The Affordable Care Act case study essay

The Affordable Care Act case study essay
 

The Affordable Care Act case study essay
The Affordable Care Act provides a wide spectrum of quality improvement activities that are divided into three main categories which includes evaluating new models of healthcare, focusing reimbursement from volume to quality, and overall system improvement. As nurse practitioners, we are responsible for fostering these changes in our clinical practice. Chapter seven looks at various key aspects of the ACA and the health reforms it focuses on.
Read chapter 7 of the textbook and complete the case study questions for chapter
Guidelines
Your assignment submission should be 200-250 words in length. It should contain proper grammar, be free of spelling errors, and reflect critical thinking.  Submit your assignment utilizing the APA 7th Edition format. Ensure all references are properly cited. Remember if it is not your original thought process, you need to provide a reference.
 

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Case Study, Chapter 7 

Question 1

The American Health Care Act (AHCA) and the Better Care Reconciliation Act (BRCA) which were the bills aimed at repealing and replacing the Affordable Care Act (ACA) did not gather enough support in Congress to become law. These bills aligned with the healthcare reform priorities of the party and had some elements. They intended to lower taxes as Republicans generally prefer government involvement in healthcare (Chapter 7). Additionally, they aimed to eliminate government mandates, the mandate and decrease federal spending on healthcare aligning with fiscal conservatism. Their goal was to make health insurance more affordable for sicker individuals. This was planned by allowing insurers to charge premiums for individuals and reducing requirements for essential health benefits. However, these bills faced criticism due to consequences such as reduced coverage for populations and uncertainty in the market. Understanding these characteristics provides insights into how Republicans approach healthcare reform.

Question 2

There are ways to address the mandate, in the Affordable Care Act (ACA) that could help minimize political unrest. One option is for policymakers to introduce rewards or tax credits as a means of encouraging people those with lower incomes to voluntarily enroll in health insurance. This approach has its advantages such as reducing government interference and respecting choices (Williams & Dhillon, 2019). However, it may not be as effective in achieving coverage. In the healthcare sector we have seen examples of incentives like employer sponsored wellness programs and Medicaid expansion incentives, for states, which highlight their potential in promoting enrollment and encouraging health behaviors. However, it is important to acknowledge that there are tradeoffs and complexities associated with these approaches.

Question 3

The pros of having a public option include increased competition, potentially lower costs, and broader access to healthcare. It could provide a safety cushion for individuals who cannot afford insurance. However, there are concerns regarding government control the possibility of costs if not properly managed and opposition from insurers (Chapter 7). The Office of Personnel Managements compromise was designed to increase competition by partnering with multistate plans accomplishing some of the objectives of an option without relying on government run healthcare. This compromise may have been acceptable to lawmakers because it strikes a balance between private interests addressing worries, about government involvement while fostering competition and affordability.

Question 4

Compromising on the state role in the ACA has both advantages and disadvantages. On the positive side, allowing states greater flexibility can lead to more rapid innovation in healthcare policy tailored to local needs. State legislatures might find it more convenient to cater to a group of constituents which could potentially promote stability (Mackintosh & Armstrong, 2020). Nevertheless, this approach carries the risk of creating a fragmented landscape of healthcare programs and policies across states. This fragmentation could undermine the consistency and consumer protections at the level. The publics ability to access health insurance and healthcare services may greatly vary depending on each states approach. For instance, in states like California or New York where healthcare policy has historically been more advanced granting control to the state may improve access to care. On the other hand, in states like Texas or Florida that have demonstrated resistance towards expanding healthcare access it could lead to disparities in terms of both accessibility and affordability (Chapter 7). Therefore, while allowing flexibility at the state level presents opportunities for innovation, it is crucial to consider striking a balance between state autonomy and national coherence in order to ensure equal access to healthcare throughout the entire country.
 
 

References

Chapter 7. Affordable Care Act Reframed and uncertain.

Mackintosh, N., & Armstrong, N. (2020). Understanding and managing uncertainty in health care: revisiting and advancing sociological contributions. Sociology of Health & Illness, 42, 1-20.

