Premium Essay

Affordable Care Act Case Study

Submitted By
Words 455
Pages 2
According to the U.S Health and Human Services website, the Affordable Care Act was designed to put the consumer back in charge of their own healthcare through comprehensive health reforms. The goal was to make healthcare more affordable and to provide accessible, higher quality healthcare to families, seniors, businesses, and taxpayers. The program includes those Americans without insurance and those with inadequate coverage on their existing plans. The plan has been also called “Obama
Care” as it was enacted under the leadership of President Obama. 1
Medicaid, which currently covers nearly 50 million low-income Americans is a federal/state partnership of which all 50 states participate. Significant variations exist among states, however, they must meet federal minimum requirements. The Affordable Care Act of 2010, expanded Medicaid to all …show more content…
Through 2016 the federal financing will be at 100% with the percentage decreasing to 95% in 2017, 94% in 2018, 93% in 2019, and 90% in 2020 and beyond with the states responsible for the balance. Some of the provisions of the Affordable Care Act that will directly affect Medicaid are:
• Modifies how income is calculated for most Medicaid applicants, including those in the new eligibility group
• Provides all newly eligible adults with a benchmark benefit package that meets the minimum essential health benefits that will be available in the new health insurance exchanges
• Includes new mandatory and optional benefits in Medicaid such as coverage of free-standing birth clinics and tobacco cessation services for pregnant women which are new mandatory benefits
• Enhances efforts to improve Medicaid program integrity, including fraud and abuse prevention, detection and recovery initiatives
• Makes various changes to prescription drug

Similar Documents

Premium Essay

Affordable Care Act Case Study

...One provision of the Affordable Care Act that I am particularly in favor of, is the coverage of preventative care without being charged a copay or coinsurance (Fox & Shaw, 2014). These include specific serves for adults, children, and pregnant women. I have talked many times about the importance of preventative care. Not only is preventative care beneficial to the patient, but it can also help combat the soaring cost associated with healthcare. Having insurance coverage has always had an effect on the use of preventative services (Siu, Bibbins-Domingo, Grossman, 2015). There are now 63 preventive services covered under the ACA (Preventive Services, 2014). Studies have shown that 100,000 lives could be saved annually if people would utilize these preventative care services (Fox & Shaw, 2014). And even more impressive 9 out of 10 deaths could have...

Words: 413 - Pages: 2

Premium Essay

Affordable Care Act Case Study

...Patients living in poverty face multiple barriers to quality healthcare. The concept of “primary care …as a regular source of care characterize by continuity, comprehensiveness, co-ordination, availability and convenience” is a foreign concept (Wetta-Hall, et-al., 2005, p. 12). The Affordable Care Act (ACA) seeks to partially address this issue by providing insurance to all Americans. The case study identified that as a result of the poor having insurance “primary care increased but use of emergency services fell, and over time total health care costs declined” (Total health care, 2012). When the uninsured needed healthcare regardless of urgency they used the familiar and convenient emergency department which was substantially more expensive...

Words: 370 - Pages: 2

Premium Essay

Affordable Care Act Case Study

...Introduction The Affordable Care Act (ACA) was signed into law in the year 2010. Ever Since it came into existence, it faced many controversies. There are various parts of ACA which gained varying degrees of popularity. The provision of ACA that provided coverage to people with pre-existing conditions like diabetes and cystic fibrosis and the provision which put an end to lifetime caps gained enormous popularity amongst Americans. On the other hand, individual mandate and the penalties for not signing up for any coverage was not so popular provision of ACA. Nobody can deny that the ACA has tackled many challenges in the US healthcare effectively. Due to Medicaid expansion in states, many uninsured individuals got received the coverage. The...

Words: 742 - Pages: 3

Premium Essay

Affordable Care Act: A Case Study

...Chauncey, For Americans that have never had healthcare coverage or are currently getting by without it, the Affordable Care Act (ACA) could forever change their lives. This is because treatment and cures, they may not have had otherwise, will now be available to them. Additionally, “ACA insurance expansions could greatly decrease out-of-pocket spending for low-income adults seeking primary care” (Saloner, Polsky, Kenney, Hempstead & Rhodes, 2015, p. 773). This is because the working poor have income and sliding fee schedules often suggest paying more than their life situation may allow. Yes, consumers will drive health care in the future. However, it will be the responsibility of people in position of influence to keep the cost reasonable...

