The development of the Affordable Care Act (ACA) directed at slowing the growth of health care spending in the United States (BBC News, 2019). The ACA plan provides numerous benefits to its beneficiaries, which is no guarantee that the health insurance policy will cover all of them. The essential benefits of ACA include laboratory services, hospitalization, emergency services, treatment drugs, pediatric services, psychological health, and substance usage sickness services (Rand, 2019).
ACA offers cover for ambulatory patient services with outpatient care without hospital admission, precautionary, wellness services, and chronic ailment management, prenatal period, childbearing, and newborn care. The provisions offered by the ACA are used by the health insurers, states, and American citizens in making crucial life-changing decisions (Muchmore & Liss, 2020). The challenge is on the long-term application of the plan in benefiting their lives hence require improved provisions from the plan they choose.
The ACA goals seek to expand access to care, make coverage affordable, and limit the number of uninsured American individuals. The plan expanded eligibility for Medicaid and developed new marketplaces where individuals without coverage from employers can purchase policies directly from insurers. ACA has offered about 20 million individuals with insurance, and an estimated 24 million individuals have gotten access to free or subsidized care through the Medicaid expansion and tax credits at the marketplace (Rand, 2019).
Research indicates that Medicaid expansion states faced considerable reductions and gains in the uninsured rate among the low-income population widely and within particularly vulnerable populations (Guth et al., 2020). With the reduction in uninsured individuals, ACA's significance in contemporary American society is above par. The expansion of Medicaid also improved financial security, the affordability of care, utilization of services, improved access to care for low-income families (Guth et al., 2020).
In America, there is a large proportion of low-income families who are assisted by then ACA plan. The enacted ACA and Medicaid expansion has posted positive net effects for state revenues and budgets. ACA subsidizes premiums for moderate- and low-income earners using tax credits offering progressive subsidies of large amounts to low-income earners. The individual mandate instigated in the plan obligates adults to seek coverage with a fine on those who fail.
The plan seeks to promote insurance for everyone, which is crucial in case of a medical emergency such as the current covid-19 epidemic. The personal plans for the clients are cheaper in 2020 (Luthra, 2019). The premiums are lower than average with individuals qualified for government subsidies ending up with no monthly payment. According to the health reform news update from The Commonwealth Fund, the ACA contributed significantly to the reduction of ethnic and racial disparities when accessing insurance coverage (HealthMarkets, 2020).
Changes to ACA
The individual mandate requires a change to fit every person. The overall goal of the plan is noble, but choosing an insurance plan depends on the individual will and agency. With the high number of low- and moderate-income earners, a fine of 695 dollars per adult and 347.50 dollars for children as of 2017 is burdensome to them (Rand, 2019). although it has proved essential in promoting enrollment, I believe incentives will be more effective in motivating most people to choose an insurance plan. More so, the addition of continuous coverage requirements will serve as a replacement of individual mandate in repealing it.
Furthermore, the ACA following formula for determining marketplace tax credits needs to be changed. The formula requires enrollees to contribute a maximum amount for a premium based on their income (Rand, 2019). The formula protects the enrollees from a sharp increase in premiums but creating a challenge in its sustainability in the long run. The repeal of the formula seeks to set the tax credit different from the premiums. The introduction of a flat-rate tax credit offers a shift of the cost from older to younger people. The flat-rate tax credit will improve annual premium contribution for older individuals a drop in premium contribution. Also, the new tax credit will raise the number of uninsured people for individuals ranging from 50 years of age to 65, which is a substantial number of Americans (Rand, 2019).
Reason for Change the ACA
Changes in ACA are associated with conflict between numerous health policy programs. There is a disparity between reducing costs of the insurance plans and premiums versus expanding the coverage to reach every American. More so, there is an issue between incentivizing work and effectively targeting tax credits. Changes will help to target the tax credits effectively while at the same time incentivizing work.
The modifications will preserve the choices of numerous patients who require comprehensive coverage. Also, the changes will protect the most expensive and the sickest patients. The alterations will minimize costs shifting to customers and states while reducing the cost liability of the federal governments.
The changes are to attract more Americans back to using ACA and refrain from using short term plans with lower premiums (HealthMarkets, 2020). Although the plan offers higher premiums than the short-term plans, it provides comprehensive coverage in critical areas, mainly emergency room service, prescription drug coverage, maternity care, and protection against pre-existing conditions.
The ACA program works efficiently and correctly, requiring a few developments to fit the needs of all Americans. The programs need to create a friendly environment to attract more Americans to enroll and reduce the number of uninsured to the lowest number possible. The current burdensome individual mandate of ACA causes some individuals to refrain from enrolling. The low-income earners will get dejected with the 2.5 percent cut in their income, which they devote 80 hours per month attending job training, volunteering, or working. The law has proven useful for needy individuals, and its removal will affect the poor in society.
Modifying the ACA plan allows the states that are reluctant to expand Medicaid to offer their insights on improving the law. The millions of people without health insurance working in service-oriented positions being paid minimum wage and are a sign of employment for numerous low skilled workers have a chance of enrolling in an affordable insurance plan. Economic downtime in the United States since 2008 contributed to increasing the number of families under economic stress due to underemployment or job loss; hence are affected by premiums and forced to join the insurance plan.
With better replacement to the individual mandate, these families will evaluate and decide on the insurance plans that fit their families best. Changes in the ACA plan contribute extensively to mitigating economic distress and improve the health of every family member according to their needs. In addressing health education specialists, changes should present opportunities for promoting health throughout the united states.
BBC News. (2019, March 29). Has Trump managed to kill off ObamaCare? https://www.bbc.com/news/world-us-canada-24370967
Guth, M., Garfield, R., & Rudowitz, R. (2020, March 17). The Effects of Medicaid Expansion Under the ACA: Updated findings from a literature review - Report. The Henry J. Kaiser Family Foundation. https://www.kff.org/report-section/the-effects-of-medicaid-expansion-under-the-aca-updated-findings-from-a-literature-review-report/
HealthMarkets. (2020, March 23). Healthcare Reform News Updates: Stay up-to-date on Healthcare Reform. https://www.healthmarkets.com/resources/health-insurance/trumpcare-news-updates/
Luthra, S. (2019, November 21). 2020 Affordable Care Act Health Plans: What's New. NPR.org. https://www.npr.org/sections/health-shots/2019/11/21/781224043/2020-affordable-care-act-health-plans-whats-new
Muchmore, S., & Liss, S. (2020, January 6). Beyond the ACA: Healthcare legal fights to watch in 2020. Healthcare Dive. https://www.healthcaredive.com/news/beyond-the-aca-healthcare-legal-fights-to-watch-in-2020/569793/
Rand. (2019, September 10). The Future of U.S. Health Care. RAND Corporation Provides Objective Research Services and Public Policy Analysis | RAND. https://www.rand.org/health-care/key-topics/health-policy/in-depth.html
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