Assignment 4: Health Insurance And The Affordable Car 602169

Assignment 4: Health Insurance and the Affordable Care Act Due Week 8

Suppose you have been tasked with purchasing health insurance for your organization that has fifty full-time employees. Use the Internet or Strayer databases to research different types of health insurance. Write a 2-3 page paper in which you: Suggest one (1) plan that you would use to purchase health insurance for your organization. Determine the extent to which employee lifestyle choices and health economics would factor in to your chosen plan. Provide a rationale for your response. Analyze the implication of the Affordable Care Act on your decision to purchase insurance. Debate two (2) advantages and two (2) disadvantages of purchasing health insurance for your employees, as opposed to having your employees receive governmental insurance. Use at least two (2) quality references. Note: Wikipedia and other Websites do not qualify as academic resources. Your assignment must follow these formatting requirements: This course requires use of new Strayer Writing Standards (SWS). The format is different than other Strayer University courses. Please take a moment to review the SWS documentation for details. Be typed, double spaced, using Times New Roman font (size 12), with one-inch margins on all sides; citations and references must follow SWS or school-specific format. Check with your professor for any additional instructions. Include a cover page containing the title of the assignment, the student’s name, the professor’s name, the course title, and the date. The cover page and the reference page are not included in the required assignment page length. The specific course learning outcomes associated with this assignment are: Analyze the impact of healthcare financing and health insurance on healthcare access, quality, and cost. Analyze the influence of health policy and health reform on healthcare access, quality, and cost in the U.S. Use technology and information resources to research issues in healthcare policy, law, and ethics. Write clearly and concisely about healthcare policy and law using proper writing mechanics.

Paper For Above instruction

The landscape of health insurance in the United States has undergone significant transformations, especially following the enactment of the Affordable Care Act (ACA). For organizations with a modest workforce, such as the one with fifty full-time employees described here, selecting an appropriate health insurance plan requires careful consideration of both the organization's needs and the broader health policy environment. This paper explores the selection of a suitable insurance plan, the influence of employee lifestyle choices and health economics, the impact of the ACA on such decisions, and a balanced discussion of the advantages and disadvantages of employer-sponsored insurance relative to government-provided options.

Selection of an Appropriate Health Insurance Plan

The preferred plan for this organization is a Preferred Provider Organization (PPO) plan. PPOs offer flexibility by allowing employees to choose their healthcare providers without referrals, which is particularly attractive for a relatively small workforce that may have diverse healthcare needs. PPOs typically offer broader provider networks and faster access to specialists, making them suitable for organizations aiming to prioritize employee autonomy and comprehensive coverage. Additionally, PPO plans often feature a range of premium and deductible options, enabling the organization to balance cost considerations with the desired level of coverage.

Impact of Employee Lifestyle Choices and Health Economics

When selecting a health insurance plan, employee lifestyle choices and health economics are critical factors. Employees' habits regarding smoking, exercise, diet, and preventive health practices directly influence the organization's health costs. For example, a workforce with higher rates of obesity or smoking necessitates a plan that emphasizes wellness initiatives, preventive screenings, and smoking cessation programs to mitigate long-term costs. From an economic perspective, healthier employees tend to utilize fewer healthcare resources, reducing overall expenses. Therefore, a wellness-oriented PPO plan that incorporates preventive care incentives can promote healthier lifestyles, ultimately reducing premiums and out-of-pocket costs for both employees and the organization.

Implications of the Affordable Care Act on Insurance Decisions

The ACA has significantly impacted employer-sponsored insurance by mandating coverage for preventive services without copayments and prohibiting denial based on pre-existing conditions. It also introduced employer mandates for larger organizations, although this organization remains below the threshold. The law emphasizes affordability and coverage mandates, which influence plan selection by encouraging comprehensive coverage options that include preventive and mental health services. Moreover, the ACA has fostered the development of health insurance marketplaces, providing employees with additional coverage options independent of employer-provided insurance. These changes induce organizations to adopt plans aligning with ACA standards to comply legally and enhance employee satisfaction.

