Consumer and Provider Costs
Whenever a new policy or piece of legislation is introduced that will disturb the current status quo, it is only natural to expect that it will be met with some resistance. The healthcare field is not exempt from this and many times opinions are formed without having sufficient knowledge of what the change will actually encompass. If the audience were to consider the Affordable Care Act (ACA), several secondary effects could be examined to reveal both positive and negative aspects as a result of its inception. The writer would like to explore some of these in detail, not for the purpose of influencing opinions, but rather to provide context for understanding.
The Policy Itself
In 2010, the Affordable Care Act was created as an attempt to make medical insurance coverage available for low income individuals and their families. It is the culmination of two bills: The Patient Protection and Affordable Care Act and the Health Care and Education Reconciliation Act of 2010. Combined, these bills work to increase coverage while lowering costs to both patients and our federal government. During a three-year span (2013-2016), the ACA was responsible for dropping the rate of uninsured Americans by 5.1%. The targeted demographic in this legislation are those whose income falls under 138% of the national poverty line (“Medical billing & coding certification”, 2020).
Since there are many strong opinions surrounding this particular law, both positive and negative points will be covered for the reader to consider. All efforts were made to present these facts free from bias as the author believes each individual is capable of forming mature, detailed thoughts, provided they have access to unfiltered information. Processing the full scope of data will result in better informed opinions and a clearer understanding of matters linked to the ACA.
Observing the Positives
“The Affordable Care Act (ACA) requires insurers to cover certain preventive services without cost to patients” (Chang, 2013, p. 1). Part of the allure of this program resides in the fact that subsidies are made available to diminish the steep cost of premiums for those falling into the appropriate bracket, “particularly those without access to affordable coverage through their employer, Medicaid, or Medicare” (“Health Reform”, 2020, para. 2). Perhaps the most touted positive accompanying the ACA is that “health insurance companies can’t refuse to cover you or charge you more just because you have a pre-existing condition (U.S. Department of Health & Human Services, 2020, para. 1). It would be impossible to note every benefit under the ACA in this paper, but the attempt has been made to provide a reasonable number of instances for the point of showcasing that they exist.
Recognizing the Negatives
For many, the costs associated with healthcare help create entry barriers preventing access to care. The rapid ascension of prices has steadily surpassed wage increases. One can observe this through the 25% spike in health-related actions burdening the middle class since the previous decade (Brown, 2018). Additionally, cost control can come at political price in part because of varying ideologies and provider desires to retain and expand on their financial incomes (White, 2018). Due to the ACA mandate allowing for private insurance shopping, “market performance is seriously compromised, in the sense of price exceeding marginal social cost, anytime there are monopoly (or oligopolistic) sellers protected by persistent barriers to entry (Nichols, 2012, p. 550). While certainly not all negative fallout of the ACA is listed here, it is enough to illuminate concerns stemming from it.
Conclusion
Sound logic reveals that there are always two sides to any proposition. In order to acquire comprehension, it is paramount to understand opposing arguments. Benefits of the ACA are rooted in expanded access to care, reduced fees and acceptance for those with previous conditions, positively affecting those needing it most. Readers can see that a substantial part of the ACA’s main detraction is based on the excessive amount of political posturing inherent in it, regardless of the ideology one subscribes to. Another unavoidable factor is provider and organizational interest in profit increases that clash with the natural intent of the law. Ultimately, “it is hard to overlook the real-actual provisions in the reform law to help the reader draw his/her own conclusions about the potential for future bi-partisan solutions to our health care woes” (Nichols, 2012, p. 552).
References:
Brown, E. C. F. (2018). Health Reform and Theories of Cost Control. Journal of Law, Medicine & Ethics, 46(4), 846–856. SAGE Journals: Your gateway to world-class research journals
Chang, K. (2013). Explaining preventive visits and the ACA. (2013). Family Practice Management, 20(5), 1-2.
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 & Management, 38(4), 1028–1052. Error - Cookies Turned Off
Health Reform (2020). Explaining Health Care Reform: Questions About Health Insurance Subsidies
Medical billing & coding certification. (2020). Understanding the Affordable Care Act
Nichols, L. M. (2012). Government Intervention in Health Care Markets Is Practical, Necessary, and Morally Sound. Journal of Law, Medicine & Ethics, 40(3), 547–557. SAGE Journals: Your gateway to world-class research journals
U.S. Department of Health & Human Services. (2020). HHS.gov. https://www.hhs.gov/answers/affordable-care-act/can-i-get-coverage-if-i-have-a-pre-existing condition/index.html#:~:text=Yes.,that%20new%20health%20coverage%20
starts.&text=They%20don't%20have%20to%20cover%20pre%2Dexisting%20conditions
White, J. (2018). Hypotheses and Hope: Policy Analysis and Cost Controls (or Not) in the Affordable Care Act. Journal of Health Politics, Policy and Law, 43(3), 455–482. https://doi.org/https://read.dukeupress.edu/jhppl/list-of-years
Whenever a new policy or piece of legislation is introduced that will disturb the current status quo, it is only natural to expect that it will be met with some resistance. The healthcare field is not exempt from this and many times opinions are formed without having sufficient knowledge of what the change will actually encompass. If the audience were to consider the Affordable Care Act (ACA), several secondary effects could be examined to reveal both positive and negative aspects as a result of its inception. The writer would like to explore some of these in detail, not for the purpose of influencing opinions, but rather to provide context for understanding.
