Healthcare reform policies and implementation

¶ … Uninsured Population

Insurance Premiums

Budget Deficits

Healthcare Trends

Public Opinion

"Obamacare"

The topic of this research is "PPACA- Patient Protection an Affordable Care Act." PPACA has created a great impact in the healthcare industry of United States of America. The study is based on the critical analysis of the act by reviewing the performance since its inception.

Arguably the most prominent recent healthcare reform has been PPACA (Patient Protection and Affordable Care Act). PPACA is also known as the Affordable care act and Obamacare. It was signed by the President Obama in the year 2010 in collaboration with the Healthcare Reconciliation Act. This act is considered to be one of the most major reforms passed in the healthcare system of United States; the last such major reform was passed in the year 1965 in the form of Medicaid.

When this provision Act was passed in 2010, there were 50 million uninsured people in the United States of America. In two years time around 20 million people have come under the health insurance coverage which is a huge number. It was estimated that the number of uninsured people will reduce from 30 million to 25 million in about a decade's time. So far the progress made in the two years has increased the expectations and now the estimate is even lower than that. CBO now estimates that in the year 2019, there would be 22 million uninsured residents if the act exhibits the same progress.

It is important to understand the significance of the Act as it is addressing a key issue of health insurance in the United States of America. It's not only the uninsured population that is faced with challenges related to getting access to healthcare facilities, the basic human values and compassion for fellow human beings have made this a problem for those people who are insured. It is obvious that the hospital and medical charges are very expensive and they are out of reach for a major population in the United States who are also unable to pay for the health insurance schemes. This also puts a burden on the people who are insured and they pay the bills and fees for the uninsured population because the state has to cover for the high medical expenses. PPACA- Patient Protection an Affordable Care Act is an attempt to provide a better solution for the general public. This Act has been able to solve some key issues in the healthcare system of the United States and has made a positive impact since its inception.

The aim of PPACA is to decrease the number of the uninsured Americans and by doing so decreasing the overall healthcare costs of the U.S. Healthcare system. There are various mechanisms that enable this act. It includes tax credits, subsidies and mandates to individuals, families, employees, and employers in an attempt to increase the overall insurance coverage rate. There are a number of reforms additionally that were made to the act in order to streamline the processes and get better results. PPACA also require the insurance companies to support their cause by covering all the applicants regardless of sex or pre-existing conditions. The state officials are hopeful that this act will lead to a great decrease in the Medical costs and will decrease the future deficits. (Kruger, 2009)

Provisions:

It all started in the year 2008, when Healthcare reforms was a major topic of discussion in the political campaign run by the republicans and the Democrats. The race picked up great speed and eventually a lot relied on the debates by Hillary Clinton and Barrack Obama. Both of the two candidates proposed their healthcare policies and solutions to cover almost 50 million Americans who were without health insurance. The two candidates proposed entirely different policies on this issue. Hillary Clinton's plan was to create a direct requirement of the health insurance coverage to all the individuals while Obama's plan was to subsidize the health insurance schemes which would indirectly lead to an increase in the overall health care insured population of the United States. (John, 2011)

Obama also stated that it is one his four priorities to increase the health insured population in the United States if he wins the presidential campaign. Soon after he was appointed the President of the United States, he started working on the healthcare reforms. There were number of experts called, seminars held and strategies developed in order to cater to the healthcare reforms. After a number of meetings and conferences, the statesmen were able to pass PPACA Act which was initially named the Affordable Act but then later on it was taken back as the formal name of the Act was Protection and Affordable Care Act. (Feldman, 2011)

The PPACA Act is planned in several stages. The first phase started in the year 2010, and then gradually the provisions were made in the law to cater to the additional requirements of the healthcare reforms. Some of the provisions made in the law were supporting the existing provisions of the law while some replace the existing provisions.

One of the important provisions of the PPACA was the guaranteed issue. This means that the medical conditions and facilities will be provided to the insurance holders regardless of sex, race, community, pre-existing conditions etc. The only exception made in the law is for the smokers as they are subject to be treated differently in case of insurance claims. A lot of emphasis is laid on the individual mandate. This mandate is a call out to the people to share the responsibility along with the state.

A key feature of this act was the subsidies that were provided by the state. The state carved out a policy which helped in attaining the low income group in their insurance bracket. The families and individuals with a low income were given subsidies up to 100% at the federal level. In some extreme cases the subsidies were given up to 400%.

