Efficacy of the Affordable Cost Act 2010 - Case Study Example

Policy Analysis Paper Affiliation Table of Contents Table of Contents 2 2 3 Part 1: Introduction 3 1.1 Background of the Affordable Care Act 2010 3 1.2 Description of the Policy 3 1.3 Current Situation 4 1.4 Premises of ACA 2010 5 Part 2: Rationale for the Affordable Care Act 2010 7 2.1 Burden of Chronic Disease and ACA 2010 9 Part 3: Efficacy of the Affordable Cost Act 2010 9 3.1 ACA 2010 and Conventional Health Care Goals 11 Part 4: Implementation 12 4.1 Challenges Facing ACA 2010 Implementation 12 Part 5: Recommendations 13 Part 1: Introduction 1.1 Background of the Affordable Care Act 2010 One of fundamental Acts in the history of the United State is the Patient Protection and Affordable Care Act (PPACA) that was signed into law in March 2010. Its provisions as projected were to come into play from January 1st, 2014 as a deliberate government effort towards achieving universal health care (Harmon, 2011, p. 49). The advent of the new millennium saw an increased global push towards universal health care driven by increased affordability and access. As a strategic move to secure consumer’s interest, the US government designed this policy that would secure the health care, financial system from a runaway cost of health care services. The proponents of this public policy Act argue that it caters for basic health care needs for consumers. Antwi et al., (2012, p. 145) its inception, the Act was enacted purposely to expand insurance coverage for American populations. Today, it is a federal statute that has been signed into law, although its full implementation remains controversial. One of the greatest challenges for this act was the court suits that were filed on the basis that the Act was an abuse of the US constitution. There was a raging debate across the US with the Republicans questioning the Democrats intentions. However, the June 28, 2012 ruling by the US Supreme Court upheld constitutionality of the Act. However, the ACA is a public policy that has gradual implementation that will see its full implementation by the year 2020 (Davidson, 2013, p. 314). 1.2 Description of the Policy The PPACA is commonly called Affordable Care Act (ACA) whose crafting reflects a historical growth and expansion of consumers, health care demand in the growing population. According to some quarters, the inauguration of the Act in January 2014 closes a 75-year journey towards embracing health care reform towards achieving consumer-friendly policy that would generate monumental step towards becoming a global leader in health care policy (Blumberg 2010, p. 78). After signing the document, President Obama observed that it was a law that was purposely crafted to meet modern and future generations. Despite the 75-year old push to achieve health care reforms, the call to pursue health care system with health care financing becoming its anchor gain popularity in 2009, July 14 when the House Democrats introduced into the house a 1000-page plan that would overhaul the health care system (Holahan & Dorn 2010, p.102). During the 2009, the debate raged throughout the summer, periodic culminating into the ACA 2010. One of the fundamental pillars of this policy was the need to prevent consumers’ from escalating cost of health care services by introducing what the Act calls shared responsibility. In the new reform, every person would be covered with a hybrid medical insurance cover including the jobless and less privileged persons in the society. 1.3 Current Situation The ACA 2010 will go down as the major consumer-friendly health care Act that has started transforming demand-supply forces of health care services. The Act has a comprehensive projection that will see approximately 31 million Americans currently uninsured get a medical cover by 2020. However, some economists have argued that the sustainability of this Act is uncertain as the global economic crisis continues to hit the US economy. In order to put the Act into practice, the US expenditure on health will go up from the current 15% of total GDP to about 18% according to some economists (Kennedy, et al., 2010, p. 212). The questions raised by those opposed to this policy are the growing population with dwindling economy will put pressure to those employed. Of course, the Act came with a proposal of tax increment, a move that appeared to anger US corporate bodies. The content of the Act presents an incredible recipe for expansion of medical cover to the advantage of the lower social class population while transfers burden to the working class. It has been heralded for its distribution policy; it promotes equity and universal access to medical insurance cover, a move that has put the American Department of Health ahead in the modern economies. Apart from promoting universal medical coverage, the Act has comprehensive details of restructuring health care through Medicare disbursement from fee-for-service to the adoption of bundled payments (United States 2013, p.345). 