Identify two key components of the ACA that positively influenced Americans.
One of the primary goals of health reform, such as the Affordable Care Act (ACA),
is to improve insurance coverage and enhance access to health care. In reference to Medford et
al. (2015), the ACA provided subsidized insurance through the health care marketplaces for
small businesses and individuals without access to employment based insurance. The number
of uninsured Americans has decreased from 41 million to 27 million since the ACA’s initial
open enrollment period in the fall of 2013.
ACA helps to ensure that getting sick no longer implies financial ruin by expanding
access to affordable health insurance coverage. ACA not only expands coverage, but it also
improves financial security for families who already have coverage. Insurance firms can no
longer sell low quality policies with annual or lifetime coverage limits as a result of the ACA
(Nikpay et al., 2017).
When the ACA was first initiated, the Marketplace (site for signing up for insurance
plans) offered many options for Americans seeking healthcare insurance coverage.
Within two years, many insurance companies withdrew from offering ACA policies to
those eligible. Explain your thoughts as to why this occurred and whether there should
have been provisions in the ACA to prevent this.
The insurance firms all claimed significant losses as the reason for exiting the
health exchange market formed under the Affordable Care Act and concerns about financial
sustainability. In 2014, medical claims and administrative costs grew faster than premiums,
and health insurers' overall operating profits (known as underwriting gain) fell significantly
from previous years (Pines et al., 2016).
Improved financial performance will require higher rates, especially as the ACA's
reinsurance component began to phase out in 2017. This reinsurance has been critical in
assisting insurers with their transformation. Because it has taken longer than intended,
authorities should consider extending the Affordable Care Act's reinsurance program until the
reformed market has matured (Pines et al., 2016).
References
Medford, L. N., Eswaran, V., Shah, R. M., & Dark, C. (2015). The Patient Protection and
Affordable Care Act's Effect on Emergency Medicine: A Synthesis of the
Data.:Annals of emergency medicine,:66(5), 496–506.
https://doi.org/10.1016/j.annemergmed.2015.04.007
Nikpay, S., Freedman, S., Levy, H., & Buchmueller, T. (2017). Effect of the Affordable Care
Act Medicaid Expansion on Emergency Department Visits: Evidence From
State-Level Emergency Department Databases.:Annals of emergency
medicine,:70(2), 215–225.e6.
https://doi.org/10.1016/j.annemergmed.2017.03.023
Pines, J. M., Zocchi, M., Moghtaderi, A., Black, B., Farmer, S. A., Hufstetler, G., Klauer, K.,
& Pilgrim, R. (2016). Medicaid Expansion In 2014 Did Not Increase Emergency
Department Use But Did Change Insurance Payer Mix.:Health affairs (Project
Hope),:35(8), 1480–1486. https://doi.org/10.1377/hlthaff.2015.1632
