Affordable Care Act overview and implementation

Affordable Care Act (ACA)
• Differentiate between at least three groups of stakeholders impacted by the ACA.
Obamacare or the ACA (Affordable Care Act) was primarily designed and put into effect in the year 2010 with an objective of offering better healthcare insurance coverage for the American people and minimize the heavy costs incurred by the American people to access healthcare (Thompson, 2014). Although ACA has achieved sizeable success in coverage there are still many challenges facing it including slow adoption across America, funding problems and problems getting the support of the public (Center for Public Impact, 2017). The main stakeholders of ACA include the healthcare providers, healthcare consumers, employers, and the States.
Consumers: Healthcare consumers in America details about 55% Americans who have healthcare insurance cover through the employer. 33% Americans have healthcare insurance cover through government program. These people may not be impacted by the variations and tides in the healthcare insurance coverage (HCC, 2013). The estimates from the CBO (Congressional Budget Office) revealed that the nonelderly people without insurance would decrease by 26 million from the initial 55 million uninsured in the year 2013 to 29 million uninsured in the year 2017 (HCC, 2013). Borrowing from the CBO prediction it is expected that much marketing and publicity on health insurance with the objective of getting to the young population will be done. Notwithstanding the great expectation the performance of ACA has been mixed (Collins & Saylor, 2018). Increase in the level of premiums and public controversy owing to the mismanagement of expectations and political issues have adversely affected the performance of ACA (Center for Public Impact, 2017).
Evidence exists to the effect that ACA has enhanced healthcare insurance access for about 20 million people. This is not what was expected. The objective was to alleviate the number of uninsured people to 22 million and from 50 million (Center for Public Impact, 2017). The enrollment of ACA in the marketplace has been wanting. CBO estimates showed that approx. 21 million Americans would get enrolled into the program. According to current estimates only approx. 9.4 million to 11.4 million Americans have been enrolled into the program (Center for Public Impact, 2017). According to the majority opinion from the public the impact of ACA was not fully beneficial. A 2015 inquiry revealed that 54% Americans thought that this healthcare law had no effect on their family to the point of the inquiry (Center for Public Impact, 2017).
Moreover 26% of Americans thought that ACA had had some negative personal impact on them. 19% thought that ACA had impacted them positively. Other Americans opposed to the ACA thought that it had undesirable consequences such as higher insurance premiums in the States of Minnesota and Wisconsin (Center for Public Impact, 2017). State regulators in Wisconsin made an announcement that insurance premiums would go up by approx. 15.88%. Other health insurance plans would see the premiums go up by approx. 30.37%. Some large insurance companies stopped providing healthcare insurance through Obamacare exchange in the State of Wisconsin (Center for Public Impact, 2017). The commercial world has also perceived some the insurance negatively. Most plans for small groups and individual markets put in place before the enactment of ACA never met the requirements of the new mandate and rules. Insurers made adjustments to comply with the new regulations although consumer choices declined fundamentally (Center for Public Impact, 2017). The variation between the plans depended on cost sharing size including the deductibles and the extent of networks by providers. With the standardization of plans the cost sharing and premiums increased therefore forcing the network of providers to shrink (Center for Public Impact, 2017).
Employer: The employer and the individuals are likely to benefit from a transparent competition between the providers of insurance cover upon the start of open enrollment which already did in 2013. For an em0ployer the ACA provision states that only companies that have an excess of 50 workers are allowed to offer insurance cover for their employees. The employees must be working for more than thirty hours every week (HCC, 2013). Industry experts have speculated that the rule may lead many large companies to alter the timetables of their employees and give incentives to smaller companies. The goal is to make them retain a workforce that is lower than 50 employees (HCC, 2013).
Providers: With ACA implementation providers are expected to continue with integration with an objective of providing lower healthcare costs and higher quality of healthcare (HCC, 2013). In order to give incentives for the provision of quality and efficiency in patient care there were bundle programs of payment that came into effect beginning 2013. In addition, there has been deliberate effort to enhance access to preventative and primary healthcare services. In the process physicians offering primary healthcare services have a guaranteed reimbursement for amounts not lower than 100 percent of the Medicare rates of payment in both year 2013 and in year 2014 (HCC, 2013). Providers have had to contend with the standardization of plans which has caused cost sharing and premiums to increase. The number of provider networks has shrunk as a result (Center for Public Impact, 2017). The new ACA rules have made forced the providers to reduce the choices that customers have with respect to their cover of choice and the premiums allowed. The variation in the health insurance plan is made up of cost sharing size including provider network scope and deductibles.
• Examine the financial impact of the ACA on each group of stakeholders.
