Affordable Care Act of 2010

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Wilmington University *

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Feb 20, 2024

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Americans are required to posses a minimum essential coverage for health insurance, including basic health care benefits. Insurance companies cannot deny coverage to individuals based on prior health conditions or risk of health conditions. Insurance companies will be required to offer income-based premiums and offer a subsidy exchange. For many years, healthcare reform was a major topic of discussion. Americans with pre-existing conditions and lower incomes faced challenges obtaining affordable healthcare. The Affordable Care Act (ACA) of 2010 made healthcare more accessible to American families. Sometimes called Obamacare, the act gave millions of previously ineligible individuals and families access to medical coverage through the healthcare marketplace. The primary goals of the ACA are to make affordable healthcare available to more people by subsidizing premiums for low-income families, to expand the Medicaid program to cover adults with income below the poverty level, and to lower the costs of healthcare. AFFORDABLE CARE ACT OF 2010 INTRODUCTION BY : JOANEAH DIXSON, KRISTEN MORAN, & IRFERD KAINE KEY POINTS Insurance companies are prohibited from revoking care or coverage from plans already in place. POLICY BRIEF:
"In the wealthiest nation on Earth, no one should go broke just because they get sick" ~ Barack Obama AFFORDABLE CARE ACT of 2010 Prior to the Affordable Care Act, insurance companies had very little restrictions in providing health care coverage. Companies were able to charge high prices for policies, while limiting coverage (Richard, 2016). “The ACA is the most comprehensive reform of the US health care system since President Lyndon B. Johnson signed the amendments to the Social Security Act on July 30, 1965 creating Medicaid and Medicare” (Dolan & Mokhtari, 2013). This policy is crucial for families because approximately 50 million Americans were without health insurance coverage due to high costs and insurance companies turning away individuals based on previous health conditions (DeNavas-Walt et al. 2011; O’Neil 2010). The Affordable Care Act prohibits insurance companies from denying customers care and discriminating against individuals with higher risks or history of health issues (Tanner, 2013). Inflation mixed with rising demand for health care services have likely driven the health care market up, drastically increasing the costs of services in the American people. Between 1990 and 2012, the cost of health insurance policies doubled, experiencing an average of 9% annual increase in 2011. This increased the burden of those paying for healthcare out of pocket, creating greater barriers for average Americans to afford current coverage. This may result in reducing the amount of coverage received by individuals and families or falling out of plans completely (Roby et al., 2013). The Affordable Care Act makes eligibility of receiving care more accessible by requiring insurance companies to offer packages to individuals of lower-income brackets and requiring basic coverage plans. WHY IT MATTERS? The Affordable Care Act was enacted to expand the overall health care coverage of Americans. This act is groundbreaking because it requires all health insurance companies to provide a package of insurance to anyone who makes up to 133% of the federal poverty level (Roby, Watson, Jacobs, Graham-Squire, Kinane, Gans, Needleman, & Kominski, 2013). All citizens earning between 100- 400% of the federal poverty line are now eligible to purchase insurance coverage through an exchange using tax subsidies. This plan has provided opportunity for approximately 35-55% of previously uninsured individuals to acquire some level of health insurance coverage. OVERVIEW POLICY BRIEF:
INTERVIEW Interview with Anthony Braxton, local Delawarean: Q.What healthcare, if any, did you have prior to the enactment of the Affordable Care Act? A: Medicaid and Medicare health insurance coverage Q.Which, if any, healthcare benefits do you currently receive? A. Still under both programs. Q.How has your coverage changed since Obama Care? A. Prior to ACA, I had to pay dental and eye insurance out of pocket. Now, I am covered for dental insurance and eye care. Q.Has the quality of coverage changed for you? A. The quality of coverage has increased due to an increase or expansion of benefits provided through my plan (receive more benefits now). These were automatically added to my existing plan. Q.How would you describe your satisfaction with your current health insurance coverage? A. I think my coverage is excellent. This program has helped many people, including myself, receive medical benefits that they would not receive otherwise. It is also