Words: 334 - Pages: 2

Premium Essay

The Affordable Care Act: A Case Study

...• How did politics shape the outcome in unexpected ways? The Affordable Care Act (ACA) is an example on how legislative procedures works and how that procedure help shape the legislative history in unexpected ways. Congress, signed into law by the President Obama in March 2010, passed the Affordable Care Act. A few years later the Supreme Court rendered a final decision to uphold the health care law. Prior to passing the Affordable Care Act into law, President Obama had requested over $30 billion for the National Institutes of Health so that it could continue to work towards Alzheimer’s disease research. • Did “pork” spending or “apportionments and allotments” budget amendments affect the legislation? Pork spending is when government...

Words: 260 - Pages: 2

Premium Essay

Affordable Care Act Case Study

...Lack of direct payment or low payment rates discourage many nurse practitioners from establishing or leading independent primary care centers (6). Restrictive state scope-of-practice laws impede the ability of NP’s to work efficiently and can pose significant barriers to care delivery (6). Policy makers may wish to consider two main approaches if they wish to alter the opportunities for NP’s to meet the needs of a collapsing primary care workforce: state legislative and payer reforms are a necessity. Our patients deserve a health policy that is able to meet their needs in the coming year. The Affordable Care Act (ACA) policy seeks to move the U.S. health care system from a fee-for service system based on volume and quantity to a payment model...

Words: 260 - Pages: 2

Premium Essay

Affordable Care Act Case Study

...For decades, our health care organization mainly focused on the cost and reimbursement aspects of health care. For this purpose, the Affordable Care Act was implemented on March 23, 2010, to expand health insurance coverage, improve the quality of health care and lower costs for everyone overall. As a result, this has helped our health care system change by not rewarding providers for the quantity of care but the quality of care. Quality health care can be described by receiving health care services that are medically necessary, accurate documentation, and utilizing the right tests/procedures at the appropriate time. Meanwhile, the ACA has created provisions to incentivize quality of care and manage how the care is being delivered. A few...

Words: 290 - Pages: 2

Premium Essay

Affordable Care Act Case Study

...This study determines the possible effects of the Affordable Care Act (ACA) on a large WWAMI (Washington, Wyoming, Alaska, Montana, and Idaho) medical education program which trains primary care health professionals for rural regions. Under the ACA, demand for primary care health professionals increases as more people will get health coverage. Medical schools are accepting more students to satisfy this demand, but there are limits on graduate medical education and residency positions are also limited. This will still result in insufficient supply. The authors examine the impact of ACOs (Accountable Care Organizations) on this program and resulting challenges in the recruitment and retention of health care workforce. The program currently focuses...

Words: 467 - Pages: 2

Premium Essay

Affordable Care Act Case Study

...Since the Affordable Care Act was approved , many people need to be enrolled in different health insurance plans and this increase the influx of patients in the hospitals and primary care physician offices . The shortage of physicians and health care workforce, the millions of American with insurance coverage , and Medicaid expansion have caused that health care administrators need to get creative to think of ways to close gap and hire doctors, nurse ,and other staff to account for the increased patient load. The health care workforce has a critical shortfall of health professionals over the next decade. The solution is complicated but the administrator need to create strategies to resolve this problem and give the best health care...

Words: 845 - Pages: 4

Premium Essay

Affordable Care Act Case Study

...The Affordable Care Act was one of the largest undertaking piece of legislation that the United States government has ever put together and implemented. The three branches of Government consists of the executive, legislative, and judicial branches of government. These branches are to be a checks and balance for each other to ensure that the American people best interest is kept at the forefront of the decisions made in Washington (McLennan, 2011). The executive branch of the federal government has the responsibility of creating and developing a process for how a piece of legislation would it affect the American people and give the directive on how that piece of legislation should look and be instituted. The Congressional or legislative branch...

