Introduction 

BHA FPX 4003 Assessment 1 Attempt 1 The Affordable Care Act and Beyond

In 2010 President Barrack Obama signed the Affordable Care Act (ACA) into law impacting the US healthcare system tremendously by increasing access to care, reducing cost, and improving quality. Although the Affordable Care Act improved access to health care, it emphasized the need for policies that increase funding and streamline enrollment. Since the creation of the ACA, newer reform policies and initiatives have been implemented, such as the American Rescue Plan Act of 2021. In this paper, I will be analyzing the impacts of The Affordable Care Act on the healthcare ecosystem we inhabit today and the related significance of the American Rescue Plan Act of 2021.

Sources Addressing the Affordable Care Act 

Buntin, M. B., & Graves, J. A. (2020). How the ACA dented the cost curve. 

Health Affairs, 39(3), 403-412,412A-412G. http://dx.doi.org/10.1377/hlthaff.2019.01478 

Numerous provisions of the Affordable Care Act (ACA) were designed to make health care more affordable, yet the act’s cumulative effects on health care costs are still debated. A key question is whether the ACA reduced the annual rate at which total national health care spending increased and brought per capita spending growth rates down. We review the direct and indirect effects of the ACA on spending across segments of the health insurance market. We highlight areas where the ACA has affected spending, but we emphasize that the ACA’s long-run impact on spending will depend on sustaining the adjustments made to provider payment systems and expanding the emphasis on value across payers throughout the ACA’s second decade beyond.

Davis, K., Abrams, M., & Stremikis, K. (2011). How the affordable care act will strengthen 

the nation’s primary care foundation. Journal of General Internal Medicine, 26(10), 1201-3. http://dx.doi.org.library.capella.edu/10.1007/s11606-011-1720-y

As the country turns toward the implementation of the Patient Protection and Affordable Care Act, realizing the potential of reform will require a significant transformation of the American system of health care delivery. To that end, the new law seeks to strengthen the nation’s primary care foundation through enhanced reimbursement rates for providers and the use of innovative delivery models such as patient-centered medical homes. Evidence suggests that these strategies can return substantial benefits to both patients and providers by increasing access to primary care services, reducing administrative hassles and burdens, and facilitating coordination across the continuum of care. If successfully implemented, the Affordable Care Act has the potential to realign incentives within the health system and create opportunities for providers to be rewarded for delivering high-value, patient-centered primary care. Such a transformation could lead to better outcomes for patients, increase job satisfaction among physicians and encourage more sustainable levels of health spending for the nation.

Shaw, F. E., Asomugha, C. N., Conway, P. H., & Rein, A. S. (2014). The patient protection 

and affordable care act: Opportunities for prevention and public health. The Lancet, 384(9937), 75-82. http://dx.doi.org.library.capella.edu/10.1016/S0140-6736(14)60259-2. The Patient Protection and Affordable Care Act, which was enacted by the US Congress in 2010, marks the greatest change in US health policy since the 1960s. The law is intended to address fundamental problems within the US health system, including the high and rising cost of care, inadequate access to health insurance and health services for many Americans, and low healthcare efficiency and quality. By 2019, the law will bring health coverage and the health benefits of insurance–to an estimated 25 million more Americans. It has already restrained discriminatory insurance practices, made coverage more affordable, and realized new provisions to curb costs (including tests of new healthcare delivery models). The new law establishes the first National Prevention Strategy, adds substantial new funding for prevention and public health programs, and promotes the use of recommended clinical preventive services and other measures, and thus represents a major opportunity for prevention and public health. The law also provides an impetus for greater collaboration between the US healthcare and public health systems, which have traditionally operated separately with little interaction. Taken together, the various effects of the Patient Protection and Affordable Care Act can advance the health of the US population.

