Current or Proposed Health Care Policy to Improve Access to Quality, Cost-Effective Health Care
Access to quality and cost-effective health care is a critical issue facing many populations worldwide. Various policies have been implemented or proposed to improve access to health care services for specific population groups. This paper will examine a current or proposed health care policy aimed at improving access to quality, cost-effective health care. The policy selected for this paper is the Affordable Care Act (ACA) in the United States.
Background of the ACA
The ACA, also known as Obamacare, was signed into law in 2010. It represents a comprehensive health care reform intended to expand access to health insurance coverage, improve the quality of health care, and reduce health care costs for individuals and families in the United States (Centers for Medicare & Medicaid Services, 2021). The ACA aimed to achieve these goals through various mechanisms, such as expanding Medicaid, creating health insurance marketplaces, and implementing insurance reforms.
Improving Access to Health Insurance Coverage
One of the primary goals of the ACA was to improve access to health insurance coverage for the uninsured and underinsured populations. It achieved this by expanding Medicaid eligibility and establishing health insurance marketplaces (also known as exchanges), where individuals and small businesses can purchase subsidized health insurance plans (Blumenthal, Abrams, & Nuzum, 2020).
Under the ACA, states were given the option to expand their Medicaid programs to cover more low-income individuals and families. Medicaid is a joint federal-state program that provides health coverage to certain vulnerable populations, including low-income adults, children, pregnant women, elderly adults, and people with disabilities. Prior to the ACA, Medicaid eligibility criteria varied significantly across states, resulting in many low-income individuals lacking access to affordable health insurance.
The ACA expanded Medicaid eligibility to include individuals and families with incomes up to 138% of the federal poverty level, regardless of their age, disability status, or family composition (Blumenthal et al., 2020). As of January 2021, 38 states and the District of Columbia have adopted Medicaid expansion, covering millions of previously uninsured adults (Kaiser Family Foundation, 2021).
Health Insurance Marketplaces
The ACA established health insurance marketplaces to provide a platform for individuals and small businesses to purchase private health insurance plans. These marketplaces offer a range of health insurance options, including qualified health plans that comply with the ACA’s coverage requirements and receive subsidies to make coverage more affordable for eligible individuals (Blumenthal et al., 2020).
The marketplaces allow individuals to compare different insurance plans based on factors such as coverage, cost, and quality. They also provide subsidies, in the form of premium tax credits and cost-sharing reductions, to lower-income individuals and families. These subsidies help make health insurance more affordable and accessible for those who would otherwise struggle to afford coverage.
The ACA implemented various insurance reforms to improve access to quality, affordable coverage for all individuals. These reforms include prohibiting insurance companies from denying coverage or charging higher premiums based on pre-existing conditions, eliminating annual and lifetime limits on coverage, and allowing young adults to stay on their parents’ insurance plans until the age of 26 (Centers for Medicare & Medicaid Services, 2021).
The Affordable Care Act has been a significant health care policy aimed at improving access to quality, cost-effective health care in the United States. Through mechanisms such as Medicaid expansion, health insurance marketplaces, and insurance reforms, the ACA has increased access to health insurance coverage for millions of previously uninsured individuals and families. Although the ACA has faced various challenges and criticisms, it has undoubtedly made progress towards achieving its goal of expanding access to affordable health care. Continuation and improvement of such policies are crucial to ensure equitable access to quality, cost-effective health care for all populations.