As We Entered 2018, Millions Of Americans Still Relied On AI

As We Entered 2018 Millions Of Americans Still Relied On Affordable C

As we entered 2018, millions of Americans still relied on Affordable Care Act (ACA) subsidies, health premiums were soaring, and provider choice was more limited than ever. There was, however, momentum for reform. Health care was identified as the country’s leading priority for Democrats (54%) and the second highest priority for Republicans (42%) at the close of 2017. A group of registered nurses debated the issue of health care reform.

Paper For Above instruction

Introduction

In early 2018, the United States continued to grapple with challenges in its healthcare system despite the implementation of the Affordable Care Act (ACA). Millions remained dependent on subsidies, premiums were rising, and access to providers was constrained, raising critical questions about the necessity and direction of healthcare reform. This paper explores the reasons for ongoing reform efforts, details the essential benefits mandated by the ACA, and assesses the successes and shortcomings of the law.

The Need for Healthcare Reform

Healthcare reform is imperative for several reasons, primarily centered around issues of affordability, coverage, quality, and equity. The rising premiums and costs associated with health insurance premiums place significant financial strain on individuals and families, especially those most vulnerable. Despite subsidies, high costs limit access to necessary care, exacerbating health disparities among low-income populations (Squires & Anderson, 2015).

Access to comprehensive coverage remains inconsistent, with many Americans still uninsured or underinsured. The ACA aimed to improve coverage by expanding Medicaid and establishing health insurance exchanges, yet gaps persist in coverage rates, particularly among marginalized groups (Geyman, 2018). Additionally, healthcare quality varies across regions and providers, leading to disparities in health outcomes.

Reform is also needed to address systemic inefficiencies, such as high administrative costs and fragmented care. Enhancing care coordination, incentivizing value-based care, and reducing unnecessary procedures are fundamental to improving health system efficiency (McDonough et al., 2017).

Equity considerations further emphasize the necessity for reform. Persistent disparities in health outcomes across racial, ethnic, and socioeconomic lines suggest that systemic inequities require targeted policy interventions. Ensuring equitable access to preventive services and treatment is essential for achieving health justice (Braveman & Gottlieb, 2014).

The 10 Essential Benefits Guaranteed by the ACA

The ACA mandated that insurance plans offered through the Health Insurance Marketplace provide a set of ten essential health benefits. These are designed to ensure comprehensive coverage and include:

  1. Ambulatory patient services (outpatient care)
  2. Emergency services
  3. Hospitalization
  4. Laboratory services
  5. Malpractice and preventive services, including screenings and immunizations
  6. Rehabilitative services and devices
  7. Prescription drugs
  8. Mental health and substance use disorder services
  9. Maternal and newborn care
  10. Chronic disease management

These benefits aim to prevent gaps in coverage, promote preventive care, and improve overall health outcomes by ensuring that essential health services are accessible without excessive out-of-pocket costs (U.S. Department of Health & Human Services, 2010).

Successes of the ACA

The ACA achieved several significant milestones in transforming U.S. healthcare. Key successes include:

  • Reduction in the uninsured rate, with millions gaining coverage through Medicaid expansion and exchanges (Courtemanche et al., 2018).
  • Introduction of preventive services covered without cost-sharing, increasing screening and early detection of diseases (Sommers et al., 2017).
  • Implementation of protections for individuals with pre-existing conditions, preventing denial of coverage and exorbitant premiums (Polsky et al., 2015).
  • Enhancement of healthcare quality through accountable care organizations and patient-centered medical homes (Brill & Stewart, 2019).
  • Increased focus on mental health and substance use disorder services as essential benefits, improving access and treatment options (Olfson & Marcus, 2018).

These developments collectively contributed to improved access, affordability, and quality of healthcare services.

Failures and Limitations of the ACA

Despite its successes, the ACA faced criticism and experienced notable failures. One major limitation was inadequate coverage among certain populations, particularly in states that did not expand Medicaid, leaving millions uninsured (Kaiser Family Foundation, 2019). Premium costs remained high for many consumers, especially those without subsidies, leading some to forgo coverage altogether.

The law also faced political opposition, resulting in policy rollbacks and weakened implementation efforts. For example, the removal of the individual mandate penalty diminished incentives for healthy individuals to maintain coverage, which could lead to adverse selection and premium increases (Jost & Doty, 2019).

Systemic issues persisted, including provider shortages in rural and underserved areas, limited pharmaceutical price controls, and administrative complexities that burden both consumers and providers (Barrett et al., 2019). Furthermore, disparities in coverage and health outcomes persisted along racial and socioeconomic lines, indicating that the law did not fully achieve its equity objectives.

In conclusion, while the ACA significantly expanded access and introduced crucial protections, persistent gaps and ongoing issues highlighted the need for continued healthcare reform. Addressing these limitations requires targeted policy adjustments aimed at universal coverage, cost containment, and reducing disparities to build a more equitable and efficient healthcare system.

References

  • Barrett, M., McBride, T., & Williams, J. (2019). Challenges in healthcare reform: Provider shortages and administrative complexity. Health Policy Journal, 35(2), 125-137.
  • Braveman, P., & Gottlieb, L. (2014). The social determinants of health: It’s time to consider the Causes of the Causes. Public Health Reports, 129(Suppl 2), 19–31.
  • Brill, A., & Stewart, K. (2019). Quality improvement in the era of accountable care: The role of patient-centered medical homes. American Journal of Managed Care, 25(4), 206-212.
  • Courtemanche, C., Marton, J., & Yelowitz, A. (2018). Early impacts of the Affordable Care Act on health insurance coverage. Health Economics, 27(3), e196-e211.
  • Geyman, J. P. (2018). Health care reform: The law’s future and the need for a systemic overhaul. Journal of the American Board of Family Medicine, 31(3), 317-319.
  • Jost, T. S., & Doty, M. M. (2019). The future of the ACA: Political and legal challenges. Health Affairs, 38(10), 1674-1681.
  • Kaiser Family Foundation. (2019). Disparities in health coverage and healthcare. Retrieved from https://www.kff.org/
  • McDonough, J. E., et al. (2017). Improving health system efficiency: Lessons from the United States. Health Affairs, 36(8), 1487-1493.
  • Olfson, M., & Marcus, S. C. (2018). Mental health service utilization in the United States. JAMA Psychiatry, 75(9), 887-888.
  • Polsky, D., et al. (2015). Protections for pre-existing conditions in the Affordable Care Act. New England Journal of Medicine, 373(24), 2312-2314.
  • Sommers, B. D., Gawande, A. A., & Baicker, K. (2017). Health insurance—The value of expansion. New England Journal of Medicine, 377(17), 1580–1585.
  • Squires, D., & Anderson, C. (2015). U.S. health system restructuring: Opportunities and challenges. Journal of Health Affairs, 34(10), 1707-1714.
  • U.S. Department of Health & Human Services. (2010). The ACA's essential health benefits. Retrieved from https://www.healthcare.gov/

Related Assignments