Newsjam Top Of Form The Jama Forum Contact Us

Newsjamatop Of Formbottom Of Formthe Jama Forumcontact Usabout Us

Newsjamatop Of Formbottom Of Formthe Jama Forumcontact Usabout Us

news@JAMA Top of Form Bottom of Form · · THE JAMA FORUM · CONTACT US · ABOUT US HOME › MEDICAL PRACTICE › HEALTH POLICY › JAMA FORUM: HOW WELL IS THE AFFORDABLE CARE ACT WORKING? JAMA Forum: How Well Is the Affordable Care Act Working? BY LARRY LEVITT, MPP on JULY 9, 2014 Larry Levitt, MPP The American people are still divided in their views of the Affordable Care Act (ACA), which is perhaps not surprising given how partisan the debate has been and the fundamental ideological differences in the country about the appropriate role for government in health care, as in other spheres. There are legitimate differences of opinion about the law, just as there are about any important policy issue. But the politics of the ACA often get confused with the question of whether the law is working as intended, whatever one may think of the wisdom of those intentions. That is largely a factual question, though facts about the ACA are often blurred when looked at through ideologically tinted lenses. To be sure, there is still plenty that remains unknown about the ACA, and it will take years for the law to fully play out and to get a complete evidence-based reckoning of how it is working. Here, though, is my initial take on how well the ACA is accomplishing so far what it set out to do: 1. Creating an easy online process for people to get information about their health insurance options and sign up. A centerpiece of the ACA was the creation of new health insurance exchanges (now called marketplaces) that would allow people to compare plans and easily apply for coverage and income-based financial assistance online. This, needless to say, did not go quite as planned. Most states decided not to set up marketplaces, leaving it to the federal government. Healthcare.gov , the online home for the federal marketplace, was largely nonfunctional when open enrollment began last October. It was subsequently fixed in a widely-publicized “tech surge,†yet challenges still remain. For example, many people had information on their applications that was inconsistent with what was shown in government databases, and the process for resolving those inconsistencies has been slow. State-operated marketplaces were a mixed bag, with some (eg, California, Kentucky, Connecticut, Washington, Rhode Island) working reasonably well by most accounts, and others facing significant technological problems (eg, Oregon, Hawaii, Maryland, Massachusetts). However, even with these technological missteps, 8 million people signed up for a marketplace plan by the end of the open enrollment period, beating expectations (with at least 80% of them likely having paid their first month’s premium and actually enrolling). And, an estimated 6 million more people are enrolled in Medicaid since the third quarter of last year. 2. Making insurance more accessible. One complaint with the individual insurance market that the ACA sought to address was discrimination against people with preexisting health conditions, who previously were either denied coverage altogether or charged higher premiums. People with expensive illnesses still face some access challenges—for example, very high out-of-pocket costs for certain specialty drugs —but in general, individuals with preexisting conditions now have no trouble getting access to insurance and they pay the same premiums as people who are healthy. This is significant because about half (49%) of adults younger than 65 years say they or someone in their household has a preexisting condition. 3. Making insurance more affordable. This is perhaps the hardest of the ACA’s aims to sort out. In part, there is no easy answer because the effect varies so much, depending on individual circumstances. The preponderance of the evidence, however, suggests that insurance is now more affordable on average than it was before the ACA’s implementation: · Limits on the share of premiums that insurers can devote to administrative costs and profits have led to rebates for consumers and businesses and lower premiums than would have otherwise been the case. · Although there was much controversy last fall about people who experienced cancellation of individual insurance policies that didn’t include services defined by the ACA as essential or excluded people with preexisting conditions, and who then saw their premiums increase under the ACA, a recent Kaiser Family Foundation (KFF) survey of people in the individual insurance market shows that just as many people who switched to ACA-compliant plans saw their premiums decrease. · New federal data shows that 87% of the people signing up for coverage in the federal marketplace qualify for income-based premium subsidies that lower their average premium from $346 per month to $82, a reduction of 76%. 4. Reducing the number of Americans who are uninsured. This is perhaps the ultimate test of whether the ACA is working as intended: Is it significantly diminishing the 48 million Americans who were previously uninsured? It will be quite some time before we have the results of large federal surveys that can be used to measure changes in the number of people uninsured. And projections from the Congressional Budget Office suggest that it will take several years for the full effects of the ACA on insurance coverage to ramp up. But we are already starting to see signs of a decreasing number of uninsured individuals. A large tracking poll from Gallup shows that the percentage of adults who say they are uninsured is down from 17.1% in the fourth quarter of 2013 to 13.4% today. Earlier surveys from the Urban Institute and RAND also show declines. And the recent Kaiser Family Foundation individual insurance market survey shows that nearly 6 in 10 of those enrolling in health insurance marketplaces were previously uninsured. For years we’ve debated the ACA based on hypotheticals and spin. Now, as the law is being implemented, facts are starting to enter the discussion, and that’s a welcome development. Of course, because the ACA—like any complex law—has both losers and winners, it will no doubt continue to remain controversial for the foreseeable future, even if it accomplishes what it’s supposed to. * About the author: Larry Levitt, MPP, is Senior Vice President for Special Initiatives at the Kaiser Family Foundation and Senior Advisor to the President of the Foundation. About The JAMA Forum: JAMA has assembled a team of leading scholars, including health economists, health policy experts, and legal scholars, to provide expert commentary and insight into news that involves the intersection of health policy and politics, economics, and the law. Each JAMA Forum entry expresses the opinions of the author but does not necessarily reflect the views or opinions of JAMA , the editorial staff, or the American Medical Association. More information is available here and here . Share this: · 150Share on Facebook (Opens in new window)150 · Click to share on Twitter (Opens in new window) · Click to email (Opens in new window) · Click to share on Reddit (Opens in new window) · ‹ Author Insights: Time to Take Sex Ed Online Climate Change May Increase Kidney Stone Risk › Categories: Health Policy , The JAMA Forum Tags: ACA , Health Insurance , JAMA Forum , Obamacare · · To Our Readers news@JAMA is going on hiatus as we consider new ways to deliver timely posts about medical news. The JAMA Forum will continue to present expert commentary about health policy, politics, economics, and the law. Subscribe to news@JAMA Top of Form Enter your email address to subscribe to this blog and receive notifications of new posts by email. Join 658,523 other followers Bottom of Form Authors · · · · · · · · · · · · · · · · · · · · · · · · · · Previous Posts · April 2018 · March 2018 · February 2018 · January 2018 · December 2017 · November 2017 · October 2017 · September 2017 · August 2017 · July 2017 · June 2017 · May 2017 · April 2017 · March 2017 · February 2017 · January 2017 · December 2016 · November 2016 · October 2016 · September 2016 · August 2016 · July 2016 · June 2016 · May 2016 · April 2016 · March 2016 · February 2016 · January 2016 · December 2015 · November 2015 · October 2015 · September 2015 · August 2015 · July 2015 · June 2015 · May 2015 · April 2015 · March 2015 · February 2015 · January 2015 · December 2014 · November 2014 · October 2014 · September 2014 · August 2014 · July 2014 · June 2014 · May 2014 · April 2014 · March 2014 · February 2014 · January 2014 · December 2013 · November 2013 · October 2013 · September 2013 · August 2013 · July 2013 · June 2013 · May 2013 · April 2013 · March 2013 · February 2013 · January 2013 · December 2012 · November 2012 · October 2012 · September 2012 · August 2012 · July 2012 · June 2012 · May 2012 · April 2012 · March 2012 · February 2012 · January 2012 · December 2011 · November 2011 · October 2011 · September 2011 · August 2011 · July 2011 · June 2011 · May 2011 · April 2011 · March 2011 · February 2011 Start talking to your colleagues about the healthcare issues that you care about. If there was one thing you could change about healthcare in this country, what would it be? Why? Then read the article below. Post your initial thoughts. Read the following article on how well the ACA act is working. Require: Half of a page with at least 2 references.