1.4 Premises of ACA 2010 American Journal of Medicine (2011, p. 3) states that the ACA is premised on eight transformational areas. One of the elements is to promote quality and affordable health care for all Americans through shared responsibility. The proponents of the Act argue that the move will transform health care financing to a systemic insurance market and eliminate discriminatory practices such as pre-existing conditions of exclusion. Some of the projected immediate improvements of this element include elimination of lifetime annual limits benefits of the old insurance policies. Besides, it extends the age limit of the dependent coverage to 26. Finally, the ACA element will cap company non-medical and administrative expenditures so that the allocations to the medical cover are increased. The Second element of the Act is linking the payment to the quality outcome unlike in ordinary health care market. Evidently, the Act launched a FY2013 that has linked Medicare payments to quality performance. It is therefore a public policy Act that is premised on ensuring quality of services. Besides, this has been captured in the Act through the Physician Quality Reporting Initiative (PQRI) launched in 2013 as a strategy that will bridge the gap between consumers and quality care (Moon, 2012, p. 102). Besides, the Act establishes HHS secretary whose purpose is to promote quality infrastructure in part of the strategy that will ensure quality health care is accessed by the Medicare cardholders. Some of the health care services include long-term care in hospitals, hospice, and rehabilitation services apart from the overt curative services. As it is, the Act is a comprehensive guideline and links with HHS secretary ensures improving payment accuracy in order to ensure cost-effectiveness of the implementation (United States 2013, p.412). Besides, the Act ensures imaging and wheelchair services are catered for. These are some of those expenses that used to raise the cost of health care. Moreover, United States (2010,p 314) the ACA will create Health care Quality Improvement (CQI) team that will be tasked for ensuring that there is quality of any services advanced to those covered by e policy. Unlike the previous insurance covers, the new scheme will incorporate those with chronic illness before the acquisition of the medical cover. Following controversial debates by stakeholders, including leading corporate bodies and subsequent Supreme Court ruling, the ACA is now an integral component of the US health care financing system. The fears of increased taxes, transparency and increased health care demands with limited resources in public hospitals pose threat to the practicability of the ACA 2010 implementation. Part 2: Rationale for the Affordable Care Act 2010 As the primary goal of this Act, the purpose is to promote a universal medical insurance cover for all the US citizens. The integral rational for this ACA 2010 is the creation of a platform that ensures universal access of health care services irrespective of the socioeconomic circumstances. It was driven by intention to promote a healthy nation and protect the rural community, the jobless and desolate children from the escaping cost of health care services. Therefore, the rationale was to create a level ground that ensures that not every citizen of the US is discriminated from accessing any health care services. Secondly, it was aimed at elimination bottlenecks in the old insurance policy that limited the age of the dependents to only 18 years; this was seen as a legal age that each person should have a personal medical cover. In reality, at this age a person is at high school or college. The majority still depend on their parents to shoulder their medical bills. The rationale for raising the dependent age of 26 was seen as a viable option that will cover the vulnerable youths from excruciating out-of-pocket health care financing system. In addition, the Act envisioned crafting a scheme that will promote a healthier community by improving access to a myriad of preventive, curative and rehabilitative health care services. The HHC secretary creates a school-based and community based health care programs that are funded through the expanded medical care scheme. Besides, it was crafted after the Center of Disease Control (CDC) promised to offer grants to evaluate chronic disease risks (Biles & Arnold, 2012, p. 67). Hence, the rationale projected was creating an inclusive Act that does not only focus on the hospital bills, but also expand medical services to meet the health promotion campaigns that have been operating below the standards because of lack of adequate finances to fund its projects. Besides, Davidson (2013, p.316) observes that the ACA 2010 provides a unique opportunity for the medical staff workforce. As an integral part of its