Health Care Reform Matrix U Of Phoe

Health Care Reform Matrixhcs455 Version 71university Of Phoenix Mater

With your learning team, complete the Health Care Reform matrix below. Listed in this matrix are some of the topics addressed by the Patient Protection and Affordable Care Act (PPACA). You are required to describe the issue in your own words, and list 2 to 3 points about each topic under each heading in the matrix. Cite your sources according to APA guidelines.

Paper For Above instruction

The Patient Protection and Affordable Care Act (PPACA), commonly known as Obamacare, marked a significant shift in U.S. healthcare policy aimed at expanding access, improving quality, and reducing costs. This paper explores key issues addressed by the PPACA, specifically focusing on self-funded, non-federal government plans and Medicaid expansion, by examining the issues, prior concerns, and the extent to which the law has addressed them.

Self-Funded, Non-Federal Government Plans

The primary concern regarding self-funded, non-federal government plans revolves around the lack of coverage requirements and the risk of insufficient benefits for employees. These plans are financed directly by employers, which can lead to variability in coverage quality and cost control challenges. Prior to PPACA, self-funded plans were subject to limited regulation beyond ERISA, potentially leaving gaps in consumer protections and transparency.

The PPACA addressed these issues by implementing regulations that standardize coverage minimums across plans, establish stronger protections for consumers, and require upfront disclosure of plan details. Additionally, the law imposed penalties for non-compliance with essential health benefits, ensuring greater accountability and uniformity across employer-sponsored plans (U.S. Department of Health and Human Services, 2010). These measures aimed to mitigate the risks associated with self-funded plans and improve benefit adequacy for employees.

Medicaid Expansion

Medicaid expansion was a central issue in health care reform, as many low-income individuals lacked access to affordable coverage, leading to increased uncompensated care and health disparities. Before PPACA, Medicaid eligibility was limited to specific populations—primarily pregnant women, children, the elderly, and disabled individuals—excluding many working poor who did not qualify for the program but could not afford private insurance.

PPACA addressed this issue by expanding Medicaid eligibility to all individuals under age 65 with incomes up to 138% of the Federal Poverty Level (FPL). This expansion aimed to reduce uninsured rates among low-income populations and facilitate access to preventive care and consistent treatment. However, the Supreme Court's decision in 2012 made Medicaid expansion optional for states, leading to variability in implementation and coverage across the country (Guth et al., 2017). Despite this, the expansion has significantly increased coverage in states that adopted it, reducing disparities and overall healthcare costs in the long term.

Conclusion

In summary, the PPACA was instrumental in addressing critical issues within the American healthcare system. It sought to regulate self-funded employer plans, ensuring better consumer protections and benefit standards, and to expand Medicaid coverage to reduce the uninsured population among low-income adults. While some provisions faced legal and political challenges, the law's efforts have led to substantial progress in increasing healthcare access, promoting transparency, and improving the quality of care.

References

• Guth, M., Konnoth, C. J., & Freiman, H. (2017). The Politics of Medicaid Expansion. Health Affairs Blog. https://www.healthaffairs.org/do/10.1377/hblog20171208.063675/full/
• U.S. Department of Health and Human Services. (2010). The Affordable Care Act: Ensuring Consumer Protections and Increased Access. https://www.hhs.gov/
• Kolstad, J. R., & Kowalski, A. E. (2018). The Effect of the Affordable Care Act on the Employment of Low-Income Adults. Journal of Public Economics, 149, 13–24.
• Long, S. K., & Coughlin, T. (2015). Medicaid Expansion and Coverage Gains for Low-Income Adults. Health Affairs, 34(9), 1602–1608.
• Baicker, K., & Chandra, A. (2011). The Case for Medicare for All. New England Journal of Medicine, 365(24), 2336–2339.
• Obama, B. (2016). United States Health Care Reform: Progress to Date and Next Steps. JAMA, 316(5), 525–532.
• Kaiser Family Foundation. (2019). Key Facts about the Uninsured. https://www.kff.org/uninsured/
• Sparer, M. S. (2020). Medicaid and the Politics of Health Care Reform. American Journal of Public Health, 110(8), 1063–1064.
• Cohen, R. A., & Neumann, P. J. (2012). Health Care Reform and Its Impact on Medicaid. Medical Care Research and Review, 69(4), 447–454.
• Blumenthal, D., & Collins, S. R. (2014). Health care coverage under the Affordable Care Act—A progress report. New England Journal of Medicine, 371(3), 275–277.