The Affordable Care Act Health coverage was developed to provide and guarantee coverage for sickness, injury and preventable health measures. Many people suffer from illness’ that go untreated because they have no health insurance or cannot afford it. The Patient Protection and Affordable Care Act allows everyone to have health insurance. In this case study I will explain how the affordable Care Act in North Carolina has improved.
The impact of the Affordable Care act on the population that it affected The Patient Protection and Affordable Care Act (ACA) is the most comprehensive reform of the United States. The Affordable Care Act (ACA) also called Obama Care transforms the non-group insurance market in the United States, mandates that all residents will have health insurance, significantly expands public insurance and subsidizes private insurance coverage, raises revenues from a variety of new taxes, and reduces and reorganizes spending under the nation’s largest health insurance plan, Medicare. Many people are opposed to Obama Care, simply because their high Republican beliefs won’t allow them to participate in any program put in place by a Democrat.
Participating in a Healthcare program shouldn’t be chosen by whichever political party you believe in, it should be determined by carefully thought out plans and weighing the pros and cons of whichever coverage best suits you and your family’s needs. The Affordable Care Act does not affect people or families currently covered with adequate health insurance. Those who already have Heath Care in place are protected by the “Grandfather Policy”. However, it does affect lower income Americans without health care making below 138% of the Federal Poverty Level (FPL). They may qualify for Medicaid under Medicaid expansion, if they meet all of the policies requirements.
This puts health care within reach of many people denied health care in the past. The President of the United States put laws in place that all people participate in the Affordable Care Act and get health care insurance or be penalized and pay monthly fines. This legislation ensures that all people be treated equally… the rich, poor or anywhere in between, you must have health insurance. To some this program seems very beneficial, but we as Americans do not like the government controlling our Medicare choices.
These newly enacted Affordable Care Acts were set in place to help all Americans receive health care and medical treatment. This act wasn’t put in place to provide care to people living in the United States illegally; undocumented immigrants and people who have been in the United States for less than five years do not qualify. The uninsured people, who gain insurance coverage in 2014, will obtain their coverage through the state’s Medicaid program. Beginning in 2014, the Affordable Care Act requires that states expand Medicaid coverage to most uninsured adults with modified adjusted gross income no greater than 138% of the federal poverty limit. Children in families with incomes no greater than 200% FPL will continue to be eligible for Medicaid or North Carolina Health Choice (North Carolina’s Child Health Insurance Program (CHIP). Other people will gain coverage through private insurance offered through the Health Benefit Exchange (HBE). (Milstead, 2013, p. 199).
The impact of the economics of providing care to patients from the organizations view In the case study, the impact of the affordable care act on North Carolina uninsured population in 2011 showed childless, non-disabled, nonelderly adults could not qualify for Medicaid. Being poor, unemployed or homeless did not qualify a person for Medicaid. People, who are uninsured, are more likely to delay care and less likely to receive preventive services, primary care, or chronic care management. As of 2014, The Affordable care Act adults will be able to qualify for Medicaid if their income is no greater than 138 percent of the Federal Poverty Level. That income level was set at $30,429 for a family of four in 2010. However, some states do allow a family of four to have higher incomes and still qualify. The case study also showed that providing Medicaid to all people across the chart insured total coverage to all people and the FPL (Federal Poverty Level) had risen to a level where all people were nearly identical to one another.
Suggesting that if health care is provided equally throughout the nation there will be a lull in infectious diseases and untreated illnesses because everyone would seek treatment since they have coverage. Some of the economic growth and plans involve tax credits to individuals and families participating in Affordable Care Act, helping to keep participation affordable to all. Doing so helps to promote membership to all, thus keeping costs at a minimum and entices more families to participate. Another planned impact would be the cap placed on insurance company’s expenditures, careful monitoring of costs to provide service will eliminate overcharging by insurance companies and its affiliates.
The government understands that it will take a number of years before the Affordable Care Act will show how much of a positive impact this program has on its participants. However, the government promises that keeping health care costs affordable will eventually lower rates and spending across the board. It says that with health care more available to all, more people get better and employees will come in to work reducing sick days and create better productivity, and financial gain for everyone.