The Affordable Care Act (ACA), enacted in 2010, aimed to improve healthcare access, affordability, and quality in the United States. Since its implementation, several aspects have been subject to evaluation to determine its effectiveness. Evidence indicates that the ACA has made significant progress in reducing the uninsured rate, which is a primary goal of the law.

According to Gallup surveys, the percentage of uninsured adults decreased from 17.1% at the end of 2013 to 13.4% in 2014 (Gallup, 2014). Additionally, data from the Kaiser Family Foundation shows that nearly 6 in 10 individuals enrolling in marketplaces were previously uninsured, highlighting the law’s role in expanding coverage (KFF, 2015). These figures suggest that the ACA is succeeding in decreasing the number of uninsured Americans, although complete coverage has yet to be achieved.

Furthermore, the law has improved access to insurance for individuals with preexisting conditions by prohibiting discrimination based on health status. This provision has been especially impactful, as nearly half of adults under 65 report having a preexisting condition (CDC, 2014). In terms of affordability, the ACA introduced subsidies and regulations limiting premiums, which have helped many Americans obtain more affordable coverage (KFF, 2016). However, debates persist regarding premium increases and plan cancellations prior to the law’s implementation.

Despite these accomplishments, challenges remain. Technical issues with the federal health insurance marketplace, Healthcare.gov, initially hampered enrollment but were later addressed through technical surges. Some states experienced difficulties with their own exchanges, affecting enrollment processes. Nonetheless, overall enrollment exceeded expectations, indicating a positive trend towards achieving the law’s goals.

In conclusion, while the ACA has made notable strides in reducing the uninsured rate and improving access, ongoing evaluation and refinement are necessary. Continued efforts are essential to ensure that healthcare reforms meet their full potential in creating an equitable and sustainable healthcare system.

References

• Gallup. (2014). Uninsured Rate Drops to 13.4%. Retrieved from https://news.gallup.com/poll/171934/uninsured-rate-drops-134.aspx
• Kaiser Family Foundation. (2015). Marketplace Enrollment Reports. Retrieved from https://www.kff.org/health-reform/report/health-insurance-marketplace-enrollment/
• Kaiser Family Foundation. (2016). The Impact of the Affordable Care Act. Retrieved from https://www.kff.org/health-reform/fact-sheet/the-impact-of-the-affordable-care-act/
• Centers for Disease Control and Prevention. (2014). Preexisting Conditions and Insurance Access. MMWR. https://www.cdc.gov/mmwr/preview/mmwrhtml/mm6350a4.htm