case study

According to World Health Organization, health policy is defined as decisions, plans and actions that are set in place to achieve specific health care goals within a society. Recently, numerous health policies and legislations have been enacted but there is a law that had a huge impact in the healthcare industry.

On the 23rd of March 2010, Affordable Care Act (ACA) 2010 was enacted and had a great impact in several areas in the healthcare field especially in the insurance aspect. ACA tremendously increased deductibles, premiums, out of pocket cost specifically with coverage that are sold in the health insurance exchanges. Most of the provisions of the ACA have led to the payers (insurance companies) to spend more on healthcare services for patient that are sick. Meanwhile, emergency care, hospital no longer have provide healthcare for patients who are uninsured and cannot afford to pay for medical services out of pocket because ACA expanded Medicaid which now covers the treatment expenses.

Before the ACA was enacted, a lot of people were without insurance and after the ACA was enacted, about 20 million people got coverage. Providing coverage for about 20 million people was one of the factors that inflates premium rates. Because of the ACA, payers can no longer deny people with pre-existing condition whose treatment are expensive. In addition, ACA now require health plans to cover preventive care like immunizations to fully covered by the insurance which is another factor that inflates premiums.

Another huge impact of the ACA is the individual mandate which require everyone to get insured or get penalized that now makes payers to provide more coverage for Americans which means more expenses for payer.

Reference

https://healthpayerintelligence.com/features/how-the-affordable-care-act-changed-the-face-of-health-insurance