Discussion Question responses

Write a response for each discussion Question.

10.1 riedel

COLLAPSE

The Affordable Care Act is a health care reform that was implemented to help provide insurance to individuals who had no insurance through the public programs or through an employer. The plan required most residents to have insurance coverage and if they did not have access, they could enroll through the American Health Benefit Exchange. The act provided subsidies to those who qualified to help cover the premium costs. A part of the affordable care act was that preventative services would be covered at no cost to the individual (hhs.gov). A large debate that has gone on with the affordable care act and Hobby Lobby is that they do not want to cover contraceptives due to religious beliefs. A part of the act is that employers must provide contraception as part of their health care coverage.

The case began in 2013 and ruled in favor of Obamacare requiring Hobby Lobby to pay for contraceptives until a decision could be reached in Federal Court. On June 30, 2014 the supreme court ruled that certain for-profit companies cannot be required to pay for specific types of contraceptives for their employees (Mears and Cohen, 2014). The Obamacare administrators are working on ensuring that women will still have coverage for contraceptives.

This type of ruling will have an impact on providers on what type of contraceptive coverage they will offer to their patients. They will have to be in tuned to how much a brand name verse a generic may cost in order to help their patient pick which option is best for them. The provider may also want to look at how much the shot, pill, IUD, etc. could cost as this too could lead to a different decision for the patient. It is also up to the patient to communicate with their doctor that they may have to pay out of pocket for their option, and which one will be less expensive if they find that they cannot afford their first choice.

This ruling is also opening the doorway that can lead to other large organizations to begin to argue that other laws affect their rights based on religious freedoms. This could affect laws on employment, civility, and safety, as well as other health concern rights. It will be interesting to see how far other rulings will go with religious beliefs after the ruling in this case.

Booker 10.1

COLLAPSE

During President Obama's term, Congress enacted the Patient Protection and Affordable Care Act of 2010 (ACA). The legislation is long and complex and covers nearly every aspect of the nation's health care system. The ACAs main purpose is to provide insurance to the more than 32 million that are currently uninsured in the United States. The law has 5 main components to this effort:

• All Americans must have some form of health insurance or pay a penalty through the tax code.

• The law requires state Medicaid programs to provide coverage to all persons with incomes below 133% of the federal poverty level. However, Medicaid expansion is now an option and not a mandated requirement.

• Each state must set up insurance exchanges or healthcare marketplaces. This allows the uninsured to purchase affordable private coverage.

• Employers with more than 50 FTEs must provide full healthcare coverage to their employees or pay a financial penalty to the federal government.

• Private insurance companies are required to comply with a host of federal regulations that seed to eliminate the practice of discriminating against people with preexisting conditions (Knickman & Kovner, 2015).

The biggest changes to the ACA came in 2014-2016 when Medicaid coverage expanded in 31 states and health insurance exchange or marketplace policies provided coverage for some 12.7 million enrollees ("Health Reform," 2016). An article by Newark (2016), reports a tremendous amount of success of the ACA in providing insurance coverage to most Americans also underlines one of the Act's core failures: That coverage remains unaffordable for many of those who do not have public or employer covered insurance. A record number of Americans have insurance coverage than ever before. However, private insurers are stating their intent to increase their premiums by double-digit percentages this year. Several insurers are falling off the exchanges due to losing money. In October of 2015 the ACA implemented an increase in federal match for Children's Health Insurance Program (CHIP). This increase provides for a 23 %-point increase in the CHIP match rate up to a cap of 100%. In January 2016, the ACA implemented healthcare choice compacts. This permits states to form health care choice compacts and allows insurers to sell policies in any state participating in the compact. Upcoming for 2018 the ACA plans to implement tax on high-cost insurances. This implementation imposes an excise tax on insurers of employer-sponsored health plans with aggregate expenses that exceed $10,200 for individual coverage and $27,500 for family coverage.

TURMAN DB 10.1

COLLAPSE

The Patient Protection and Affordable Care Act of 2010 (PPACA) is healthcare reform legislation enacted by Congress. This act was designed to reduce the number of medically uninsured, and underinsured nonelderly citizens in the United States, and to make medical insurance coverage more affordable, and accessible (Carpenter, 2011). The goals of the ACA is to establish a comprehensive dynamic and flexible foundation for a system of care that can develop policies and respond efficiently and effectively to changings in effort to improve quality care and prevent unnecessary cost growth reducing long-term fiscal imbalances (Orszag, & Emanuuel, 2010). The ACA intended to reduce the gaps providing greater access and more comprehensive and cost efficient system for delivery of quality care. The ACA is by fare the largest and most complex piece of legislature to affect the healthcare industry since the passage of Medicare and Medicaid. The ACA will continue to influence and shape the delivery of healthcare now and in the future (Knickman, & Kovner, 2014).

Recent events of the U.S. Supreme court and the ACA is the ruling against the issue of the cost sharing provision. This provision in the ACA requires that the insurance companies offer health plans to reduce out-of-pocket costs to consumers who qualify. The government then reimburses the insurance companies to offsets the added cost. This public money cannot be spent by the government without congress appropriations in an effort to provide check and balance within the U.S. government. The ACA however is being argued as violating the Constitution by committing billions of dollars from the Treasury without approval from congress (Vogue, 2016).

This can affect all parties involved. This ruling is expected to be appealed by the Obama administration which affects the governmental branch and spending tax dollars. Providers are not directly affected, but the heavy burden of patient's inability to pay bills because of high deductible can impact cost of care. The patients will be affected by the fact that the deductibles will rise this coming year if they have not risen already. From the payor's perspective they are directly affected, if they are not given money to offset the deductibles they will pass the cost on to the patient continuing the cycle of burden to be found on the provider and patient end.

The presidential election will be a key indicator of whether or not the U.S. Supreme court will waiver on the decision that the ACA is unconstitutional in disseminating money to offset insurance deductibles bypassing congress approval. This and other ACA changes driven by the republicans remain to be seen or impactful until 2017 when a new president takes office (Advisory Board, 2015).