Consumers: The financial impact of ACA on consumers has been visible. The name ACA suggests that the program should be affordable. The purpose was to make healthcare affordable to all Americans. The escalation of healthcare costs has presented a sizeable burden to the American people. Between the year 2001 and the year 2010 the number of adults who are of a working age and having medical expenses totaling 10% and above of their income increased from the initial 21% to 32% (Nowak et al., 2013). During the same period the percentage of adults of working age living below poverty line and having medical costs totaling more than 10% of their income doubled. Similarly, the number of people in families indicating difficulty with payment of their healthcare costs grew from 15% to 21% (Nowak et al., 2013). Among the people who were forgoing care 65% to 75% indicated difficulties in meeting the cost as the main reason for that decision. In general terms the cost of healthcare has significantly increased for consumers following the enactment of the ACA.
Employers: According to Abraham and Royalty (2017) the ACA had little to no impact on employment, compensation, or hours worked. Labor reforms in accordance with the ACA law were intended to get most employers to enroll their employees into the insurance program and get as many working-class Americans to enjoy the affordable care. The impact seems to have been minimal.
Providers: In the short run insurance cover providers expected a surge in the number of people requesting the service. Millions of the American people were expected to get coverage through ACA owing to the marketplace insurance exchange under the state and federal governments. The Americans who aren’t able to afford insurance coverage would be eligible for subsidies from the government. Some States intended to expand cover for those living below the poverty level. Consequently, the demand for more reimbursements from healthcare institutions took a toll on the insurance providers. Providers have had to contend with the standardization of plans which has caused cost sharing and premiums to increase. The number of provider networks has shrunk as a result (Center for Public Impact, 2017). The new ACA rules have forced the providers to reduce the choices that customers have with respect to their cover of choice and the premiums allowed. The variation in the health insurance plan is made up of cost sharing size including provider network scope and deductibles.
• Summarize benefits of the ACA on each group of stakeholders.
Consumers: To a certain level ACA has enhanced coverage although increased premium levels and controversy presented by mismanaged expectations and political turmoil has taken a toll on ACA.
Employers: According to Abraham and Royalty (2017) there are no real benefits for the employer that can be written home about because of the increasing premiums and obligations on the employers shoulder to provide insurance for employees working for more than 30 hours each week.
Providers: A larger clientele has expanded the pool of resources that insurance providers are working with.
• Summarize drawbacks of the ACA on each group of stakeholders.
Consumers: Higher premiums, inability to pay premiums, and political controversy are the major drawbacks with ACA. The new laws were expected to make healthcare affordable but so far that has not been visible.
Employers: The employer may have to pay more premiums if they have more than 50 employees working for them for more than 30 hours every week. This means that the expenses on each employee may increase.
Providers: The growth of the number of people taking advantage of the ACA to enroll for the insurance program and visit hospitals for treatment has suddenly shot up. This means that the reimbursement requirements have increased, therefore, forcing the providers to raise their premiums. The new ACA rules have also forced the providers to reduce the choices that customers have with respect to their cover of choice and the premiums allowed (Center for Public Impact, 2017)





References
Abraham, J., & Royalty, A. B. (2017). How Has the Affordable Care Act Affected Work and Wages?. Ldi Issue Brief, 21, 3, 1-5. Retrieved 20, December, 2018 from https://ldi.upenn.edu/brief/how-has-affordable-care-act-affected-work-and-wages
Center for Public Impact. (2017). The Affordable Care Act in the US (Obamacare), North American, Health. Retrieved 20, December, 2018 from https://www.centreforpublicimpact.org/case-study/affordable-care-act-us-obamacare/
Collins, B. L., & Saylor, J. (2018). The Affordable Care Act. Nursing Management, 49(8), 42– 48. https://doi.org/10.1097/01.NUMA.0000538917.37912.d4
HCC. (2013). The ACA in 2013: What Can Stakeholders Expect? Health Capital Consultants. Retrieved 20, December, 2018 from https://www.healthcapital.com/hcc/newsletter/4_13/HTML/ACA/6.4_aca.php
Nowak, S. A., Eibner, C., Adamson, D. M., & Saltzman, E. (2013). Effects of the Affordable Care Act on Consumer Health Care Spending and Risk of Catastrophic Health Costs. Santa Monica, Ca; Washington, Dc; Pittsburgh, Pa; New Orleans, La; Jackson, Ms; Boston, Ma; Doha, Qa; Cambridge, Uk; Brussels, Be: Rand Corporation
Thompson, T. (2014). The Affordable Care Act. New York, NY: Greenhaven Publishing LLC.