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What is the ACA? (Affordable Care Act)

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First and foremost, the Affordable Care Act, or the ACA, has been a scrutinized, and controversial topic for a number of years, and is still just as controversial as it was back then, in today’s times. It was introduced in 2009, but was not put into effect until 2013. The initial main goal of this ACA, was to try and improve the quality of care that patients everywhere were receiving. The other main, and important things that this ACA was trying to do was to lower the amount of people in the United States that did not have health insurance, and with that being done, hopefully increase the health and wellness of America as a whole. This ACA gave companies, employers and people different types of incentives like tax breaks, and tax penalties, and other things to try and begin to enforce these types of rules and regulations. With all of this there were a number of things that were changed, and done to try and move the power of healthcare to the consumer themselves (Atkinson, G, et al., 2015).

These new changes, included different types of tax breaks, tax penalties, mandates, subsidies, and insurance exchanges. With all of those new things implemented, the ACA, also made it so that insurance companies had to change their standards of coverage, so they could cover more people, and more people that they would not have covered previously. They were no longer allowed to turn customers away for they preexisting illness, or issues, or because of their sex. The ACA forces people to have health insurances, and if they do not have them then they get fined, and those fines continuously go up year after year of not having insurance. These exchanges that were set up would allow for people to shop for the different insurances they want, and would allow them to get the coverage they wanted and needed from the comfort of their homes without having to go to an insurance agency or establishment of that sort. The exchanges were are not the only way to enroll, and you can still get insurance the normal way everyone is used too. If the enrolled party is below the poverty level they can even get help paying their deductibles, and the rest of their out of pocket expenses for the different coverage plans, it could even be possible for people to qualify for low cost care. The ACA is pages and pages of laws and regulations, a lot of it not being understood by most people, and everyone has their own opinion on whether it is good or bad (Pallarito, 2014).

Mandates and Single Payer Plan from a Healthcare Point of View

It is hard enough to get a new program up and running, but keeping it running, and everyone following the specific rules can be even more difficult. That is why it is important for the ACA to have rules, regulations and mandates that the different states must follow in order to be compliant with the ACA. Also, when doing this, it needs to be taken into consideration how the different parts of the act are effected. The consumers are not the only ones that are part of this. The entire realm of healthcare would, and is going to be effected by the implementation of the ACA. Obviously, the most important thing in healthcare should always be the patient and the quality of care that is being provided to the patient. When bringing into consideration the ACA, there are a number of different things that are discussed. Obviously, like previously stated the quality of care needs to be top notch when treating patients, but at the same time figuring out how to implement, and efficiently provide service to all of the patients that are going to be coming in is also a huge importance. The ACA will do some good in the healthcare world, it will discourage adverse selection. The mandate would require that people could not be turned away for prior conditions, and anything like that, so people who would not normally be covered, would be covered, and they would be able to receive the care that they needed. (Small Business)

Normally the insurance company’s prices are dependent on how many people are buying and using insurance. A lot of people do not buy insurance until they absolutely need it, and this causes the premiums, and the prices of the insurance to go up greatly. The ACA forcing people and everyone to buy insurance can only help this cause. If everyone is forced to purchase insurance, the insurance companies can lower the prices for the premiums, because they are going to be getting a bunch of money because of all the people who have to try and buy insurance. With small businesses, they may be too small to be able to shelter themselves with their insurance. There will not be enough employees to cover the cost if one employee was to get seriously hurt or something like that (Small Business).

Single Payer Insurance

Single payer insurance is another option to solve the healthcare and insurance crisis in the United States of America. In this type of situation, everyone is insured through the government. Technically, it would be like an extension of Medicare and Medicaid. The coverages of the people would be determined by what their needs are, and how much coverage they would need for a certain amount of years until it could be evaluated again. Some of the countries that use this type of healthcare are: Canada, Australia, and Spain. With one single insurance like this, it would eliminate the ability for insurance companies and different employers to limit where your insurance is accepted, and where you can go to receive care. With one insurance coverage type, people would be able to go anywhere they wanted to receive care because their insurance would be accepted no matter what. With that aspect being thought about it would extremely limit the ability for there to be any type of adverse selection. If everyone has coverage, and can get care anywhere, it would be hard to justify turning anyone away from the healthcare facility (Waters, H)

Other issues

There are always good, and bad things that can come from a single event or situation. The ACA is no different in this aspect. There is always much debate on what is right, and what is wrong for something like this. There are some pretty clear cut positives and negatives from an act like this. With the amount of people needing insurance going up with the ACA, it will increase the demand for the insurance, which will decrease the price for insurance. The supple of insurance will increase as well because insurance companies will no longer be able to turn different people away based on their prior medical conditions. Health care providers would love a situation like this because it could increase the number of patients they get to see in a day, and it will also insure that the patients that they do see are insured. With more people having insurance, and having healthcare available to them, there would be an increase in the use of preventative medicine. People that normally do not go to the doctor would be going, and figuring out how to be the best version of themselves. A situation like this could lead to a much better, and healthier America.

With the positives of something there are always some negatives. With those negatives, there obviously comes the possibility that there will be moral hazards. One of the moral hazards could be some sort of fraud. There may be some fraud cases that develop because of the ACA. Doctors and medical professionals could look to mess with documents, and falsify document to make it look like patients were getting different things done that are more expensive so that they are reimbursed a larger amount of money. There could also be smaller companies that may not be able to afford the big-time insurance and all of the insurance for their employees, so that could possibly be looking to find ways around offering their employees the benefits.

Some professionals think that hospitals will struggle trying to abide by all of the ACA rules, regulations and laws. “The health insurance marketplaces have brought eight million customers, not all of them newcomers, to hospital doors. However, hospitals have had to contend with the pricing demands of qualified health plans (QHPs), which sell individual health plans and must comply with federal rules, some of which filter down to hospitals (Barlas, 2014)”. The new insurance policies, and all of the competitive health care plans, so the hospitals will could have some hindered business coming through the doors.

Conclusion

The Affordable Care Act, in theory, is a great thought for the United States of America. Health care for everyone would be a great thing, the hard part is that figuring out the best way to do that, while accommodating everyone that needs accommodating. It has been scrutinized, and been a controversial topic of debate for a number of years now. Most people scrutinize the mandates and the different rules and regulations that the ACA requires that people use in order to gain insurance, and to keep it. The ACA is a work in progress, that could ultimately end up being something extremely important for the United States of America. It is successful in a number of other countries, so why couldn’t it work in America? It is going to be interesting to see how the work of the law makers, and everyone to try and make this ACA more excepted by everyone, and get more people to understand the importance of it. Healthcare is an important aspect of life, and everyone should be able to have it and receive medical care.

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