The Affordable Care Act (ACA) includes a provision that mandates all individuals to be covered by a health insurance plan, which has been a cause of significant controversy. Specifically, Sec. 5000A outlines a minimum essential coverage and tax penalties for failing to meet said coverage. This provision serves a dual purpose of ensuring Americans have access to health care, while at the same time attracting funds for the increased need for health care and insurance (Fiedler, 2020). Moreover, by mandating universal coverage, this provision ensures that the increased financial burden is equally distributed among the population.
Proponents of Sec. 500A point to the benefits of increased and, ultimately, universal insurance coverage: increased quality and access to care and spreading the financial burden. Furthermore, the entire ACA’s purpose of providing more equal access to health care is viewed as moral and just (Robertson-Preidler, et al., 2020). However, opponents of Sec. 5000A still contest its benefits, and even its constitutionality (Pratt, 2021). Particularly after the act was changed to remove the tax penalty for remaining uninsured, the provision was argued to be unconstitutional, unenforceable, and ultimately meaningless (Pratt, 2021). As one of the most broadly applicable and controversial provisions of the ACA, Sec. 5000A has a profound effect on health care organizations.
For California’s Office of the Patient Advocate (OPA), ACA presents a significant challenge. The office’s goal is to provide patients with information on available health plans, as well as inform them of their rights and manage their health care-related complaints. ACA has brought significant changes to the country’s health care system, including standards of care and insurance policies. Moreover, as a hotly debated issue, it can have various types of misleading information around it. Finally, Sec. 5000A, in particular, attracted previously uninsured patients, especially from groups who would not have previously sought it and, thus, were not informed about insurance. Therefore, informing and educating patients on these changes and providing accurate assessments and recommendations became a more challenging task. This is further complicated by the changes the act has taken since its introduction. While making OPA’s work more challenging, however, APA seeks to improve health care coverage and quality, thus aligning with the organization’s values.
Sec. 5000A’s ultimate effect on California’s OPA can be described as positive. As a government organization that focuses on gathering and distributing information, it benefits from having more patients interacting with the health care system. This allows it to collect more accurate feedback, particularly from patients belonging to underserved groups. In turn, this feedback can be used to better understand patient needs and preferences, and provide higher quality information and education. Furthermore, the feedback gathered by the OPA can be used to inform and guide further policy changes and research. Because of this, the organization can fulfill its purpose with a higher degree of accuracy and reliability.
However, this increase in the number of interactions also corresponds to a greater workload. Creating additional patient information and education materials constitutes more work. In turn, it raises questions about funding, which, for a government organization, maybe a significant issue. Thus, the positive effect of Sec. 5000A on OPA’s work is contingent on it receiving additional funds necessary to process the increased flow of information through it. If the office is underfunded, it may find itself incapable of processing the feedback and complaints it receives, and suffer negative outcomes in terms of collecting accurate information in time for it to remain relevant.
References
Fiedler, M. (2020). The ACA’s individual mandate in retrospect: What did it do, and where do we go from here? Health affairs (Project Hope), 39(3), 429-435.
Pratt, D. (2021). Focus on: The Supreme Court hears oral argument (again) on the constitutionality of the Affordable Care Act. Journal of Pension Benefits: Issues in Administration, 28(3), 9-15.
Robertson-Preidler, J., Trachsel, M., Johnson, T., & Biller-Andorno, N. (2020). The Affordable Care Act and recent reforms: Policy implications for equitable mental health care delivery. Health Care Analysis, 28(3), 228-248. Web.