Many of us have our own opinions of the individual mandate that fell under the Affordable Care Act (ACA). The individual mandate required U.S citizens and non-citizens to have health insurance, otherwise they must pay a penalty to the Internal Revenue Service (IRS) if they did not have coverage all year around (Congressional Budget Office, 2016). For healthy individuals who felt like obtaining health insurance should be a choice, the individual mandate received a negative outlook. On the other hand, physician practices benefited from this mandate because they received a larger payment from insurances for services than uninsured patients could pay in office. The Congressional Budget Office (CBO) estimates that with the repeal of the individual mandate, there is going to be a 3 million to 6 million decrease in those enrolling in health insurance (Eibner et al., 2018). The cost of services performed in a physician practice setting can amount anywhere from $600 to $900. The amount paid by and collected from un-insured patients for their visits can range anywhere from $150-$300. This results in a greater deficit to the practice.
We have seen how the individual mandate effected physician practices with a positive outcome but let us discuss how we can mitigate the negative effects that came with the repeal of the individual health insurance mandate. To start, we can focus on the provider to patient relationship and encourage those current patients to come in for preventative visits such as their annual physical exams. This can improve continuity of care while keeping the patient flow in the office constant. Another way of improving the deficit within physician practices can start with making health insurance more affordable at every level of income (Holahan et al., 2017). By improving the affordability of health insurance, people are more likely to enroll and increase their well-being by taking preventative measures and visiting their health care provider without the fear of not being insured or being able to afford it.
Written by: Lisa Silva
Reference:
Congressional Budget Office. (2016). Options For Reducing the Deficit: 2017 to 2026 (p. 236).
https://www.cbo.gov/sites/default/files/114th-congress-2015-2016/reports/52142-budgetoptions2.pdf
Eibner, C., & Nowak, S. (2018, July). The Effect of Eliminating the Individual Mandate Penalty
and the Role of Behavioral Factors. The Commonwealth Fund, (), 1-27. https://eds.b.ebscohost.com/eds/pdf...2ae-a031-46b1-b813-3f048c25635a@sessionmgr103
Holahan, J., & Blumberg, L.J. (2017, January). Instead of ACA Repeal and Replace, Fix
It. Urban Institute, 1-17. http://www.urban.org/sites/default/...6/2001054-repeal-and-replace-aca-fix-it_2.pdf
We have seen how the individual mandate effected physician practices with a positive outcome but let us discuss how we can mitigate the negative effects that came with the repeal of the individual health insurance mandate. To start, we can focus on the provider to patient relationship and encourage those current patients to come in for preventative visits such as their annual physical exams. This can improve continuity of care while keeping the patient flow in the office constant. Another way of improving the deficit within physician practices can start with making health insurance more affordable at every level of income (Holahan et al., 2017). By improving the affordability of health insurance, people are more likely to enroll and increase their well-being by taking preventative measures and visiting their health care provider without the fear of not being insured or being able to afford it.
Written by: Lisa Silva
Reference:
Congressional Budget Office. (2016). Options For Reducing the Deficit: 2017 to 2026 (p. 236).
https://www.cbo.gov/sites/default/files/114th-congress-2015-2016/reports/52142-budgetoptions2.pdf
Eibner, C., & Nowak, S. (2018, July). The Effect of Eliminating the Individual Mandate Penalty
and the Role of Behavioral Factors. The Commonwealth Fund, (), 1-27. https://eds.b.ebscohost.com/eds/pdf...2ae-a031-46b1-b813-3f048c25635a@sessionmgr103
Holahan, J., & Blumberg, L.J. (2017, January). Instead of ACA Repeal and Replace, Fix
It. Urban Institute, 1-17. http://www.urban.org/sites/default/...6/2001054-repeal-and-replace-aca-fix-it_2.pdf