rationale, it aims at creating a competent and diverse workforce in the health sector that will steer the expanded health care needs towards universal quality. Improving the health care workforce is one of the elements that have never existed within any insurance policy. As it is, the Act represents a divergent health care needs. Its rationale is drawn from the recognition that achieving global health care service standard is a result of multiple factors, and health care staff and financing are central to the overall success of the national goals. Creation of a National Commission to review the health care workforce and link consumer needs to quality and timely care in the US national care system was another rationale. For many years, the US health workforce has continuously undergone slowed and delayed progress in integral issues such as policy reviews and participating in issues pertaining to health. The ACA 2010 provides for the creation of a national body that will integrate health care issues through comprehensive and informed point of view. Sadly, Harmon (2011,p. 213) notes that politicians in congress and senate continue to be sole legislators on issues of health care while a vibrant workforce within health care professionals exists. In recognition of this important milestone, the ACA rationale was justified and creation of a national health commission has gained popularity within and outside the health sector. Apart from participating in the health care policy direction, the Act also establishes possibility of the commission to include health care assessments and making recommendations to the senate. Additionally, the rationale for this Act is motivated by the Healthy People 2020, whose projection is the creation of healthy people through promotion of accessible and affordable schemes for all forms of diseases. Moreover, the Primary Health Care package, the PHC was solidly designed to promote a healthy population across the cohorts. While pursuing universal health care goals, the Act was created also with a rationale of aligning existing health care resources with the projected health care needs. Besides, it draws its reasons from the growing burden of chronic diseases such as diabetes, hypertension and different forms of cancers that are now becoming a huge care burden in terms of costs to the consumers (Dennehy, 2011, p.51). 2.1 Burden of Chronic Disease and ACA 2010 Due to the Act recognition of the burden of chronic illness, the Act provides for the insurance of those with pre-existing chronic diseases a move that is different from that used in the old medical scheme. In so doing, the insurance seeks to support persons who are diagnosed of these chronic diseases. Some analysts argue that the expanded scheme has been the highest tax burden ever experienced in America. However, those who support the Act argue that it is established based on a strong rationale that bridges disparity that has been in existence for many years. As a pillar of the Act, the rationale is to narrow and perhaps remove divergent health care outcome. Part 3: Efficacy of the Affordable Cost Act 2010 One of the significance of the Act is creating of buffer system for the high cost of medical bills. In practice the health economists argue that it is easy to access health care services if the mode of payment is not the out-of-pocket (Ewing, 2012, p.81). With expanded medical care, the access has been improved and the call of quality health care has been institutionalized. Moreover, the Act has given the rural community and the jobless an advantage because the federal health care systems are now subsidizing the medical covers. Certainly, many nations have strived to undertake deliberate health care reforms, but it is only the US that is arguably in the right path towards achieving universal health care. In meeting the universal coverage, the Act provides tax credits for individuals and families that ensure affordable insurance to all. Secondly, the Act has created public programs that include community based and school health program as an important recipe in the expanded health care reform. This is important in creating a medical transition from a curative medical approach towards health care promotion and preventive medicine. Moreover, Bovbjerg (2010, p. 67) examines that the Act creates an HHS secretary that is tasked with ensuring that the care advanced is quality and meet the minimum standard is advanced to all Americans. In my view, the Act offers an equal ground to all persons; it presents a path towards promoting a classless health care system because of the insurance subsidies given to the rural communities and those from poor background. Besides, it is an Act that is anchored on the public good. It bridges the public expectation on the part of government in mitigating the health concerns. Notably, it has excellent inclusive criteria that focus on extending dependants limit to a more acceptable age. The expansion of dependent age to 26 and inclusion of those with pre-existing chronic diseases under the stipulation of the Act presents one of the actual displays of commitment to share the burden of disease. It recognizes the fact that most people with chronic diseases who were initially uninsured were greatly disadvantage in the old insurance scheme. The ACA 2010 is a right move towards consumer protection from the high cost of medical services because it encourages access to hospital. Just as economists argue, the rates of hospital visits have substantially increased by over 15% by the end of 2013 as the Act stated becoming operational (Kennedy et al., 2010, p. 56). 