Affordable Care Act Case Study
The Affordable Care Act (ACA) ran its persuasion campaign on the desire to improve the health care system by providing superior medical services to more Americans at an affordable price. However, controlling costs in health care coverage continues to be a concern. In fact, most Americans still find that health insurance through the ACA’s Exchange is unaffordable with premiums and deductible taken into account. Thus, the continued rising cost of health care may be attributed in part to the direct costs consumers bear through high premiums and deductible plans.
To discuss this issue, three key facts are to be taken into account:
1. First, taxes and regulations in the ACA have put new restrictions on employer-based care, making that …show more content…
Although CBO determined that the ACA will reduce the federal budget deficit by more than $100 billion over the first decade and by more than $1 trillion between 2020 and 2030, these savings will just be “numbers” if policy makers do not reform health care delivery to bring down the long-term growth in costs. However, proponents of the ACA argue that ACA is set up to doing just that. The future will decide!
In the end, there are no easy answers when it comes to controlling health care costs in the United Sates. As Dr. Whitlock pointed out, there is a reason why we don’t have a single payer system. The question is whether or not we want to remain a capitalist society. Nonetheless, several efforts have been made in past to try to address the cost growth such as reducing provider reimbursement, but such measures failed to constrain the rate of health care cost growth. Consequently, if costs are to be controlled, more profound changes in policy remain to be seen.
Question …show more content…
Typically, low-income seniors and younger people with disabilities are among the beneficiaries. However, to be eligible for dual eligibility, you must be a Medicare part A and B recipient and also receive full Medicaid benefits. There are an estimated 9 million people in the United Sates that receive this dual benefits. Medicare is the primary payer for most services, but Medicaid covers benefits not offered by Medicare such as payment for all or part of Medicare copayment, coinsurance, and deductibles. Dual-eligibles are often in poorer health and require more care compared with other Medicare and Medicaid beneficiaries. However, where it gets dicey is that it is challenging to coordinate care between Medicare and Medicaid for the dual-eligibles for the simple reason as suggested by Dr. Whitlock that the two systems of care do not talk to each other. To the extent that providers are often confused about their responsibilities. Consequently, a physician may bill Medicare and not be familiar with benefits that are available through Medicaid. In addition, State Medicaid agencies have legal obligations to pay Medicare cost-sharing for most dual eligible. However, the Medicaid benefits vary by Sates since each has discretion over optional benefits (OB) and this present more challenges and complicate the matter