Healthcare reform bill overview and implementation

¶ … Patient Protection and Affordable Care Act

On March 23, 2010, President Barack Obama signed the Patient Protection and Affordable Care

Act (PPACA). This is more commonly referred among United States Citizens as Health Care Reform.

This revolutionary law offers three main guarantees: First, health insurance for all American's, not just those who can afford it; Second, cost reduction in the insurance premiums for individuals and businesses; Lastly, higher quality care. On the surface, the PPACA seems all around beneficial for all

American's, but there are some aspects that need to be further analyzed. There is no doubt, this law will give those who are uninsured or under-insured, better coverage and ensure better quality health care, but there is one factor that may have been overlooked; the PPACA comes at great financial cost for citizens, will take a decade to fully implement and will be not be sustainable for generations to come.

The PPACA has several provisions targeted specifically at aimed at cultivating our health care system in America. (RAND, 2009). Some of the primary provisions pertain to augmenting health care accessability and decreasing cost for citizens. The following are a few of the paramount provisions in the PPACA:

Prevent insurance companies from denying enrollees due to current health status

All plans must be sold to anyone regardless of pre-existing health conditions

Premium costs will have limits to promote affordability

Demand every individual have insurance or penalties will ensue

Demand every employer offer health insurance to employees or penalties will ensue

Impose a tax on high cost insurance, also known as "Cadillac Plans"

Expand Medicaid programs to include everyone who earns below 133% of the federal poverty level.

It seems this new law will bring ample affordability, protection and equality to the table for most Americans. However, one must also examine the substantial road blocks in the practical and political realm. This includes the implementation of significant changes to our current Medicaid program, reformation of market regulations within the private health insurance sector, and the challenge of creating new systems for providing subsidies for those who require them. One must also remember that state governments are responsible for the design of laws and their key components. The possibility of PPACA getting repealed is very likely, if states oppose the primary components of this new law.

One of the dominant aspects of the PPACA, is expanding Medicaid to people and households whose income is at or under the 133% poverty level. At this time, many officials believe this expansion would cover 3/5 of those who are currently uninsured. Medicaid programs are state funded as well as federally funded, but each state determines their individual guidelines pertaining to qualifying eligibility and what services can be provided. As of now, the PPACA factors in a federal reimbursement cost that is associated with it's expansion from 2014 to 2016. After this, there is a reimbursement for 95% for the first three years (2014 -2016) and then up to 95% for subsequent years (KFF, 2010). Even with the benefit reimbursement, in the years that follow. However,

administrative costs associated with individual states have not been included into the official PPACA

cost estimates over the course of its lifetime. This could consume up to 5.5. percent of total federal and state expense, and each share the half of the burden. Given the state of the recent recession and the fact that most states are already significantly over budget, this could create an enormous hardship. Since 2003, Medicaid programs account for the largest portion of individual state budgets, at 22% of entire state expenses (Owcharenko, 2005). While federal government has the capability of maintaining deficits, states do not have this luxury. They have to balance out their budgets, so the PPACA is likely to present Since states are required to balance their budgets and not maintain deficits like the federal government, this will present an untenable affliction on spending costs (Owcharenko, 2005).

For a little over two years now, the PPACA is a law, with several intricate provisions addressing increased access to overall healthcare. Incrementally, the cost containment and improved care quality will be placed throughout various stages over the next decade. Health care administrators must comply with all elements and provisions listed in the PPACA law, so as to guarantee optimum patient care and ensure compliance with laws that affect insurance providers and businesses. The administrator may hire, train, and supervise staff, purchase supplies and equipment and prepare official reports (FLAHEC,

2007).

The most influential dispute in the PPACA may be the long-term effect on the American economy. As of now, we are slowly recovering from the great recession of 2008, but it will be many years before we make a full recovery. Health care reform is complicated and it hopes to identify all facets of the health care system, with a single piece of legislation. While we may obtain better access to quality care, there may also become a financial burden with greater coverage, as well as penalties for not having insurance. . Employers must also conform to all requirements to cover their employees, but their costs will increase as well, especially with penalties for non-compliance. As a domino effect, the greater cost to employers could be passed to employees with lower hourly wages and decreased salaries. Continuing the domino effect, there will be higher prices for goods and services, while incurring cuts in salaries. Increased government spending is guaranteed and they will be solely in charge of providing care and financing for U.S. Citizens for many years. The questions that metaphorically speaking, remain the giant elephant in the room include: