Passage of Patient Protection and Affordable Care Act

1. Which features of the ACA are essential for ensuring that the United States can reduce the number of people experiencing health care disparities?
2. Which features of the ACA are most troubling to you and why?

The Patient Protection and Affordable Care Act (ACA 2010): The Good and the Bad

The Patient Protection and Affordable Care Act 2010 (simply referred to as the ACA 2010) is a revolutionary healthcare policy that sought to bring about some equity in healthcare access (Sultz & Kroth, 2018). With its signing into law in 2010 by President Obama, an additional 22 million poor Americans who could hitherto not access healthcare were brought into coverage (Kominski et al., 2017). In this paper, I point out some features of the ACA that have helped in reducing healthcare disparities and some that are troubling.Passage of Patient Protection and Affordable Care Act

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            There are two particular features of the ACA that are instrumental in reducing the number of Americans suffering from health disparities. The first one is the requirement for mandatory coverage for every American citizen and resident. What this means is that everyone is now required by the law to get healthcare coverage. What the framers of the law hoped to achieve was economies of scale. Once everyone took healthcare insurance as a matter of course, the insurance premiums that each person would pay would be low and affordable to everyone. The second feature that helps in reducing disparities in healthcare access is the provision in the law that persons with pre-existing conditions must not be denied coverage by payers (Kominski et al., 2017). It is a fact that most people with pre-existing conditions are from marginalized and poor communities such as African Americans and Hispanics.

On the other hand, there are two features of the ACA 2010 that are troubling to me. The first one is the feature of individual mandate. This is where an individual who does not take healthcare coverage is punished by a penalty. There are many reasons why a person may be unable to purchase the coverage, however little the premium is. An example is the old (above 65 years old) homeless persons who do not have an income at all. The other troubling feature is the monetary incentive program for insurers to continue covering pre-existing conditions (Rosenbaum, 2011). If another administration (like Trump’s) takes power, they may frustrate this provision and cause a crisis for those who have pre-existing conditions by withholding the incentive funds. The payers will then withhold this coverage in turn, distressing very many poor Americans who will have no alternatives.  Passage of Patient Protection and Affordable Care Act

References

Kominski, G.F., Nonzee, N.J. & Sorensen, A. (2017). The Affordable Care Act’s impacts on access to insurance and health care for low-income populations. Annual Review of Public Health, 38. http://dx.doi.org/10.1146/annurev-publhealth-031816-044555

Rosenbaum, S. (2011). The Patient Protection and Affordable Care Act: Implications for public health policy and practice. Public Health Reports, 126(1), 130-135. https://doi.org/10.1177/003335491112600118

Sultz, H.A., & Kroth, P.J. (2018). Sultz and Young’s health care USA: Understanding its organization and delivery, 9^th ed. Jones & Bartlett Learning. Passage of Patient Protection and Affordable Care Act