BHA FPX 4003 Assessment 1 Attempt 1 The Affordable Care Act and Beyond

Sources Addressing the American Rescue Plan Act

Egelberg, J. K. (2022). New funding options under the American rescue plan act of

2021. Journal of Pension Benefits, 29(3), 13-15. http://library.capella.edu/login?qurl=https%3A%2F%2Fwww.proquest.com%2Fscholarly-journals%2Fnew-funding-options-under-american-rescue-plan%2Fdocview%2F2648610494%2Fse-2%3Faccountid%3D27965

The American Rescue Plan Act of 2021 offers pandemic-related relief similar to the relief offered as a result of the Great Recession. After a request by the American Academy of Actuaries for clarification, the Treasury did provide some answers to some of the issues. This article summarizes these developments.

Goldowitz, I. (2021). The multiemployer pension rescue under the American rescue plan 

act of 2021: Taxpayer dollars well spent. Journal of Pension Benefits, 29(1), 27-33. http://library.capella.edu/login?qurl=https%3A%2F%2Fwww.proquest.com%2Fscholarly-journals%2Fmultiemployer-pension-rescue-under-american-plan%2Fdocview%2F2629425455%2Fse-2%3Faccountid%3D27965

The American Rescue Plan Act of 2021 made several changes to assist multiemployer plans and sponsors of single-employer plans. These should help stabilize the multiemployer system, including the PBGC multiemployer insurance fund, slow the decline of single-employer plans, and support retirement security while Congress considers new retirement models for active employees. Though the multiemployer rescue involves taxpayer support that is unprecedented in the pension context, there are sufficient guardrails, and retiree spending can be expected to buoy the economy and the tax base.

Keith, K. (2021). The American rescue plan expands the ACA. Health Affairs, 40(5), 

696-697. http://dx.doi.org.library.capella.edu/10.1377/hlthaff.2021.00597

President Joe Biden signed the American Rescue Plan Act (ARPA) into law on March 11, 2021. The legislation temporarily expands the Affordable Care Act (ACA) premium tax credits and increases federal financial incentives for states that have not yet done so to expand their Medicaid programs to low-income adults. These changes were enacted just ahead of the ACAs eleventh anniversary, as the nation awaits a Supreme Court decision on another global challenge to the law. Enrollment through HealthCare.gov has increased during the broad special enrollment period announced by the Biden administration, and federal officials have issued new guidance on ARPA, COVID-19, and more.

Impacts of the ACA and The American Rescue Plan Act 

on the U.S Health Care Ecosystem 

Affordable Care Act Overview

The Affordable Care Act (ACA), formally known as the Patient Protection and Affordable Care Act, and informally known as Obamacare, is a United States federal statute signed into law by President Barack Obama on March 23, 2010. Together with the Health Care and Education Reconciliation Act of 2010 amendment, it represents the U.S. healthcare system’s most significant regulatory overhaul and expansion of coverage since the enactment of Medicare and Medicaid in 1965. The law has 3 primary goals: Make affordable health insurance available to more people. The law provides consumers with subsidies (“premium tax credits”) that lower costs for households with incomes between 100% and 400% of the federal poverty level (FPL). Expand the Medicaid program to cover all adults with income below 138% of the FPL. Not all states have expanded their Medicaid programs. Support innovative medical care delivery methods designed to lower the costs of health care generally (Davis, 2011). One of the mandates of the Act is the establishment of electronic health insurance marketplaces, which provides opportunities for consumers to search for affordable health insurance plans. There is also a mandate that individuals who do not have health insurance can purchase a health insurance plan if they can afford it or pay a fine. Both mandates have decreased the number of uninsured in the United States (Niles, 2019). 

The American Rescue Plan Act Overview 

On March 11, 2021, President Biden signed the American Rescue Plan Act of 2021 (H.R. 1319) into law. The $1.9 trillion packages, based on President Biden’s American Rescue Plan, is intended to combat the COVID-19 pandemic, including the public health and economic impacts. The law helps keep people healthy by supporting community health centers in medically underserved areas, expanding Medicaid coverage for low-income families, and raising subsidies for health insurance under the Affordable Care Act (ACA). The law also invests in the US family planning clinic network to help clinics meet increased demand and overcome pandemic-related hurdles and allows states to extend Medicaid coverage to people for 12 months after they give birth to address the US maternal mortality crisis (Egelberg, 2022).