Words: 427 - Pages: 2

Premium Essay

Patient Protection And Affordable Care Act Case Study

...Mental illness policy under “The Patient protection and Affordable care Act” (ACA) According to Medicaid office, the Patient Protection and Affordable Care Act, provides Americans with better health security by putting in place comprehensive health insurance reforms that expand coverage, hold insurance companies accountable, lower health care cost, guarantee more choice, and enhance the quality of care for all Americans. The attempts of 1985 case “Metropolitan Life Insurance Company V. Massachusetts to improve mental health system Act was extensively amended and failed coverage of certain mental health conditions. How? The Court went on to apply the deemer clause to conclude that the mandated benefit law could not be enforced-. Blackman J. (1985). This is an example of the health care dilemma. The healthcare disparity was shining upon the general population. The issue was patchwork in the public and private health care providers (hospitals, clinics, and doctors ‘offices) resulting in clear differences and no underlying safety among the vulnerable...

Words: 642 - Pages: 3

Premium Essay

Health Care Affordability

...Impact of Affordability on Access to Health Care Services: a Case Study of Texas Introduction Access to healthcare arguably forms an integral aspect of human existence. However, in recent times, access to health care appears to have been militated by Health care and health insurance laws, the US policies on health insurances, earnings of an individual and a host of other factors. Although the enactment of the Patient Protection and Affordable Care Act (ACA) appears to serve as a partial force which enables people to have access to health care if earnings are below the stipulated national minimum wage, however the extent to which this solve this situation is still a subject of controversy (Sommers, Buchmueller, Decker, Carey, & Kronick,...

Words: 475 - Pages: 2

Premium Essay

Affordable Care Act Case Summary

...The Affordable Care Act: A Case Study LaTonya Bolden EDU 806 November 26, 2017 Dr. Steven Moskowitz University of New England Table of Contents Executive Summary ………………………………………………………………………………………3 Introduction ...……………………………….…………………………………………………………….3 Bardach’s 8 Step Process and FMLA ……………...……………………………………………..……….5 Conclusion…………………………………………………………………………………………….…...8 References………………………………………………………………………………………...……….9 Executive Summary This case study will analysis the Affordable Care Act from its creation to its implementation during the Obama Administration. It will also discuss the challenges that the law currently faces. In the analysis, the eight step process created by Eugene Bardach will...

Words: 1067 - Pages: 5

Premium Essay

Journalism in 2016

...Research Database YOU SEARCHED : Affordable Care Act research topics 1 2 3 4 5 6 7 8 9 10 [...] Universal Health Care, A Moral Duty This 11 page research paper offers a current overview of the issues associated with the topic of universal healthcare provision and the Affordable Care Act (ACA). Universal health care as a moral and ethical duty is stressed. Bibliography lists 11 sources. Minimum Wage, Healthcare Reform A 3 page research paper that covers two topics. The first half of the paper presents the history of the federally mandated minimum wage, and the second half discusses the Supreme Court's announcement that it will rule on the constitutionality of the Affordable Care Act's required mandate for all Americans to purchase health insurance. Bibliography lists 2 sources. ESRD in NC, Access to Care for Underprivileged A 4 page research paper that examines the Patient Protection and Affordable Care Act (ACA) and how it impacts care for underprivileged patients with end stage renal disease (ESRD). Bibliography lists 2 sources. Health Care Changes Resulting from the PPACA In a paper of ten pages, the author writes about the Patient Protection and Affordable Care Act. The author of this paper considers four changes within health care as a result of the act including changes of private insurance, changes for the state regulations, the individual mandate provision, also age related coverage and preexisting conditions. There are three sources cited...

Words: 1182 - Pages: 5

Premium Essay

Health Insurance Case Study

...Increasing health plan premium costs are a growing burden for the employers who choose to provide health insurance coverage to employees. For small business owners operating on limited budgets, these increases are even more significant. The passage of the Affordable Care Act (ACA) creates additional responsibilities for employers regarding the minimum requirements and pricing of insurance plans for employees. Employers make difficult decisions to determine how to continue to provide health insurance at a fair and reasonable price, without harming the small business. The case study by Spencer (2014) examines the options of small business owners, John and Liza, faced with a 25% increase in health insurance rates. Once it is determined that the increase is due to the age and health status of several employees, the owner must decide whether to penalize certain employees with increased contributions, or have all workers absorb the added costs equally. In addition, there is concern that hiring a potential new employee, Robert, will increase insurance rates even further due to the pre-existing health condition of his spouse. It is challenging to select an option that has a fair and balanced impact on the company and its employees. While financially it is easiest for the company to have each employee absorb the cost of the premium increase, this is not a fair option if premium increases for all are due to the lifestyle factors of a small representation. There is an increased risk of...

Words: 1396 - Pages: 6