Introduction
The Affordable Care Act (ACA) is President Barack Obama’s comprehensive healthcare reform, signed into law in March 2010. The Patient Protection and Affordable Care Act is a set of healthcare regulations aimed at increasing access to health insurance for millions of uninsured Americans. The act increased Medicaid eligibility, established health insurance exchanges, required Americans to acquire or receive health insurance, and barred insurance companies from refusing coverage based on pre-existing illnesses. The bill contains tax credits and cost-saving reductions to assist low-income people and families in lowering their expenditures.
Improvements Brought by the Affordable Care Act
Health Insurance Marketplaces and Subsidized Coverage
The ACA increased insurance coverage in several ways. First, it established state-level health insurance exchanges based on the principles of competition and choice, allowing consumers to evaluate similar coverage alternatives and pick among competing plans. The health bill also offered subsidies to low-income people and households up to 400% of the federal poverty level to help them obtain health insurance (Mclntyre & Song, 2019).
Expansion of Medicaid Eligibility and Reduction of the Uninsured Population
Second, the ACA increased Medicaid eligibility to people and families with earnings up to 138% of the income threshold, which is approximately US$35,000 for a family of four (Mclntyre & Song, 2019). Since the law’s introduction in 2010, the country’s uninsured population has decreased by around 20 million (Mclntyre & Song, 2019). Health insurance expansions were supported by complementary programs that encouraged individuals to enroll in coverage. Federal tax credits that decreased the financial burden of monthly premiums (and, in certain circumstances, cost-sharing) made marketplace plans more appealing to low-income users.
Implementation of Consumer Protections and Essential Health Benefits
Moreover, it introduced additional federal minimum consumer safeguards, including the prohibition on insurers discriminating based on medical status. They could not turn individuals away or charge higher rates because of pre-existing medical issues. A list of ten essential health advantages was created (Mclntyre & Song, 2019). The annual and lifetime restrictions on covered health benefits have been eliminated. The dependent coverage clause of the bill allowed children up to the age of 26 to remain on their parents’ insurance, benefiting between 2 and 3 million young people (Mclntyre & Song, 2019).
Stabilization of the Insurance Market Through Risk Management Programs
This form of the regulated individual market was unfamiliar territory for most insurers when it debuted. They were in charge of estimating the anticipated healthcare expenditures of anyone who chose to enroll in coverage, while having no expertise to inform their predictions. Typically, open enrollment occurs toward the end of the year period, during which healthcare plans can be modified through the ACA’s marketplace.
To alleviate insurers’ worries about enrolling unexpectedly sick populations, the ACA included three federal protections: risk corridors, reinsurance, and risk adjustment (Mclntyre & Song, 2019). The first two were just transitory; they expired after three years but provided insurers time to establish their feet and appropriately price their goods. Risk adjustment is a long-term policy designed to protect insurers from picking healthier participants and avoiding sicker populations (Mclntyre & Song, 2019). As a result, public opinion on the role of government in the healthcare sector is increasing (Mclntyre & Song, 2019). These changes in public opinion show that an increasing number of Americans may be open to suggestions that would shift the ACA in a more progressive direction.
Conclusion
The ACA has various measures aimed at reducing health inequities. Many ACA rules directly influence insurers and have a direct effect on reducing health disparities. Furthermore, gaps in care quality among racial and ethnic groups have not altered much over time. Five targets are outlined in the action plan to reduce health disparities, which are to transform healthcare delivery, improve the health, safety, and well-being of Americans, improve the workforce and infrastructure, and contribute to scientific knowledge and innovation. Each objective has a plan and a lead agency to ensure its completion. Furthermore, the ACA established offices of minority health in numerous health agencies that did not previously have such offices.
Reference
Mclntyre, A. & Song, Z. (2019). The US Affordable Care: Reflections and directions at the close of a decade. PloSMed, 16(2).