Patient Protection and Affordable Care Act Essay
Papers: The paper shall be in your own words and not exceed three content pages and formatted in APA format. The cover page, abstract and reference pages will make your paper six pages in total. You will be graded on Format, Content, Organization of Response, Syntax and Semantics. Rubric for Papers: • On Time Submission (10%) Submission on or before due date. • Organization of work and Brevity (10%) Ensure paper is required number of pages, readable and points raise are precise and concise as outlined in introduction. • Content (60%) Show evidence of understanding of topic with respect to course content. • APA Format (20%) Make sure APA format is used and consistently so, with clear citation and accuracy of sources Assignment The Patient Protection and Affordable Care Act (ACA) of 2010, or healthcare reform has had a great impact on the lives of patients, healthcare providers and investors. With respect to the material provided in Chapter 1 of our text, briefly describe the main provisions of healthcare reform and its implications for the practice of healthcare finance. With respect to the material provided in Chapter 2 of our text, what are some features of the ACA that affect healthcare insurance and reimbursement?
Implementation of the ACA has decreased the number of uninsured Americans. A Gallup survey reports the percentage of American adults lacking health insurance fell from 18% at the end of 2013 to 11.9% in the first quarter of 2015 (1). The largest gains in insurance rates occurred for Americans earning <$36,000 in annual household income as well as among Hispanics—groups that were previously most likely to be uninsured (1). As of March 2015, ∼11.7 million people had enrolled in a Marketplace plan (including both federally facilitated and state-run Marketplaces) (2). A little less than two-thirds of Marketplace enrollees in states using the www.healthcare.gov platform self-reported their race. Of those who did, just over one-third indicated that they were members of a race or ethnicity at high risk for developing diabetes, including 11% Latino, 14% African American, and 8% Asian (2).
Most Marketplace enrollees are receiving financial help to pay for their coverage. In the open enrollment process for 2015, 87% of Marketplace consumers who enrolled in coverage in the 37 states using the healthcare.gov platform qualified for premium tax credits, and 60% were eligible for cost-sharing reductions (2). Among individuals who qualified, average monthly premiums would have been $364; however, after the premium tax credits, monthly premiums averaged $101 (2).
In addition to requiring Marketplace plans to provide a plain-language SBC to help consumers shop for and compare plans, all Marketplaces must have some form of Assister program to help consumers understand their options and enroll. One type of Assister, called Navigators, not only are available to help consumers enroll in plans, but are also required to provide outreach and education to raise awareness about the Marketplaces. According to a 2014 survey of Marketplace Assister programs, during the first Marketplace open enrollment period in 2013/2014, >4,400 Assister programs helped an estimated 10.6 million people (3). To support the work of Assisters, the U.S. Department of Health and Human Services (HHS) has created and distributed consumer education tools in multiple languages, including a toolkit to help people with new health coverage understand their benefits and connect to primary care and the preventive services that are right for them (4).