Advantages of Employer-Sponsored Insurance

  • Enhanced Employee Satisfaction and Retention: Offering a comprehensive health plan demonstrates a commitment to employee well-being, which can improve morale and reduce turnover. Employees often value employer-sponsored insurance more than other benefits because it reduces their financial burden and provides security.
  • Tax Advantages: Employer contributions toward employee health insurance are tax-deductible for the organization, and employees generally receive these benefits on a pre-tax basis, lowering taxable income and payroll taxes.

Disadvantages of Employer-Sponsored Insurance

  • Cost Burden on Employers: Health insurance premiums can be substantial, especially as healthcare costs rise. For small organizations, bearing this financial responsibility may limit other investments or necessitate increased employee contributions, which could affect employee satisfaction.
  • Limited Flexibility for Employees: Employer plans may not perfectly fit all employee needs or preferences, especially if the organization offers limited plan options or if employees prefer plans tailored to their individual circumstances, such as specific providers or coverage features.

Comparison with Governmental Insurance

Opting for governmental insurance options, such as plans provided via the ACA marketplace or Medicaid, can offer lower premiums or broader coverage options. However, relying solely on government programs may reduce the organization's control over plan specifics and provider networks. Moreover, some employees may prefer employer-sponsored insurance due to tax advantages and the perception of better coverage. Conversely, government programs provide social safety nets but may face funding uncertainties and wait times, which could impact employee satisfaction and access to care.

Conclusion

Choosing an appropriate health insurance plan involves balancing costs, employee preferences, and legal requirements shaped by the ACA. A PPO plan emphasizing preventive care and wellness initiatives appears optimal for a small organization prioritizing flexibility and comprehensive coverage. While employer-sponsored plans foster employee loyalty and offer tax benefits, they also pose financial and flexibility challenges. Ultimately, the decision must align with the organization’s strategic goals, financial capacity, and the evolving legal landscape, ensuring that the health needs of employees are met effectively.

References

  1. Berchick, E. R., Barnett, J. C., & Upton, R. (2019). Health Insurance Coverage in the United States: 2018. U.S. Census Bureau, Current Population Reports. https://www.census.gov/library/publications/2019/demo/p60-267.html
  2. Courtemanche, C., Marton, J., Yelowitz, A., Woo, J., & Zapata, D. (2017). Early effects of the Affordable Care Act on employer-sponsored insurance coverage. Reginal Science & Urban Economics, 67, 142-157.
  3. Long, M. C., & Coughlin, T. A. (2017). The Impact of the Affordable Care Act on the US Healthcare System. Journal of Policy Analysis and Management, 36(3), 738–744.
  4. Schoen, C., Osborn, R., Squires, D., Doty, M., & Pierson, R. (2010). How health insurance design affects access to care and costs, by income, in eleven countries. Health Affairs, 29(12), 2323-2334.
  5. Ginsburg, P. B. (2015). The Affordable Care Act’s Effects on Employer-Sponsored Insurance. The New England Journal of Medicine, 373(9), 880-883.
  6. Rosenbaum, S. (2016). Health policy challenges and opportunities. New England Journal of Medicine, 375(17), 1607-1609.
  7. Kaiser Family Foundation. (2020). The State of Health Insurance Coverage. https://www.kff.org/report-section/the-state-of-health-insurance-coverage-2020
  8. Berkowitz, S. A., Basu, S., & Phillips, R. L. (2017). How might recent healthcare reform efforts influence employer-based insurance? Journal of General Internal Medicine, 32(12), 1346–1348.
  9. Rice, T., & Unruh, L. (2018). A Review of Incentives and Disincentives for Employer-Sponsored Health Insurance. Health Affairs, 37(4), 679-684.
  10. Kronick, R., & Kahn, J. (2017). Health Reform and its Effects on Employer-Sponsored Insurance. Journal of Health Politics, Policy and Law, 42(4), 607-639.

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