The Affordable Care Act also keeps families from financial ruin now when a family member becomes sick or unable to work they can still have health coverage through policies of their own or coverage provided through a participating family member. Before when a family member got sick they had to worry about being cut off of coverage if they lost their jobs. Families also had the added worry of escalating medical expenses while they were suffering through their sicknesses. Many feared losing their homes to pay for medical expenses.
How the patients will be affected in relationship to the cost of treatment, quality of treatment, and access to treatment
The Residents of North Carolina’s will have access to quality, affordable health care under the updated health insurance reform. The Affordable Care Act of 2014 will have a positive effect on patient safety and outcomes. It will provide many resources to allow patients easier access to insurance for health care costs and preventive care such as cancer screenings and vaccines. It will give incentives to health care facilities to improve the care being given. It is also mandated for all healthcare facilities to use electronic health record systems to keep track of all patient information to minimize errors. Doing this will also ensure that all patients receive the same care and treatment at all facility’s and that hospitals can share new developments or procedures.
Reducing costs and prolonged hospital stays and long drawn out treatments, patients in need of specialized treatments can be sent to facilities better equipped to treat them with records of their treatments already in the system. (R. Kocher, J. Emanuel, M. Deparle, 2014, pp. 536-540) The Affordable Care Act provides medical coverage for families and children and is required to continue to make such coverage available for an adult child who is not married until the child reaches age 26. However, the Affordable Care Act is not obligated to make coverage available for a child of a child receiving dependent coverage. These people are considered parents themselves, and are expected to work and provide health care for their dependent children themselves.
The ethical implications of this act for both the organization and the patients
Since the beginning of 2010 adults, can qualify for Medicaid if their income is not greater than 138 percent of the Federal Poverty Level. Gaining strength over the last couple of years as of 2014 everyone is qualified to get Affordable Health Care as long as they meet the plans restrictions and verifications. As everyone in North Carolina gains health coverage, the state and county governments could potentially reduce some of the expense to safety net providers currently used to help pay for services to the uninsured. Under this new mandated health reform, hospitals and medical providers will be assured funding and payment since this program is to be funded by the federal government. Thus providing a system where medical facilities can focus on patient care, and not worry about the un or under insured not being able to pay for the care they receive.
When organizations across the entire United States are given enough funding to cover the expense of new equipment and supplies, it allows more opportunities for hiring more educated staff members, and lets health providers focus on patient care. The state of North Carolina may eventually experience a decrease in unnecessary use of the emergency department and reduced hospitalizations as more people gain coverage and access to preventive and primary care services.
Once health care is made more readily available and affordable to more people and families, the risk of fraud and abuse of services would be greatly reduced. These worries and concerns will all but be eliminated because health care would now be available to all Americans. Even Americans who were once refused treatment due to pre-existing health problems can now be seen by a physician. The Affordable Care Act prohibits pre-existing condition exclusions, refusals of treatment and all other discriminations based on health status by group health plans.
Milstead, J. A. (2013). Health policy and politics: A nurse’s guide (Laureate Education, Inc., custom ed.). Sudbury, MA: Jones and Bartlett Publishers.
Kocher, R., Emanuel, E. J., & DeParle, N. M. (2010). The Affordable Care Act and the Future of Clinical Medicine: The Opportunities and Challenges. Annals Of Internal Medicine, 153(8), 536-W.190 Kovner, A. R., & Knickerman, J. R. (2011). Health care delivery in the United States. (10th ed.). New York, NY: Springer.
2014, 01). Impact of Affordable Care Act on North Carolina Uninsured Population. StudyMode.com. Retrieved 01, 2014, from http://www.studymode.com/essays/Impact-Of-Affordable-Care-Act-On-46392180.html
(P.L. 111-152 Summary of patient protection and affordable care act (P.L.
111-148, H.R. 3590), with amendments of the health care and education reconciliation act of 2010, H.R. 4872). (2010). Tax Management Tax Practice Series Bulletin, 22(7), 12-31. Retrieved from http://search.proquest.com/docview/193794262?accountid=14872