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Aca changing healthcare

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As a result, the uninsured rate among people ages 18 to 24 fell by half, dropping to 15 percent in The ACA raised standards to ensure that children in low- and middle-income families can access health coverage. About one-quarter to one-third of new enrollees under Medicaid expansion are children.

The ACA also defined pediatric dental and vision care as part of essential health benefits, ensuring that kids covered through both the marketplace and Medicaid have coverage for those services. Further, expanding coverage to adults—through the ACA marketplaces and Medicaid expansion—helps parents stay healthy and provides financial security to the entire family.

Prior to the ACA, 9 percent of individual market plans did not cover prescription drugs. By expanding Medicaid eligibility as well as broadening the Medicaid Drug Rebate Program, the ACA gave more low-income Americans access to brand-name and generic drugs and lowered the costs for taxpayers. The ACA also expanded the B drug discount to include more providers, including critical access hospitals and rural referral centers.

The ACA also laid out a process for faster Food and Drug Administration approval of biosimilars , biologic drugs that are essentially analogous to generic versions of branded drugs.

By encouraging competitors for high-cost biologic drugs, the ACA rules on biosimilars can potentially help bring down the price of these types of prescription drug costs and help make new therapies available to patients who need them.

These are all important steps toward drug affordability, but there is much more work to be done. Medicaid expansion is particularly important for coverage and the sustainability of the health care system in rural areas. Rural residents are more likely to be covered by Medicaid: Medicaid expansion reduced the amount of uncompensated care that hospitals provide, boosting the financial viability of rural hospitals relative to their counterparts in nonexpansion states. While more than rural hospitals have closed in the past decade, the closures have occurred disproportionately in nonexpansion states.

The ACA provides patients and the health care system with resources to combat the opioid crisis , which has hit rural areas particularly hard. Without this requirement, only 1 in 3 people covered through the individual market would have had access to SUD treatment. Many people in rural and other medically underserved communities rely on community health centers and other Federally Qualified Health Centers FQHCs for comprehensive primary care.

Federal grants provide 1 in 5 revenue dollars that community health centers receive, and 70 percent of that funding comes from the Health Center Trust Fund set up by the ACA. Before the ACA closed the coverage gap, about 5 million Medicare enrollees fell into it. The ACA also invested in other improvements for the Medicare program by establishing the Center for Medicare and Medicaid Innovation , which is responsible for developing ways to improve patient care and lower health care costs.

Prior to the ACA, people would be functionally uninsured after hitting arbitrary annual or lifetime coverage limits. The ACA prohibits insurers from setting coverage limits, as well as from denying coverage or raising prices for preexisting conditions. Medicaid expansion has helped many disabled people and caregivers access care based on their income status.

Not all disabled people qualify for the traditional Medicaid disability pathway. Medicaid expansion allows disabled people to join the workforce without jeopardizing their Medicaid benefits and gives low-income workers a fallback option for coverage if they lose access to employer-sponsored insurance. Essential health benefits help disabled people access necessary services.

Prior to the ACA, 45 percent of individual market plans did not cover SUD services and 38 percent did not cover mental health care. Following ACA implementation, people with mental health conditions became significantly less likely to report unmet need due to cost of mental health care. The ACA has helped millions of Americans gain insurance coverage, saved thousands of lives, and strengthened the health care system.

The law has been life-changing for people who were previously uninsured, have lower incomes, or have preexisting conditions, among other groups. Emily Gee is the health economist of Health Policy at the Center.

Maura Calsyn is the managing director of Health Policy at the Center. The positions of American Progress, and our policy experts, are independent, and the findings and conclusions presented are those of American Progress alone. A full list of supporters is available here. American Progress would like to acknowledge the many generous supporters who make our work possible. The U. Supreme Court heard oral arguments in California v. The case was brought by a number of Republican state attorneys general and supported by the Trump administration.

The death of Justice Ruth Bader Ginsburg—and the rushed process to attempt to replace her—dramatically heightened the chance that the court would strike down the law and upend its previous decisions to uphold it.

The Center for American Progress provides coverage and analysis on the impact of the health care repeal lawsuit, including how it would harm people with preexisting conditions and disabilities, communities of color, women, young people, families, and low-income families. Elyssa Spitzer , Elyssa Spitzer. Sign Up. Insurance companies would no longer be required to issue rebates when they overcharge Americans.

The ACA protects people with preexisting conditions from discrimination Prior to the ACA, insurers in the individual market routinely set pricing and benefit exclusions and denied coverage to people based on their health status, a practice known as medical underwriting. Medicaid expansion helped millions of lower-income individuals access health care and more To date, 36 states and Washington, D. Medicaid expansion was associated with 19, fewer deaths among older low-income adults from to ; 15, preventable deaths occurred in states that did not expand Medicaid.

Rural communities have benefited from the ACA Medicaid expansion is particularly important for coverage and the sustainability of the health care system in rural areas.

Conclusion The ACA has helped millions of Americans gain insurance coverage, saved thousands of lives, and strengthened the health care system.

