The main objective of the affordable care act is ensuring people are granted access to healthcare through improved quality and lower health care expenses, consumer protections and expanded coverage. The enactment of the ACA in 2010 has mostly affected the healthcare systems both negatively and positively. Although such vital features will promote healthy patterns among communities, they will also create certain drawbacks in the healthcare sector because some essential gaps that could influence the level of community resilience will remain. For instance, the expanded coverage will no longer be a universal coverage since some states are against Medicaid programs expansion.
First, the ACA has worsened the health care workforce shortage that is growing. Secondly, the engagement of the Affordable care act which forces changes in the industry has mounted stress and instability among the healthcare workers as well as overburdening healthcare professions. Thirdly, since the ACA plans to impose additional 190 million hours of paperwork per annum, there is going to be limited time between the patients and the caregivers which will in turn drive the government to a patient-provider relationship. The ACA is expected to grant access to health insurance to millions; this will only be accomplished by a healthy and sizeable workforce to satisfy the increased demand.
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It's hard to deny the fact that there is an increased shortfall of health professionals in the healthcare sectors (Snavely, 2016). To make matters worse, the Affordable Care Act interferes with the promises they offered concerning access and quality care by intensifying the shortage, overburdening and causing stress to the already fragile system. As a result, with the increased additional hours of paperwork per annum accompanied with the presence of few workers, patients will be forced to wait longer having limited access to providers and a squeezed time with the caregivers.
On a similar occasion, the ACA has fostered some new changes in the revenue cycles of the healthcare sectors that have led to more patients becoming more responsible while also lowering the reimbursements rates. While some individuals have encountered positive results with the transition such as better quality of care and increased opportunity for shared savings; Much cannot be said since some have complained about the insufficiency in data analytics concerning infrastructure and the rise of unpaid expenses by the patients. Despite such setbacks, people have to agree to the notion that ACA has contributed a lot to change the health care sectors. As many people have gained health insurance coverage, more patients have become more responsible financially. As many consumers obtain insurance, uncompensated care expenses for providers decline. The negative side of it is that providers have complained of lower reimbursement rates under the legislation as their top concerns were the increasing number of patients.
How the ACA incorporated Social Determinants of Health Into Health Policy
In addition to the ongoing movement that fosters incorporating health outcomes to be considered in non-health policy sectors, efforts have also been made to assess the social determinants of health concerning the wellbeing of individuals. Public policy has diverted the attention of healthcare organizations by making them focus on social grounds of health. To begin with, the ACA has made efforts to extend the coverage over a population that exceeds 27 million Americans as well as reducing the rate of uninsured to a historic low. The Affordable care act has established the Accountable Care Organizations which serve to share financial risks and account for patients’ outcome in the fields of healthcare providers. This action has imposed a challenge on the health care providers by making them focus beyond certain conditions to provide extra value to patients.
With the established authority of ACA, organizations such as Centers for Medicare and Medicaid Innovation have managed to create the Accountable Health Communities Model whose primary function is to test approaches that integrate health and social services. The forum is supposed to address transportation needs, domestic violence, food insecurity, housing instability and utility assistance (Billioux et al., 2017). Under the new statutory authority, Medicaid managed care plan, and Medicaid agencies have been allowed to increase obstinacy through Centers for Medicare and Medicaid in the context of addressing enrollees’ nonmedical and social needs. The ACA has also proposed to the nonprofit hospitals urging them to engage in health needs assessments in the community to help communities develop a strategic approach in periods of three years. The community health needs assessment has addressed violence among communitiesas well as economic and food insecurity which are critical to most communities.
Proposed Changes to Health Care System Under the Current Administration
Since the enactment of the ACA of 2010, many people have criticized it suggesting for replacements with other alternatives. Earlier in 2018 the Republican president Donald Trump engaged in proposals to repeal the ACA to replace it with the following title ‘Healthcare Reform That will Make America Great Again.’ Such reforms focused on letting people subtract premiums from own tax returns, create barriers to finance both children health insurance and the Medicaid programs and foster the state of health insurance by giving permits to insurers to continue selling insurances across state lines (Saltzman, Evan & Eibner, 2016).
In this context, all ACA provisions are repealed; this includes even the expansion of Medicaid. This means the elimination of market reforms in the individual market including the prohibition of insurers in the attempt of denying coverage to individuals especially those with preexisting conditions. Under these proposals, tested advance premium tax credits will be eliminated; thus people will be granted the chance of using pretax dollars in purchasing individual market insurance. Insurers will have ease of marketing their plans to different countries without adhering with the laws of the specific nation. Such rules could accelerate the population of people who lack insurance to almost 25 million. The losses experienced in coverage will affect the poor. Also, people who will have enrolled with individual market insurance will incur higher expenses compared to those who are under the current law.
References
Billioux, A., Verlander, K., Anthony, S., & Alley, D. (2017). Standardized screening for health-related social needs in clinical settings: The accountable health communities screening tool. NAM Perspectives.
Saltzman, E., & Eibner, C. (2016). Donald Trump’s health care reform proposals: Anticipated effects on insurance coverage, out-of-pocket costs, and the federal deficit. The Commonwealth Fund, 32, 1-14.
Snavely, T. M. (2016). A brief economic analysis of the looming nursing shortage in the United States. Nursing Economics, 34(2), 98-101.