Impact on the U.S Health Care Ecosystem

BHA FPX 4003 Assessment 1 Attempt 1 The Affordable Care Act and Beyond

Both the Affordable Care Act and the American Rescue Plan were initiatives created to further improved America’s economy. Health care affordability was a key goal of the Affordable Care Act (ACA). This was evident not only in the law’s name but also in its provisions that made health care coverage more affordable, accessible, and comprehensive. Although many of these efforts added to federal expenditures for health care, the ACA also reduced Medicare payment rates and mandated changes aimed at increasing value. Although the ARPA largely focused on the devastation related to the COVID-19 pandemic, the bill is also poised to affect a momentous expansion of the Affordable Care Act. To increase access to health care and support affordability, the ARPA expands health insurance marketplace subsidies, defrays the health insurance costs of the unemployed, and incentivizes non-expansion states to expand their Medicaid programs to all low-income adults. Projections of the Congressional Budget Office (CBO) suggest that in so doing, the ARPA will extend health care coverage to an estimated 2.5 million uninsured US residents by 2023. The CBO further projects that premiums will decline by as much as 100% for as many as 3.4 million low-income enrollees. This Viewpoint discusses the ARPA elements that strengthen the ACA and describes their potential implications and uncertainties (Keith, 2021).

Conclusion

America has taken great strides in improving healthcare overall by creating reforms and initiatives to not only make health care more affordable but more accessible for everyone. 

Nearly 50 different reform initiatives have been implemented between 2010 and 2017. Although primary care is a major focus of the ACA, these additional initiatives are focused on 10 different areas, including public health, prevention of disease, community health, and increasing revenue provisions to pay for the reform (Niles, 2021).  I believe the future of U.S health care appears to improve and will continue to improve in the future mainly because advancements in healthcare always have been and always will be a priority for the government.

References

Buntin, M. B., & Graves, J. A. (2020). How the ACA dented the cost curve. 

Health Affairs, 39(3), 403-412,412A-412G. http://dx.doi.org/10.1377/hlthaff.2019.01478

Davis, K., Abrams, M., & Stremikis, K. (2011). How the affordable care act will strengthen 

the nation’s primary care foundation. Journal of General Internal Medicine, 26(10), 1201-3. http://dx.doi.org.library.capella.edu/10.1007/s11606-011-1720-y

Egelberg, J. K. (2022). New funding options under the American rescue plan act of

BHA FPX 4003 Assessment 1 Attempt 1 The Affordable Care Act and Beyond

2021. Journal of Pension Benefits, 29(3), 13-15. http://library.capella.edu/login?qurl=https%3A%2F%2Fwww.proquest.com%2Fscholarly-journals%2Fnew-funding-options-under-american-rescue-plan%2Fdocview%2F2648610494%2Fse-2%3Faccountid%3D27965

Goldowitz, I. (2021). The multiemployer pension rescue under the American rescue plan 

act of 2021: Taxpayer dollars well spent. Journal of Pension Benefits, 29(1), 27-33. http://library.capella.edu/login?qurl=https%3A%2F%2Fwww.proquest.com%2Fscholarly-journals%2Fmultiemployer-pension-rescue-under-american-plan%2Fdocview%2F2629425455%2Fse-2%3Faccountid%3D27965

Keith, K. (2021). The American rescue plan expands the ACA. Health Affairs, 40(5), 

696-697. http://dx.doi.org.library.capella.edu/10.1377/hlthaff.2021.00597

Niles, N. J. (2019). Basics of the U.S. Health Care System (4th Edition). Jones & 

Bartlett Learning. https://capella.vitalsource.com/books/9781284203882

Shaw, F. E., Asomugha, C. N., Conway, P. H. (2014). The patient protection and affordable care

act: Opportunities for prevention and public health. The Lancet, 384(9937), 75-82. http://dx.doi.org.library.capella.edu/10.1016/S0140-6736(14)60259-2

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