Williams, S. A., & Dhillon, S. (2019). Women’s obstetric and reproductive health care discourse in online forums: perceived access and quality pre-and post-Affordable Care Act. Preventive Medicine, 124, 50-54.

Chapter 7 Case Study Questions

Discussion Question 1

Even though the primary legislative bills to repeal and replace the Affordable Care Act (ACA)—the AHCA and BRCA—did not have sufficient support across U.S. Congress to become law, and some of their provisions may not have been allowed under reconciliation rules, it is worth considering the main features of the bills to understand the type of health reform changes many Republicans support (see TABLE 7-1). Overall, these bills reduced taxes, eliminated government mandates, lowered federal government spending, lowered premiums health insurance more affordable for elderly and sicker individuals?

Discussion Question 2

Are there alternatives to the individual mandate that accomplish the same goals without engendering so much political turmoil? Could policymakers have designed an incentive system that would be as effective as a mandate? What are the pros and cons of using a mandate versus an incentive? Can you think of incentives to encourage enrollment that have occurred in other parts of the healthcare system? The Affordable Care Act case study essay

Discussion Question 3

There was a lengthy debate about whether to include a public option in health reform. A public option is some type of government-run health plan that would be available to compete with private plans. A public option could exist within the health exchange model or outside of it. Instead of a public option, Congress voted to require the Office of Personnel Management, which runs the Federal Employees Health Benefit Program, to contract with at least two multistate plans in every state health insurance exchange. What are the pros and cons of having a public option? Does the Office of Personnel Management compromise achieve all or some of the goals of having a public option? Why do you believe the Office of Personnel Management compromise was acceptable to legislators but the public option was not?

Discussion Question 4

Republican policymakers that are involved in bipartisan discussions to revise the ACA are focused on providing states with increased flexibility regarding benefit design, premium pricing, and other features. Although states are generally home to social welfare changes, it is difficult to provide universal health care on a state-by-state basis. If state health reform efforts lead the way, the country could have a patchwork of programs and policies that vary from state to state, with the potential to make health coverage even more complex and inefficient than it is currently. On the other hand, it is also important to recognize that a health reform strategy focusing on states has benefits as well. At its best, state-level reform can be accomplished more rapidly and with more innovation than at the federal level. State legislatures may have an easier time convincing a narrower band of constituents important to the state than Congress has in accommodating the varied needs of stakeholders nationwide. What are the advantages and disadvantages of compromising regarding the state role in the ACA? Is it worth giving up some degree national uniformity and stronger consumer protections in exchange for political stability and allowing state to experiment with health reform design? How well do you think the public will be served in their access to affordable health insurance and access to health care if states have more control? How does your response differ if you are living in California or New York versus Texas or Florida?

The Affordable Care Act case study essay Discussion Question 5

A group of friends were talking about the Affordable Care Act (ACA), illustrating the wide-ranging viewpoints about the law. Calvin, whose daughter Mia is struggling to make a living as an artist, is pleased that Mia has health insurance for the first time since graduating from college. Although Mia cannot stay on her parents’ insurance because she just turned 27, she can now afford a good health insurance plan that she found on her state’s health exchange. While Calvin has not noticed much of a change in his own health insurance coverage, which he obtains through his government employer, his friend Katherine is upset about health reform. She does not want the government forcing her to purchase health insurance (although she always chose to be insured in the past), and she recently found out that her old plan was cancelled because it did not meet the law’s requirements. Katherine found several new plan options to choose from, but none had her exact combination of benefits, providers, and price. In addition, Katherine’s uncle, Ethan, is 55 years old and self-employed. He purchases his health insurance on his state’s exchange and because he has preexisting conditions, he is grateful to be able to find a plan. Even so, Ethan’s premiums will increase by 15% this year and his deductible is $5,000, making health care difficult to afford even with insurance. Another friend, Jara, told Katherine she should be willing to pay a little more or change some aspects of her plan to help the millions of people who can now afford insurance for the first time as a result of the ACA. After witnessing her uncle’s experience, however, Katherine is skeptical that the government is going to be able to keep its promises.

What are the competing viewpoints about the ACA exemplified by these friends? Which of these friends’ views will be the most pressing concern going forward in the discussions about the ACA? The Affordable Care Act case study essay