Nicole Rapfogel Research Associate. Explore The Series. You Might Also Like. Sep 20, The health insurance marketplace includes state-based exchanges and more Additionally, although in effect prior to , one ruling that is notable for preparedness efforts previously mentioned by Lurie is the New Requirements for Charitable c 3 Hospitals. It imposes new requirements on c 3 organizations that operate one or more hospital facilities hospital organizations.

One of the requirements is to conduct a community health needs assessment CHNA and adopt an implementation strategy for addressing the prioritized health needs at least once every 3 years.

The ACA also added section , which imposes an excise tax for failure to meet the CHNA requirements, and added reporting requirements under section b related to sections r and Lisa Tofil, partner at Holland and Knight, explained that expansion of health care coverage under the ACA is achieved by expansion of Medicaid eligibility up to percent of the federal poverty level 6 :.

In , in response to a constitutional challenge to the ACA, the Supreme Court upheld the individual mandate, but the Medicaid expansion became optional for states. As a result, there may be significant gaps in coverage in states that decide to not expand their Medicaid programs, Tofil said.

People between and percent of the federal poverty level in any state can get the sliding-scale subsidy when selecting coverage in the federal health exchange, Ebeler explained.

But those below percent of the poverty level and above current Medicaid coverage limits will have no source of subsidy in the states that are not expanding their programs. As of fall , about half of the states are not moving forward with Medicaid expansion Kaiser Family Foundation, , which could leave as many as 6 million uninsured, nonelderly adults without access to coverage.

Ebeler said it is important to consider implementation of the ACA over the longer term, pointing out that when Medicaid went into effect in , only 26 states participated in the first year, but 4 years later in , nearly all states were participating. He cautioned that even with the ACA, there will still not be universal coverage. Current projections show that overall, including those with lowest income living in non-Medicaid expansion states, undocumented residents, and those unwilling to purchase their own insurance, 30 million Americans will still lack coverage by Nardin et al.

As summarized by Ebeler, there are two key fundamental changes in financing and delivery underlying system reform. First, is the shift in measurement and payment, moving from discrete fee-for-service transactions payment for each task or service that is done at each moment to payment for clinically and economically relevant episodes for patients and providers, referred to as bundled payments. Accountability for care may be spread across provider types and over a period of time, which incentivizes those providers to work together and integrate services and provides some degree of risk transfer.

Second, there is a change in care-management capacity to favor providers over insurers in driving health care decisions. Groups of providers e. Ebeler referred to work of the Commonwealth Fund, which suggests that it is easier to implement combinations of payment, accountability, and risk if delivery is more collaborative and integrated Davis and Schoenbaum, Tofil highlighted other key changes to payments for providers under the ACA.

Partially through Section , they focus on value-based payments to incentivize quality and safety as well as to lower use and increase efficiency.

There are Medicare and Medicaid penalties for health care—acquired conditions not limited to hospital acquired , penalties for excessive preventable Medicare readmissions, as well as a focus on value-based purchasing i. ACOs, which will primarily still be fee-for-service, will focus on prevention and wellness to minimize hospitalizations, readmissions, and unnecessary care use. There are also market-driven innovations in payment through various methods.

Increased transparency has led to downward price pressure, tougher negotiations by employers with insurers, and a greater need to demonstrate value.

One area of payment reform that was of particular concern to some participants who spoke was cuts to the disproportionate share hospital DSH payments for both Medicare and Medicaid. This means that states that do not expand Medicaid will provide about the same level of uncompensated care to uninsured individuals but will now receive less federal funding for that care discussed further in Chapter 3.

Many participants noted this has dire implications for safety net hospitals, especially in a disaster. Bruce Rueben, president of the Florida Hospital Association, discussed what states are doing to prepare for payment reform and the change in emphasis from volume-drive to value-driven payments.

These collaborations have made meaningful improvements statewide, reducing the cost of care while improving the outcome. For example, avoiding unnecessary readmissions, Rueben said, is really about improving care of the patient through the continuum.

Keeping these readmitted patients out of the hospital also allows for greater bed availability in the case of an emergency or disaster when hospitals may need to surge. Through the collaborative, hospitals worked to improve hand-offs and information sharing, and established programs to help patients schedule follow-up visits and better understand their discharge instructions and medications.

As a result of these initiatives, the AHRQ assessment showed that Florida's hospital care quality performance relative to other states had increased significantly, falling on the borderline between average and strong AHRQ, Programs and collaborations such as these can be the future of health care in many geographic areas if the ACA guidelines and provisions work out the way they were designed. More integrated and collaborative everyday care can then be more easily translated to coordinated response and better continuity of care for patients in disasters.

With regard to preparedness, the financial pressures on health systems are immense, and incentives and demands are changing, Tofil said.

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Understanding Healthcare Reform: Pre-ACA to ACA to ...?

WebJul 9,  · The Affordable Care Act contains comprehensive health insurance reforms and includes tax provisions that affect individuals, families, businesses, insurers, tax . WebJan 15,  · The law has 3 primary goals: Make affordable health insurance available to more people. The law provides consumers with subsidies (“premium tax credits”) that . WebDec 19,  · Here are 5 important changes coming to ACA plans in Need help choosing the right health plan? Call a licensed insurance agent at () , or .