The Policy Itself
In 2010, the Affordable Care Act was created as an attempt to make medical insurance coverage available for low income individuals and their families. It is the culmination of two bills: The Patient Protection and Affordable Care Act and the Health Care and Education Reconciliation Act of 2010. Combined, these bills work to increase coverage while lowering costs to both patients and our federal government. During a three-year span (2013-2016), the ACA was responsible for dropping the rate of uninsured Americans by 5.1%. The targeted demographic in this legislation are those whose income falls under 138% of the national poverty line (“Medical billing & coding certification”, 2020).
Since there are many strong opinions surrounding this particular law, both positive and negative points will be covered for the reader to consider. All efforts were made to present these facts free from bias as the author believes each individual is capable of forming mature, detailed thoughts, provided they have access to unfiltered information. Processing the full scope of data will result in better informed opinions and a clearer understanding of matters linked to the ACA.
Observing the Positives
“The Affordable Care Act (ACA) requires insurers to cover certain preventive services without cost to patients” (Chang, 2013, p. 1). Part of the allure of this program resides in the fact that subsidies are made available to diminish the steep cost of premiums for those falling into the appropriate bracket, “particularly those without access to affordable coverage through their employer, Medicaid, or Medicare” (“Health Reform”, 2020, para. 2). Perhaps the most touted positive accompanying the ACA is that “health insurance companies can’t refuse to cover you or charge you more just because you have a pre-existing condition (U.S. Department of Health & Human Services, 2020, para. 1). It would be impossible to note every benefit under the ACA in this paper, but the attempt has been made to provide a reasonable number of instances for the point of showcasing that they exist.
Recognizing the Negatives
For many, the costs associated with healthcare help create entry barriers preventing access to care. The rapid ascension of prices has steadily surpassed wage increases. One can observe this through the 25% spike in health-related actions burdening the middle class since the previous decade (Brown, 2018). Additionally, cost control can come at political price in part because of varying ideologies and provider desires to retain and expand on their financial incomes (White, 2018). Due to the ACA mandate allowing for private insurance shopping, “market performance is seriously compromised, in the sense of price exceeding marginal social cost, anytime there are monopoly (or oligopolistic) sellers protected by persistent barriers to entry (Nichols, 2012, p. 550). While certainly not all negative fallout of the ACA is listed here, it is enough to illuminate concerns stemming from it.
Conclusion
Sound logic reveals that there are always two sides to any proposition. In order to acquire comprehension, it is paramount to understand opposing arguments. Benefits of the ACA are rooted in expanded access to care, reduced fees and acceptance for those with previous conditions, positively affecting those needing it most. Readers can see that a substantial part of the ACA’s main detraction is based on the excessive amount of political posturing inherent in it, regardless of the ideology one subscribes to. Another unavoidable factor is provider and organizational interest in profit increases that clash with the natural intent of the law. Ultimately, “it is hard to overlook the real-actual provisions in the reform law to help the reader draw his/her own conclusions about the potential for future bi-partisan solutions to our health care woes” (Nichols, 2012, p. 552).
References:
Brown, E. C. F. (2018). Health Reform and Theories of Cost Control. Journal of Law, Medicine & Ethics, 46(4), 846–856. SAGE Journals: Your gateway to world-class research journals
Chang, K. (2013). Explaining preventive visits and the ACA. (2013). Family Practice Management, 20(5), 1-2.
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 & Management, 38(4), 1028–1052. Error - Cookies Turned Off
Health Reform (2020). Explaining Health Care Reform: Questions About Health Insurance Subsidies
Medical billing & coding certification. (2020). Understanding the Affordable Care Act
Nichols, L. M. (2012). Government Intervention in Health Care Markets Is Practical, Necessary, and Morally Sound. Journal of Law, Medicine & Ethics, 40(3), 547–557. SAGE Journals: Your gateway to world-class research journals
U.S. Department of Health & Human Services. (2020). HHS.gov. https://www.hhs.gov/answers/affordable-care-act/can-i-get-coverage-if-i-have-a-pre-existing condition/index.html#:~:text=Yes.,that%20new%20health%20coverage%20
starts.&text=They%20don't%20have%20to%20cover%20pre%2Dexisting%20conditions
White, J. (2018). Hypotheses and Hope: Policy Analysis and Cost Controls (or Not) in the Affordable Care Act. Journal of Health Politics, Policy and Law, 43(3), 455–482. https://doi.org/https://read.dukeupress.edu/jhppl/list-of-years