3.1 ACA 2010 and Conventional Health Care Goals Additionally, United States (2013, p 445) state that the Act as stipulated is an important recipe towards attaining the Millennium Development Goals (MDGs), the Primary Health Care package and the Healthy People 2020, which are strategic global goals towards promoting global health. One of the provisions of the Health People 2020 is protective of those persons with chronic diseases; in line with this, the Ace recognizes this group by inclusion to the medical cover. However, the inclusion of those under the age of 26 and those with chronic illnesses into the medical cover as stipulated by the ACA 2010 increases the health care consumer base posing a challenge to existing limited resources in the health sector. Unlike the previous medical covers, the ACA goes beyond meeting the health care financing needs. In essence, the ACA 2010 recognizes the multiplicity of factors that are inherent to health. In reality, health care outcome of a nation is dependent on three key issues: the cost of procuring health care services, the health care workforce, and policymaking. While recognizing these integral players, the Act stipulates a mechanism of building capacity and performance appraisal for the health care workers. According to the Act, this will be attained through the creation of the National Health Commission that will be tasked with putting together resources and building a creative and vibrant workforce (Moon 2012, p 104). Analysts argue that it is the first health care Act that put multiple players and stakeholders into focus. Because the Act has been established to ensure equity in access of health care services, I argue that it creates fairness in mitigating diverse health care needs facing both the urban elites and rural communities. Traditionally, there have been skewed health care outcomes due to unfairness in resource allocation between the upper class persons and those from poor background. Arguably, the ACA 2010 is now a leveling ground between rural and urban health because by 2013, there was a 14.5% increase in the visits to the rural health care facilities. Certainly, this improvement has been made possible by the ACA 2010. Besides, according to the Affordable Act 2010 analysis, those who qualify for federal exchanges will have insurance cover subsidized thus will reduce the cost of cover by 76% (Moon, 2012, p.111). Part 4: Implementation As projected by the Act, it will come into effect fully by 2020. The implementation of its partial stipulation has seen 31% increment in the medical insurance cover. As the US embraces the new Act, the growth in demand for health care services has substantially gone up. Besides, there is continued liberalization of the insurance schemes because the Act has empowered the consumers to shop for better services through the online platform. In essence, the Act is transforming procuring procedure of the insurance policy and its implementation has seen an expanded consumer base. 4.1 Challenges Facing ACA 2010 Implementation However, Taylor (2012, p.23) argue that two things stand in the ultimate path to achieving its universal goals; firstly, there has been critics and opposition from corporate bodies. Those opposed to the Act are mainly economists who argue that ACA 2010 negates the effort to contain government expenditure at a time when cutting down the costs in government is on the verge of collapse because of lack of options. The Act has been cited as a digression from the urgency of mitigating runaway increase in government spending. Besides, the increase in tax burden has been faulted as a disastrous move that would cripple the dwindling local investment. Coupled with increasing unemployment and increasing demand for health care services, the future sustainability remains unknown according to some expert. Secondly, the ACA 2010 has been projected to increase patient admissions into the existing public and private hospitals by over 10% per annual (Taylor, 2012, p.25). It has been found by some studies that this increase is not consummate to the infrastructural development and government annual staffing. Hence, it has been argued that inclusion of the development of a workforce that is competent would be