Probably the hardest part of the stat was to ensure the insurance companies that they will also benefit from this act. The state introduced a number of health insurance exchange programs which was a great step that they took in order to subsidize the facilities and compare the facilities within the states and abroad. Small firms were provided various incentives for providing their employees insurance coverage. It was a part of their shared responsibility campaign to provide health insurance coverage to the firms employing more than 50 people. The larger companies were also benefited by the insurance exchange programs. Overall there were many provisions made in the act but the vision of the state remained the same and it was clear that the government had clear intentions of transforming the healthcare sector by making amendments in the act and reducing the overall fiscal deficit. (Barr, 2011)

"Obamacare"

PPACA Act is also termed as "Obamacare." This term was initially coined by Mitt Romney in the year 2007. It was used as a pejorative term by Mitt Romney as a part of his election campaign. However the term became extremely popular in 2012. It was used positively by the Democrats and even Obama stated that he didn't mind the use of this term. It was used heavily as a part of the election campaign in the year 2012.

Impact:

The purpose of this research is not to jut inform the readers about the facts of PPACA Act, instead the research is based around the impact that this Act has had and the future provisions that could take place related to the PPACA Act. Different stakeholders of this Act have different opinions about this Act because of the varying roles that PPACA Act plays in the health care system of the United States of America. (Jacobs, 2010)

Number of Uninsured Population:

The main impact of this act was supposed to be on the number of insured residents in the United States. The people who would still not be insured are in huge numbers and a large portion of insured people are the immigrants who do not get them insured because they are eligible to take advantage of the Emergency healthcare facilities because of the provisions present in the Medicaid Act.

Apart from the immigrants there are a number of citizens that are not enrolled in the Medicaid yet they do not get medical coverage because they are unable to pay the heavy insurance fees and they opt to pay heavy fines and penalties if they suffer from any problem. Most of these citizens are young people and are single. There is also a provision in the Health care policy that the penalties would not be awarded to people who have their household income less than 8% of the insurance coverage.

One of the key reasons for the rise in the individuals coming under the insurance bracket is the incentives to the small businesses on providing healthcare insurance for registering for the first time in the health care insurance program. The Census Bureau released a report in 2011, showed a 1.6% decline in the uninsured employees that age from 20-25. In term of number the 1.6% is a small figure but it accounts for 393,000 people insuring themselves in just over a year's time. Another report showed that out of the 4 million businesses that were offered the insurance program, almost 175,000 claimed it. (Blendon, 2010)

Insurance Premiums:

The second important impact of the PPACA Act was on the insurance premiums. Through the PPACA Act the insurance companies were ordered by the state to charge less premium amount on the policies in order to encourage people buying the insurance policies. In order to cover these insurance companies, the state had given subsidies. The insurance companies have been complying with the laws that were set by the state and have lowered down their profit margins in an attempt to provide insurance policies to a larger population.

Budget Deficits:

A key purpose of the PPACA act was to reduce the overall deficits of the CBO. CBO is the Congressional Budget Office. The report from the year 2011 shows that the budget estimated has been reduced by almost $200 billion from 2011-2020. These projections are based on the estimations that the net income from the law would bring about $800 billion in ten years which will offset the $600 billion deficits standing. (Elmendorf, 2011)

Healthcare Trends:

If we look at the healthcare spending trends then we can see a trend that the health costs have been increasing tremendously. This rising trend in the health costs has put a great pressure on the federal budget. It is extremely had to develop a framework in such times when there is a great pressure from the fiscal deficits and there is a constant rise in the overall healthcare costs. CBO has made many public statements in which they have mentioned that the current healthcare facilities are not enough to provide for a significant share of people's health. In order to tackle this fiscal pressure it is important to minimize the health budget and utilize the resources that are available to the state.

Public Opinion:

The opinion of the general public on this policy has been shifting over time. When this policy was introduced the general opinion of the public was extremely good, people thought that this policy by the state is going to provide a great benefit to them and is for their own good. With time the public opinion has shifted to the other extreme. Now generally the perception is negative against this Act. There is a lot of political influence that has led to a change in the public opinion. This law was passed by the Democrats despite facing heavy opposition from Republicans and Independents. The performance of the act has come under fierce scrutiny recently. Media has criticized the objectives of the Act and the lack of practicality of the act which is responsible for creating a negative perception from the people.