Affordable Care Act (ACA) of March 2010 is a comprehensive reform in the U.S. healthcare system. The main three goals of ACA are expanding the Medicaid program, making insurance services affordable for the entire population, and supporting medical care services to lower the cost of treatment (McIntyre & Song, 2019). The Medicaid program covers adults with FPL income below 138%. However, not all America States have expanded the program. It balances the cost of care and makes it affordable for the entire population, especially those with lower socioeconomic status. The components of ACA that can bring positive effects on improving healthcare outcomes and decreasing costs include coverage for children despite the preexisting condition, regulation of yearly limits on insurance coverage, consumer assistance program, and digitalizing consumer information (McIntyre & Song, 2019).
The ACA law 2010 prohibits insurance companies from denying coverage to children based on their preexisting health conditions. This coverage supports U.S. children below the age of 19. This means health insurance companies will continue to provide coverage despite the patient or child’s health problems before the program begins (Courtemanche et al., 2018). Some of the children are from low socioeconomic families; therefore, in case of health issues, their parents cannot afford to provide the required treatment cost for the present and existing conditions. However, with healthcare reforms, they can receive insurance coverage for their previous and present condition. Eliminating denying coverage based on preexisting conditions directly links with positive outcomes as all children can manage health issues which hinder their well-being (Courtemanche et al., 2018).
ACA regulates annual insurance coverages. It defines that all insurance companies limiting yearly patient coverage will be denied or restricted for all group plans and individual markets. The law protects individuals with extended hospital stays by regulating companies’ use of annual dollar limits. This means their respective insurance companies will cover patients or individuals hospitalized for an extended period (McIntyre & Song, 2019). Therefore, people will not be worried about expanding bills as they will be covered due to unlimited time. For example, when a cancer patient is admitted to a healthcare facility, the treatment and management time is prolonged, increasing the medication bill. Therefore, the act supports unlimited insurance coverage for them. Generally, the prohibition of limited annual dollar use will help reduce medication costs for the insured population.
The ACA bill provides consumer assistance programs in each state. The federal government grants state governments to expand and set up independent offices to assist all health insurance systems. The Medicaid program provides beneficiaries high-quality, cost-effective, and more significant health needs. Medicaid services serve as a vital program for financial protection; it limits the out-of-pocket cost to their consumers. Benefits of Medicaid programs include physical services, outpatient and inpatient services, x-rays and laboratory services, and home care. Therefore, this reflects positive healthcare services to patients and low-cost medication to its beneficiaries (Jiang et al., 2023). Also, digitalizing consumer information on online platforms helps them understand their health programs and what is best for their well-being.
Generally, ACA components are essential in defining population health and how they can afford treatment costs. The act protects patients, especially those from low socioeconomic backgrounds who cannot afford standard health care (Jiang et al., 2023). Therefore, as defined by ACA, insurance services will help reduce treatment costs and open access to healthcare services, improving patient and population outcomes.
References
Courtemanche, C., Marton, J., Ukert, B., Yelowitz, A., & Zapata, D. (2018). Effects of the Affordable Care Act on health care access and self-assessed health after 3 years. INQUIRY: The Journal of Health Care Organization, Provision, and Financing, 55, 0046958018796361. https://journals.sagepub.com/doi/full/10.1177/0046958018796361
Jiang, G. Y., Urwin, J. W., & Wasfy, J. H. (2023). Medicaid Expansion Under the Affordable Care Act and Association with Cardiac Care: A Systematic Review. Circulation: Cardiovascular Quality and Outcomes, 16(6), e009753. https://www.ahajournals.org/doi/full/10.1161/CIRCOUTCOMES.122.009753
McIntyre, A., & Song, Z. (2019). The US Affordable Care Act: Reflections and directions at the close of a decade. PLoS medicine, 16(2), e1002752. https://journals.plos.org/plosmedicine/article?id=10.1371/journal.pmed.1002752
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