid covers hospital stays; doctor visits custodial care, long-term medical care, and other health-related issues. Established of ACA influenced Medicaid functionality from different perspectives. One, it has helped to increase its eligibility to adults with low income (Antonisse et al. 2018). ACA has positive impacts on Medicaid in terms of enrollment and, more specifically, in states that have embraced Medicaid expansion. Under the act, all states are mandated to offer multiple options to individuals and provide real-time eligibility. All states are required to implement all ACA changes to expand Medicaid roles in society. Since 2016 however, ACA has been through various changes that have influenced healthcare differently; they include the following:

1. States Allowed To Add Work Requirements to Medicaid

The expansion of Medicaid is one of the main changes in the ACA approach to healthcare. Through ACA, the government can help states that chose to implement Medicaid expansion beyond family framework to all adults with low income. Besides, this change helped to increase income thresholds to enable more people to remain eligible for the medical cover. The government has changed on how ACA is applied; Medicaid beneficiaries are now required to prove their eligibility through documentation. The government wants to add more engagement requirements at the community level. As a result of this change, over 12.7 million citizens were able to get covered following new enrollment capabilities provided by Medicaid (Simmons-Duffin, 2019).

2. Elimination of Individual Mandate

The individual mandate is a federal requirement that all the residents in the USA must acquire health insurance or pay the penalty. ACA introduced this policy to help maintain premiums low by ensuring that healthier people are in the health insurance market. In 2017 however, the government, through the republicans, changed tax overhaul law to reduce the penalty for not having insurance cover to $0. The impact of this change significantly weakened the role of ACA by diminishing its ability to meet the objectives of providing health care to all (Alcalá et al. 2017). Failure to pay penalties for not having insurance causes a rise in insurance premiums since healthy people would consider buying insurance cover affecting financial capabilities to support those in need of healthcare cover.

3. Reduction of Cost-Sharing

ACA required the government to pay subsidies to insurance companies to motivate them to support healthcare. However, in 2017, the government stopped paying these subsidies claiming that these subsidies were going to insurer’s pockets (Hu et al. 2018). The impact of this change considerably affected healthcare; the new insurance markets changed. The number of people enrolling in insurance cover reduced since the government stopped paying subsidies making the companies incapable of covering for more clients. The premiums rose. Pricing strategy for insurance cover changed, which negatively influenced healthcare provision, especially for low-income families and individuals.

4. Change in Access to Short Terms Healthcare Plans

Initially, ACA required health plans to be sold through healthcare.gov and exchanges of states to cover patients with preexisting conditions. There was a limitation to short-term insurance providing essential benefits to these individuals for a short period (three months). The government has, however, expanded to 1 year before renewal (French et al. 2016). This change has helped to reduce the cost of healthcare and improve access to essential healthcare facilities for more than three months under insurance cover. As a result of this move, healthcare has become more affordable and accessible for patients with preexisting health conditions. On the other hand, the change under the ACA does not provide cover for all essential needs for patients with critical health conditions.

Conclusion

Conclusively, ACA has dramatically helped to improve access to quality healthcare, and it makes it more affordable for the general population. The introduction of ACA helped to improve Medicaid roles through the expansion of terms and conditions requiring all states to participate and provide quality care for the residents. Since 2016, however, there have several changes in ACA. Some of these changes are positive, and others influence healthcare negatively. The government is the leading participant in making changes; insurance companies providing medical covers have been affected. Most of the changes have caused a delay in the implementation of ACA, thus impacting health ace negatively.

References

Alcalá, H. E., Chen, J., Langellier, B. A., Roby, D. H., & Ortega, A. N. (2017). Impact of the Affordable Care Act on health care access and utilization among Latinos. The Journal of the American Board of Family Medicine, 30(1), 52-62. Available at: https://www.jabfm.org/content/jabfp/30/1/52.full.pdf

Antonisse, L., Garfield, R., Rudowitz, R., & Artiga, S. (2018). The effects of Medicaid expansion under the ACA: updated findings from a literature review. Published March. Available at: https://pdfs.semanticscholar.org/a263/5d0fe9bfe6e8883877206a18865f36f83a35.pdf

French, M. T., Homer, J., Gumus, G., & Hickling, L. (2016). Key provisions of the Patient Protection and Affordable Care Act (ACA): a systematic review and presentation of early research findings. Health services research, 51(5), 1735-1771. https://dx.doi.org/10.1111%2F1475-6773.12511

Hu, L., Kaestner, R., Mazumder, B., Miller, S., & Wong, A. (2018). The effect of the affordable care act Medicaid expansions on financial wellbeing. Journal of public economics, 163, 99-112. Available at: https://www.nber.org/papers/w22170.pdf

Kaestner, R., Garrett, B., Chen, J., Gangopadhyaya, A., & Fleming, C. (2017). Effects of ACA Medicaid expansions on health insurance coverage and labor supply. Journal of Policy Analysis and Management, 36(3), 608-642. Available at: https://www.nber.org/papers/w21836.pdf

Simmons-Duffin, S. (2019). Trump Is Trying Hard To Thwart Obamacare. How's That Going? Available at: https://www.npr.org/sections/health-shots/2019/10/14/768731628/trump-is-trying-hard-to-thwart-obamacare-hows-that-going