The Affordable Care Act (ACA)
The Affordable Care Act (ACA) is arguably one of the most progressive legislative enactment in American history. It is the culmination of decades of clamor for affordable healthcare for Americans. The Act envisages several benefits to the American people, chiefly being the insurance coverage proposed in the act. The act makes it mandatory for all persons to take up medical insurance cover, and this is through affordable healthcare schemes that are subsidized by the government. Despite a few challenges, its progressive implementation remains promising to the American people towards the full realization of Universal Health Care.
Research indicates that the need for the act pedestals on three key aspects wherein the case of people who are underinsured or uninsured was on the rise, and thus there was an urgent need to facilitate health access to these underprivileged classes. Additionally, the government had an apparent need and desire to concentrate on prevention as opposed to treatment. Besides, the act was enacted to promote efficiency in health care service delivery (Math et al.,2019).
Empirical research demonstrates that progress has been realized, and the apparent decrease in economic disparities demonstrates this. Arguably, this reduction was notable in all counties, and this indeed bolsters the fact that the act has brought progress to the people because healthy households are then in a position to be more productive and thus more robust economy. In any case, the expenses that would have otherwise been applied into expensive treatment are now subsidized through the coverage envisaged in the act.
Suffice to note that at the heart of the implementation of the act was the desirous collaboration between the federal government and the state government whereby infrastructural capacity at the state level was necessary owing to an influx in the number of people visiting these health care facilities. As a case manager, personal attestation supports this position whereby there was a high number of people in the hospital who even came for checkups. In any event, the role of States in the successful implementation of the Act remains integral. These include implementing individual state coverage programs as well as aid in the infrastructural realization of the Act’s objectives. Aptly is that they can provide accessible health care by implementing adequate responsive services that include ambulatory service and sufficient personnel administration.
In the early stages, this was realizable through the retention of the Medicaid and Medicare features. It is clearly obvious and can be seen in the case of hospitals within the counties whereby as a case manager, through the operation of the act, the onus of counseling on the best health care cover rests with the nurses and case managers. Under the new dispensation of the ACA, its becomes more efficient to offer such recommendation because the insurance companies are in collaboration with the government and thus costs are easily covered without the bureaucratic long and rigorous process that was previously in place. Such policy adoption has seen more people access health services without undue fear that they will be unable to afford the costs. The fact that insurance companies are obligated to cater to at least 60 percent of health bills for patients remains one of the act’s hallmark achievements. In fact, by virtue of the fact that people with pre-existing conditions are now covered indeed exemplifies the milestones realized by the implementation of the act. Previously insurance companies did not cover the case of persons with pre-existing conditions, and this prejudice occasioned a loss of lives.
Appreciation of the ACA denotes a need to fully understand the regime of funding that underpins the act, and this paper interrogates the element of cost under the act. The act and the desirous Universal Health Coverage is dominantly financed from tax wherein the government adopted a spread-out system of tax with the high-income earners contributing an amount of about 0.9 percent into the fund to cater for Medicare in hospital. Invariably, the funds are injected directly into supporting these insurance schemes. Furthermore, through fines and penalties imposed on employers who are unwilling to provide their employees with insurance schemes, the monies collected are applied to the fund.
Over time, the capital fund for running the scheme experienced a few shortages due to the increased demand and payouts in insurance. The need and expenses, in fact, surpass the budgetary allocation, even after collection of taxes, and hence this derailed the progressive implementation of the act. These are some of the drawbacks that face the Affordable care act. In fact, the act faces a lot of challenges, and despite its apparent benefits, over time, there has been a decline in the quality of services given to beneficiary members. This is attributed to the high premium cost charged by the insurance companies, which makes it hard for contributing Americans to honor their premium payments. This, in turn, translates to a low turnover for the insurance companies as well as reduced capital availability to fund the scheme. Owing to this financial predicament, the old ways that the spirit of the act sought to cure is slowly creeping in, and Americans are slowly going back to the old ways whereby due to high pricing of health care, they actually feared visiting hospitals; until such a time when they were too sick.
This regression calls for an urgent and quick solution to arrest the situation so that the progress made cannot be lost. In fact, some pundits and scholars argue that it is high time that the ACA be repealed.
Arguably, as a case manager who has interacted with patients, at a time the benefits of the act was unlimited, the position remains that stakeholders need to have a round table conversation in order to navigate the best way forward that is manifest in a win-win for both the government and insurance companies. A win for the government means that the desirous affordable health care for Americans is realized whilst, on the other hand, it is a win for insurance companies in that there is a commitment in respect of assurance for funding of the insurance coverage through timely remission of subsidized policy payments. By and large, empirical research demonstrates that there is positive and negative news regarding the progressive realization of the Act’s goals. On the one hand, the coverage of insurance has increased, and the uninsured number is low. Statistics confirm that at least the decline is from 16% to 9.1 % for the category of uninsured. On the other hand, negative news indicates that despite the reduced number of uninsured, as well as the coverage source for the insured class is not as was envisaged in the Act, whereby the coverage was dominated by the Medicaid and the Children Health Insurance Program (Cannon, 2018). It means that in as much as there is a high enrollment, the scope of cover is not as broad as initially intended
The paper takes cognizant of the multiple opposing agreements in place. The dominant argument supposes that the act seeks to oppress people who can afford premiums by forcing them to pay for more so that there is the continued funding of the scheme and this is deemed unfair. In a similar vein, they argue that the act is overly ambitious, and because of a lack in funding framework, it should be shelved until such a time when resources are sufficient. Nevertheless, this position is rebutted by the fact that these contributions aid in wealth redistribution in society and that capital redistribution can be boosted through the legislature through supplementary budgets.
For the avoidance of doubt, this paper recommends a review of the act but not an abolishment or absolute repeal, but rather reiterates the position that it can be salvaged by curing the funding challenges that mar the administration of the act.
In Summary, the Act supposes a system of progressive realization of the goals. The quick access to healthcare threshold is realized through access to emergency service and hospitalization as well as maternity service. This progressive achievement bolsters the reason as to why the act should be maintained, albeit with few amendments that touch on how to realize for funding the coverage envisaged in the act. Evidence demonstrates that insurance schemes have become affordable because the government promotes collaborative efforts between itself and the private insurance providers, wherein this should be nuanced, and in the event of any dispute, dialogue should be embraced (Béland, 2016).