Health Policy Debate
TheAffordable Care Act (ACA) became developed to make health coveragemore affordable and comprehensive in America. The Act also focused oneliminating discrimination, where individuals were required not topay additional health expenses due to their conditions (Emanuel,2014). However, the ACA has brought contentious debate in the currentadministration and changes have been proposed targeting at changingthe health policy. The purpose of this report is to discuss the ACAin relation to values, morals, and markets, as well as the winnersand losers in respect to care access and fairness.
Markets,Values, and Morals
Priorto the establishment of the ACA, Americans had three key issues withthe medical system that was in existence these issues included avast number of the uninsured, the high cost of care, and the plightof uninsured citizens who had pre-existing conditions (Tate, 2012).The marketplace for the insurance coverage provided by the ACA iseither federally-facilitated or state-based. The choice of the twomarketplaces depends on where an individual lives. When one visitsthe federally-facilitated marketplace, he/she is required to providethe ZIP code for the state. In case a person resides in an area thatis served by state-based marketplace, one is redirected to a websitethat serves his state-based marketplace. Therefore, the marketprovided by the ACA is both in the federal and states. According tothe Act, an employer-sponsored plan offers minimum value in case itcovers a minimum of 60% of the overall allowed costs of benefits,which are anticipated to be incurred under the plan (Tate, 2012).There is a moral hazard in that all uninsured citizens in America arerequired to buy a policy or go ahead and pay a penalty. This forcesthe low-risk to purchase a policy instead of paying a fine. Besides,the plan is only affordable in case the overall cost is less than9.5% of the household income (Tate, 2012).
Equity,Efficiency, and Effectiveness
Fordecades, the federal government has been driving citizens towardsemployer-based medical insurance through giving it preferentialhandling in the tax code. This is viewed as unfair to someindividuals because it is not reasonable for some Americans toreceive a tax break while others fail to obtain. Thus, there is noequity provided by ACA. Alternatively, although there is an expansionin access to care following the establishment of the ACA, only asmall percentage of health care providers have the will of acceptingnew Medicaid patients because of low imbursement. This makes thepolicy not very effective in ensuring that everyone is in a positionto access care. In making the health care efficient, the ACAintroduced the use of electronic health records (EHR), which has beena success.
Thebiggest winners of the ACA are the uninsured individuals. Accordingto the provision of ACA, people who receive an income that is belowthe newly established threshold of 133% of the federal poverty level,they can be eligible for Medicaid. Such individuals will have accessto more coverage that is affordable. Alternatively, the biggest loseris taxpayers and investors, who depend partly on investment income.This is because large ACA taxes focus on investment income. From theanalysis of ACA, it can be indicated that the Act has played asignificant role in the health of the American citizens however, Ipropose that amendments need to be made on the policy in order toimprove health access, equity, and affordability to all.
TheACA has brought contentious debate in the current administration andchanges have been proposed targeting at changing the health policy.Although there is an expansion in access to care following theestablishment of the ACA, only a small percentage of health careproviders have the will of accepting new Medicaid patients because oflow imbursement. There is need of improving health by making somechanges to the policy.
Emanuel,E. J. (2014). ReinventingAmerican health care: How the Affordable Care Act will improve ourterribly complex, blatantly unjust, outrageously expensive, grosslyinefficient, error prone system.New York: PublicAffairs.
Tate,N. J. (2012). ObamaCaresurvival guide.West Palm Beach, FL: Humanix Books.
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