Introduction
Over the last decade there have been major shifts in health care policy changes. The changes have resulted from a need for better health care within the United States. This has led to constant political deliberation and polarization around creating change in federal and state policy and service requirements. Health insurance plans are increasingly developing higher-deductible insurance policies and narrower networks. This article identifies and evaluates the positive and negative impact the changes to federal or state health care policies are having on consumer costs. What are the positive and negative impacts federal changes are having on consumer costs?
Impacts federal and state health care policies are having on consumer costs
Federal health care policy changes have expanded health care for many Americans. This has provided access to millions more people in our country (Avalere, 2018). Cover for pre-existing conditions being one of those positive changes for many people in this situation.
However, costs are increasingly shared throughout the market to other policy holders resulting in higher premiums, higher out-of-pocket costs, and limited networks. Federal and states policy changes under the Affordable Care Act (ACA) effected Medicaid expansion allowing coverage for Americans making up to 138% of the poverty level (Eibner, n.d.).
Health care networks have narrowed, reducing patient access to in-network providers. Many specialties like anesthesiologists, radiologists, and emergency physicians are now out-of-network (Avalere, 2018). According to Avalere (2018), “In 2017, 68% of healthcare plans in the exchange market offered restrictive networks, compared with 48% in 2014. Additionally, almost 90% of enrollees in ACA exchange plans experienced deductibles above $1,300, the IRS definition of a high deductible plan” (Executive Summary).
According to Livingston, S. (2019), “Nearly all of the largest publicly traded health insurance companies gave their CEOs a pay raise in 2018. That includes United Health Group, whose CEO David Wichmann's total compensation reached $18.1 million. That's an increase of 4.3% over Wichmann's 2017 total compensation” (Health insurer CEOs score big paychecks despite public scrutiny). Finally, market premiums have increased and plans now provide access to between 34% – 66% fewer providers than other markets (Avalere, 2018).
Conclusion
In conclusion, before the ACA, medical insurance premiums and coverage were less regulated and access to health care including state managed Medicaid was limited to fewer people. However, with federal and state policy change came positive and negative impacts to consumer costs and reduced policy coverage for some specialized care. However, according to Livingston, S. (2019), “Health insurer CEO compensation and company profits are topics fueling discussions about moving the U.S. healthcare system to a single-payer model to provide universal coverage to all Americans.” (Health insurer CEOs score big paychecks despite public scrutiny).
The ACA is a step forward in many ways however, change is still needed to provide cost-effective health care access to all Americans. The 2020 Presidential election will result in further change and time will tell how the resulting federal and state policies impact the consumer-cost and health care network access further.
References
Avalere (2018). Physicians for a national health program - PNHP. Retrieved from https://pnhp.org/news/higher-premiums-higher-deductibles-and-narrower-networks-in-exchange-markets/
Eibner, C. (n.d.). RAND Health Care. Retrieved from https://www.rand.org/health-care/key-topics/health-policy/aca/in-depth.html
Livingston, S. (2019). Modern Health Care. Retrieved from Health insurer CEOs score big paychecks despite public scrutiny
Over the last decade there have been major shifts in health care policy changes. The changes have resulted from a need for better health care within the United States. This has led to constant political deliberation and polarization around creating change in federal and state policy and service requirements. Health insurance plans are increasingly developing higher-deductible insurance policies and narrower networks. This article identifies and evaluates the positive and negative impact the changes to federal or state health care policies are having on consumer costs. What are the positive and negative impacts federal changes are having on consumer costs?
Impacts federal and state health care policies are having on consumer costs
Federal health care policy changes have expanded health care for many Americans. This has provided access to millions more people in our country (Avalere, 2018). Cover for pre-existing conditions being one of those positive changes for many people in this situation.
However, costs are increasingly shared throughout the market to other policy holders resulting in higher premiums, higher out-of-pocket costs, and limited networks. Federal and states policy changes under the Affordable Care Act (ACA) effected Medicaid expansion allowing coverage for Americans making up to 138% of the poverty level (Eibner, n.d.).
Health care networks have narrowed, reducing patient access to in-network providers. Many specialties like anesthesiologists, radiologists, and emergency physicians are now out-of-network (Avalere, 2018). According to Avalere (2018), “In 2017, 68% of healthcare plans in the exchange market offered restrictive networks, compared with 48% in 2014. Additionally, almost 90% of enrollees in ACA exchange plans experienced deductibles above $1,300, the IRS definition of a high deductible plan” (Executive Summary).
According to Livingston, S. (2019), “Nearly all of the largest publicly traded health insurance companies gave their CEOs a pay raise in 2018. That includes United Health Group, whose CEO David Wichmann's total compensation reached $18.1 million. That's an increase of 4.3% over Wichmann's 2017 total compensation” (Health insurer CEOs score big paychecks despite public scrutiny). Finally, market premiums have increased and plans now provide access to between 34% – 66% fewer providers than other markets (Avalere, 2018).
Conclusion
In conclusion, before the ACA, medical insurance premiums and coverage were less regulated and access to health care including state managed Medicaid was limited to fewer people. However, with federal and state policy change came positive and negative impacts to consumer costs and reduced policy coverage for some specialized care. However, according to Livingston, S. (2019), “Health insurer CEO compensation and company profits are topics fueling discussions about moving the U.S. healthcare system to a single-payer model to provide universal coverage to all Americans.” (Health insurer CEOs score big paychecks despite public scrutiny).
The ACA is a step forward in many ways however, change is still needed to provide cost-effective health care access to all Americans. The 2020 Presidential election will result in further change and time will tell how the resulting federal and state policies impact the consumer-cost and health care network access further.
References
Avalere (2018). Physicians for a national health program - PNHP. Retrieved from https://pnhp.org/news/higher-premiums-higher-deductibles-and-narrower-networks-in-exchange-markets/
Eibner, C. (n.d.). RAND Health Care. Retrieved from https://www.rand.org/health-care/key-topics/health-policy/aca/in-depth.html
Livingston, S. (2019). Modern Health Care. Retrieved from Health insurer CEOs score big paychecks despite public scrutiny