slow to achieve before the expanded needs can match the resources. Hence, critics argue that it is a recipe to deterioration of health care quality rather than a recipe for growth. Thirdly, the Act has been subject to political ideologies that are divergent. From its onset, the Republicans faulted the Act terming it as “Unaffordable Care Act,” this opposition interlaced with industrialist opposition painted a political picture to the Act (Taylor, 2012, p.31). As a result, its implementation continues to be slowed due to divergent views. Sadly, the political class has negated the central Part 5: Recommendations Despite its comprehensive stipulations, the ACA 2010 should be adjusted in line with regard to the growing effects of unemployment and increased demand for health care. One of such recommendations should be a purposeful modification of the entry criteria to the federal subsidies group by examining those who are already enrolled. Some studies recently pointed out the existence of fraud, where people falsely mislead authorities on their household income while they can afford a private insurance cover. If the current trend of trust in the report from consumers is not mitigated, the taxpayer’s money will be lost to fraudulent consumers. Antwi et al., (2012, p.148) the over 10% growth in annual hospital visits should be aligned with resources available for the consumers. As much as the ACA 2010 envisions quality care that is affordable, the growing population will strain the limited hospital resources, leading to possible deterioration of future quality of health care services. Besides, the staffing and equipping hospitals should be prioritized ahead of the full implementation of the Act. In addition, the quality of health care will be highly attained if the Medicare is further expanded and federal subsidies should be critically examined to avoid skyrocketing expenses for medical services. Lastly, the Act 2010 should have an annual review that will measure the gap between the desired end result and the actual achievements attained. Besides, the health care workforce should be empowered with the responsibility and authority to recommend necessary adjustment as the policy is gradually implemented. The future of ACA 2010 relies heavily on the government commitment to have an objective view, devoid of political ideologies on the efficiency of the policy. It is through developing a non-political assessment that will foster a meaningful analysis of the Act. The viability should be viewed from economical and practicability rather than political grounds. References Antwi, Y. A., Moriya, A. S., Simon, K. I., & National Bureau of Economic Research. (2012). Effects of Federal policy to insure young adults: Evidence from the 2010 Affordable Care Act dependent coverage mandate (pp. 145-56). Cambridge, MA: National Bureau of Economic Research. Biles, B., & Arnold, G. (2012). MEDICARE ADVANTAGE PAYMENT PROVISIONS: HEALTH CARE and EDUCATION AFFORDABILITY RECONCILIATION ACT of 2010 H.R. 4872. Blumberg, L. J. (2010). Interstate sales of insurance are allowed under the new law, but regulations provide greater consumer protections than earlier proposals. Does the Patient Protection and Affordable Care Act Permit the Purchase of Health Insurance Across State Lines? Timely Analysis of Immediate Health Policy Issues. Bovbjerg, R. R. (2010). Malpractice reforms could help curb health care spending and promote safety, but PPACA only offers small steps. Will the Patient Protection and Affordable Care Act Address the Problems Associated with Medical Malpractice? Timely Analysis of Immediate Health Policy Issues. Davidson, S. M. (2013). A new era in U.S. health care: Critical next steps under the Affordable Care Act (pp. 314-27). Dennehy, N. (2011). An Evaluation of the Succession Law Changes Introduced by the Civil Partnership and Certain Rights and Obligations of Affordable Care Act 2010. Ewing, J. A. (2012). Labor Force Participation and the Extension of Medicaid by the Forthcoming Affordable Care Act of 2010. Harmon, A. G. (2011). Bounty Hunters and Whistleblowers: Constitutional Concerns for False Claims Actions After Passage of the Patient Protection and Affordable Health Care Act of 2010. Holahan, J., & Dorn, S. (2010). What Is the Impact of the Patient Protection and Affordable Care Act (PPACA) on the States? Timely Analysis of Immediate Health Policy Issues. Kenney, G. M., Pelletier, J. E., & Blumberg, L. J. (2010). How Will the Patient Protection and Affordable Care Act of 2010 Affect Young Adults? Timely Analysis of Immediate Health Policy Issues. Moon, M. (2012). Medicare and the Affordable Care Act. Journal of Aging & Social Policy, 102-14. doi:10.1080/08959420.2012.659111 Taylor F. (2012). The Rhetoric Hits the Road: State Resistance to Affordable Care Act Implementation. Should the Affordable Care Act of 2010 Be Repealed? (2011). 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