In today’s world it is very difficult to not only have access to health care but to receive adequate coverage and to limit the out-of-pocket expenses for the consumer whilst covering the provider’s costs as well. During the Obama administration, the Affordable Care Act (ACA) was introduced and signed into law, allowing millions of people across the country to have access to basic healthcare coverage or to get health care insurance. It was not easy to get the ACA signed into law as it has its advantages and disadvantages, some which will be discussed in their article.
Once the Affordable Care Act was initiated, insurance companies could no longer refuse health care coverage to patients who had pre-existing medical conditions, which was a very important step in health care. One of the main reasons why people cannot get medical coverage is because of their history or pre-existing medical conditions because high-risk patients would cost the insurance companies a lot of money! More people across the country have access to health care coverage for treatments, medications or for routine check ups (Roland, 2015). Another great incentive with the ACA is children up till the age of 26 can be under their parent’s health care medical coverage plans (Roland, 2015). With the ACA act, not only are the patients covered but the health care organizations are also getting paid as well through the patient’s coverage whereas before patients without any coverage would be a loss for health care facilities who are providing patient care.
Whist the ACA gives health care coverage to more Americans that does not come without a high cost for all Americans as well which is the largest downfall of this new health care act. The ACA is built with higher taxes for higher income families and companies which is another way that the ACA is able to afford to provide basic coverage to so many people (Parker, 2015). Another downfall with the ACA was a lot of employers lost their medical coverage for their employees as the insurance companies could not afford to provide basic coverage while also having to cover health care costs for companies as well. Families using the ACA or families that had to get their own private coverage saw higher costs for their deductibles and premiums. This increased the out-of-pocket expense for the consumer and defeated the purpose of having health care coverage (Parker, 2015). For example, for a family of 4 that relied on the ACA coverage plan would not have to pay a high deductible every time they needed to use their insurance this in turn becomes very costly and not affordable for the patients.
The ultimate goal of the Affordable Care Act was to provide as many Americans with universal basic health care coverage and helping those Americans that were continuously denied not only medical insurance but access to health care services as well. However, the ACA has seemed to be far more expensive for consumers in the long-term run especially when requiring multiple visits to the physician over a period of time.
Thus the choices for consumers are limited to a few large providers.
How is getting rid of the individual mandate is going to help those on the ACA paid plans? As it was many were not participating and figured they would pay the penalty of not signing on as they weren’t sick, young or just couldn’t afford it.
The ACA needs to be amended or repealed and rewritten, IMO. We need to have insurance providers that will cross state lines and not the big companies only as competition is usually a good thing in any retail operation in that there will be more providers looking for business thus premiums will decrease.
Right now, ACA is unsustainable. It’s a very very complex issue.
I am not for single payor coverage in the US. To me that’s not the answer.
Being a RN I think & read about this topic a lot & have discussed this superficially with many PCP’s. I work with many PCP’s that are absolutely overloaded with patient appts as PCP reimbursement is bottom of the barrel.
Yes it’s so complicated.
I am a clinical psychologist. Both my husband and I were providers for several private insurances and also for Medicaid and Medicare. Prior to 2014 and the ACA, we both were able to maintain our offices and practices. We didn’t make a great living, but we both managed to survive. Since ACA, reimbursements are so low it is impossible to maintain offices let alone have a salary. I don’t practice at all and my husband has a few Medicaid clients.
If the government wants practitioner’s to be in business reimbursements have to be raised. And, patients have to step up and pay what they owe. Prior to going out of practice I had clients that had never paid co-pays - some as low as $3.00 a visit.
I don’t know the answers, but I don’t think it lies with the government to start a new program and step in.