Impacts of Changes in PPACA
The Patients Protection and Affordable Care Act has been one of the most significant achievements in the healthcare system of the United States. Since it was signed into law in 2010, the act has made tremendous results in the healthcare sector by increasing the quality and affordability of the healthcare while at the same time lowering the number of uninsured persons through its expansion to both public and private insurance ( Rosenbaum, 2011 ). Making changes in the PPACA by expanding its coverage and making health care more affordable could have some impacts on the American population, especially the uninsured individuals. The proposed changes in the current legislation could include increasing the use of health savings accounts for moderate-income Americans, permit the use of health reimbursement to purchase health insurance and reducing cost-sharing and improving the minimum employer coverage requirements. Such changes could affect the health care costs as well as access by the people.
Changes in the PPACA to extend the coverage can help the uninsured people have easy access to quality care at an affordable cost. By extending the coverage to include the uninsured persons and reduce the number of uninsured individuals, there will be an improvement in the quality of the health care as well as safety to all patients. One of the primary goals of PPACA is to make the coverage more secure for persons who are insured ad to extend the affordable coverage to any person who is not insured ( Hofer, Abraham & Moscovice, 2011 ). This will ensure that even the persons who are not insured are covered under the act, making them be able to access healthcare services at an affordable cost. The changes will also promote the access to quality and culturally competent care for all the Americans irrespective of the income of an individual.
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Importance of Provisions
The most important provision is the Medicaid program which was created to help the low-income families, children and individuals who would otherwise have difficulty in affording the health care costs to do so. More than 68 million Americans benefit from the healthcare coverage which makes it easy for them to afford healthcare services ( Taubman et al., 2014 ). Without this program, many children, low-income families and people with disabilities would have difficulty affording the healthcare services. Making coverage for one in every five Americans, the Medicaid program covers low-income children, adults and individuals with disabilities making it easy for them to access quality care. Medicaid is, therefore, the most significant program because it reaches out to the large population of low-income children, adults, and disabilities and makes them have access to quality care. Low-income children, families, and people with disabilities are the most vulnerable members of the society who need care and coverage so that they can have access to quality healthcare.
Medicare is the second most crucial provision in the health care programs. This is a program that covers older people to ensure they receive quality care whenever they are ill. As people get old and retire, they can no longer afford to pay for their healthcare coverage, and this puts them in a problematic situation whenever they are ill. Medicare program helps the old to remain healthy and independent while at the same time eases the responsibility for the young family members having to take care of their old ones ( Medicare Payment Advisory Commission, & Book, 2012 ). Medicare provides a guarantee for the affordable health insurance for the old. Previously, one out of two older Americans did not have health insurance putting them into a dark future should they get ill. The options that the older people had when they got sick was to either use their savings or take money from their family members. However, with the introduction of Medicare, the elderly people can now have easy access to quality health care services. This program has therefore assisted the older adults to get access to care services and improve their health outcome. The program provides a range of care services for the older people. It entails preventive services and screening for free while also offering wellness services.
The third most significant provision is the individual mandate which requires that Americans obtain health insurance or they pay a tax penalty. While the purpose of this health reform has been to expand the ACA coverage and reduce the number of uninsured persons, the program has been criticized by many as being unnecessary to achieve successful health care reform. The program has been essential in reducing the adverse selection in the reformed insurance market. Adverse selection takes place when a large number of people who are relatively unhealthy purchase health insurance than the healthy people. The critical purpose has therefore been to increase the number of people who purchase health insurance coverage so that they are protected under the ACA ( Shaw et al., 2014 ). This provision is ranked third most significant because successful health care reforms can still be achieved without necessarily making it mandatory for people to obtain health insurance or pay the penalty.
Potential Successes and Failures of PPACA
The PPACA has had some significant achievements and successes since it was signed in 2010. First, the program has led to an increased number of insured persons. Reports have shown that between 2013 and 2015, there were 17 million more people who were insured ( Huntington et al., 2011 ). This means that 17 million more people can now afford health care. The program has therefore led to increased affordability and accessibility of the health care services for the Americans. Women and children have been able to access affordable quality care under this program. The ACA prohibited gender discrimination that existed in the insurance companies making men and women pay the same amount of premiums. The program has also allowed children and persons under the age of 26 to continue getting health care services under the insurance plan of their parents. The cost of healthcare services have reduced dramatically since the introduction of the PPACA program as many Americans can now afford the cheap costs of medical services unlike before when the costs had not been subsidized. The quality of the healthcare, as well as accessibility, have been enhanced under the act of making people access quality care services easily. This has improved the health outcome amongst Americans who can now go to healthcare facilities assured of getting quality care at an affordable cost.
Despite having made some significant achievements, PPACA has had some failures as well. First, there is still a large number of uninsured people under the act. The initial projection that many uninsured people will drop from 50 million to 22 million was never realized ( Thompson, 2010 ). Also, the plan was to ensure the premiums were reduced under the act but this was never the case as premiums continued to go higher than before. A 10% average increase in the premium has been realized since the act was introduced.
Implications
While the PPACA has made some significant achievements within the healthcare sector, it has had some challenges which many have considered as its failures. However, America has moved a milestone in the area of health under this act because many people have been able to access quality healthcare services at an affordable cost ( Protection &Act, 2010 ). This has improved the health outcomes of individuals. Many people including the low-income families can now get quality care at a subsidized cost under this act. Affordability, accessibility, and quality have all been improved making the American healthcare sector move several miles ahead. Even though some failures have existed, a few reforms should be made to help address these weaknesses so that PPACA can be more effective in realizing its purpose. This, therefore, calls for some changes and amendments in areas that seem to limit the act from achieving its full purpose. With such changes, the program will emerge as one of the best in solving the healthcare issue in the United States.
Recommended Policy Changes
The first recommendation to address the challenges in the PPACA is to increase the credits for the moderate and the middle-income families. The Congress can consider increasing the size and the scope of the premium tax credit to help enhance the access to affordable health care insurance for the moderate and middle-income families. This can lead to an expansion in the coverage for the families who at the moment get little help from the program. The second recommended policy change is to increase the health saving account for the moderate income citizens. The Congress can align the PPACA requirements with the saving accounts programs and make subsidies for the health saving accounts for the middle-income families. This, when done, will further make the quality health care more affordable to the middle-income families. Also, the Congress should amend the law to allow the use of health reimbursement accounts to purchase health insurance. This can be done by amending the internal revenue code to permit the employers to use health reimbursement accounts to help the employees buy health insurance. When done, this can make health care insurance more affordable to the millions of the middle-class Americans.
References
Protection, P., & Act, A. C. (2010). Patient protection and affordable care act. Public law , 111 (48), 759-762.
Rosenbaum, S. (2011). The Patient Protection and Affordable Care Act: implications for public health policy and practice. Public health reports , 126 (1), 130-135.
Hofer, A. N., Abraham, J. M., & Moscovice, I. (2011). Expansion of coverage under the Patient Protection and Affordable Care Act and primary care utilization. The Milbank Quarterly , 89 (1), 69-89.
Thompson, T. S. (2010). Out-of-network involuntary medical care: An analysis of emergency care provisions of the Patient Protection and Affordable Care Act. Public law , 111 , 148.
Huntington, W. V., Covington, L. A., Center, P. P., Covington, L. A., & Manchikanti, L. (2011). Patient Protection and Affordable Care Act of 2010: reforming the health care reform for the new decade. Pain physician , 14 (1), E35-E67.
Shaw, F. E., Asomugha, C. N., Conway, P. H., & Rein, A. S. (2014). The Patient Protection and Affordable Care Act: opportunities for prevention and public health. The Lancet , 384 (9937), 75-82.
Medicare Payment Advisory Commission, & Book, A. D. (2012). Healthcare spending and the Medicare program. Washington, DC: MedPAC .
Taubman, S. L., Allen, H. L., Wright, B. J., Baicker, K., & Finkelstein, A. N. (2014). Medicaid increases emergency-department use: evidence from Oregon's Health Insurance Experiment. Science , 343 (6168), 263-268.