very affordable, which is necessary for people with low incomes or disabilities that would raise costs of healthcare in years prior. The uninsured Americans rate has reached the lowest of 8% in 2022. Over 50 million Americans were uninsured before Obamacare Act. 39 million Obamacare and Medicare beneficiaries have free access to a series of preventive medical services. A high percentage of uninsured individuals come from low-income families with at least one member working full-time. 1 in 5 uninsured adults decided against seeking medical care due to the high costs. STATISTICS . . . POLICY LIMITATIONS Despite the Affordable Care Act’s initiative to require all states to participate in Medicaid, a 2012 Supreme Court ruling favored the states’ choice to participate without penalty of losing federal Medicaid money. This means that residents can still be without Medicaid insurance coverage in several states. Another option for low-income earners would be to purchase health care privately using a tax subsidy. However, states are also not required to participate in the insurance exchanges and since opted out of participation. Low-income earners making below 100% of the federal poverty line do not qualify for the tax subsidy, anyway. This leaves millions of Americans without insurance, underinsured, or paying ridiculously high prices for health insurance (Roby et al., 2013). Additionally, the benefit of including more Americans under insurance policies comes at the price of a 2% greater annual increase of health care costs compared to the trends prior to the enactment of the Affordable Care Act (Tanner, 2013). However, the higher costs will be slightly offset by the subsidies in participating states. With health care being covered, at least partly by government funding, these higher prices of services will result in a higher federal budget for health care, taking away money from other need areas. Finally, the mandates for minimum essential coverage would make millions of Americans fall out of compliance with coverage and therefore be required to change their plans (Tanner, 2013). This may result in paying for coverage that is unwanted or unnecessary for the individuals. (27+ affordable care act statistics and facts: Policy advice , n.d.) Moran, Kristen. (2022, December 4). A discussion on health care coverage [Interview]. AFFORDABLE CARE ACT of 2010 POLICY BRIEF:
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REFERENCES RECENT DEVELOPMENTS DeNavas-Walt, C., Proctor, B. D., & Smith, J.C. (2011). Income, poverty, and health insurance coverage in the United States: 2010, U.S. Census Bureau, current population reports, P60-239. U.S. Government Printing Office. Retrieved from, http://www.census.gov.mylibrary.wilmu.edu/prod/2011pubs/p60- 239.pdf. Dolan, E. M., & Mokhtari, M. M. (2013). The Patient Protection and Affordable Care Act (ACA): Pros and cons. Journal of Family and Economic Issues, 34, 1-2. https://doi.org/10.1007/s10834-013-9352-5 Grafova, I. B., Monheit, A. C., & Kumar, R. (2022). Income shocks and out-of-pocket health care spending: implications for single-mother families. Journal of Family and Economic Issues, 43, 489-500. https://doi.org/10.1007/s10834-021-09780-6 Healthcare.gov (2021, July 1). HHS announces rule to protect consumers from surprise medical bills. HHS.gov. Retrieved December 4, 2022, from https://www.hhs.gov/about/news/2021/07/01/hhs- announces-rule-to-protect-consumers-from-surprise-medical-bills.html Moran, Kristen. (2022, December 4). A discussion on health care coverage [Interview]. Richard, P. (2016). The Burden of medical debt faced by households with dependent children in the United States: Implications for the Affordable Care Act of 2010. Journal of Family and Economic Issues, 37, 212-225. https://doi.org/10.1007/s10834-016-9491-6 Roby, D. H., Watson, G., Jacobs, K., Graham-Squire, D., Kinane, C. M., Gans, D., Needleman, J., & Kominski, G. F. (2013). Modeling the impact of the Affordable Care Act and the individual mandate on Californians. Journal of Family and Economic Issues, 34, 16-28. https://doi.org/10.1007/s10834-012-9349-5 Tanner, M. (2013). The Patient Protection and Affordable Care Act: A dissenting opinion. Journal of Family and Economic Issues, 34(1), 3-15. http://hdl.handle.net/10.1007/s10834-013-9350-7 27+ affordable care act statistics and facts: Policy advice. 27+ Affordable Care Act Statistics and facts | Policy Advice | Policy Advice. (n.d.). Retrieved December 4, 2022, from https://policyadvice.net/insurance/insights/affordable-care-act-statistics/ In January 2022, the Biden-Harris administration’s No Surprises Rule took effect. The rule protects consumers from excessive out-of-pocket expenses for emergency and non-emergency services, out-of-network, and ambulance services. Under the rule, “emergency services must continue to be covered without any prior authorization” (Healthcare.gov, 2021).