Blog 4: Obama's Affordable Care Act

In the 2008 Presidential elections, candidate Barack Obama key promise is to provide healthcare to every individual in America. In 2010, President Obama’s healthcare package named “The Affordable Care Act” became law. This is a significant change in the United States history of healthcare. Obama’s Affordable Care Act is comprehensive healthcare insurance reforms that will take four years to fully implement and will change many other existing healthcare insurance policies. In this blog, there will be an overview of what the Affordable Care Act is, who does it affect, and what does it mean for our country.

The Affordable Care Act have dramatically changed some of the existing policies and added newer policies. Overall, there are numerous changes, but four of many changes are the most important. The four major categories are: extending young dependent individuals medical coverage on their parents until age 26; admitting more patients into the federal funded insurance plan, Medicaid; admitting pre-existing patients into healthcare insurances; and providing all individuals with low cost healthcare insurance. Although there are many other dramatic changes to the healthcare reform; these top changes that affect both patients and the healthcare world.

One of the dramatic changes in Obama’s healthcare reform is extending the healthcare coverage for young individuals. Prior to Obama’s healthcare reform, young dependent individuals who are under their parent’s insurance policies, may only be insured until age 24. In order to qualify for healthcare insurance under the dependent’s parents, the individual must have a birth certificate to prove   and verify the dependent is the child of the policy holder. Since Obama’s healthcare reform, the insurance coverage is now extended to age 26 with verification proving the status of relationship and verification of a full time college student status. If the dependent is no longer a student or cannot verify they are a full time student status, the coverage is no longer valid. Even though, the new healthcare reform may provide dependent individuals a longer coverage period, but the dependent must be in school to receive such services. Hence, the new healthcare reform may indeed provide a significant benefit for college students under their parent’s health insurance, but it is also a negative effect on those who are not.

Another dramatic change in Obama’s healthcare reform is allowing more patients into the federally funded Medicaid health insurance program. Prior to Obama’s healthcare reform, Medicaid is a federal mandated -state enrolling insurance policy, requiring certain eligibility to be fulfilled.  Medicaid is a requirement based insurance company and not every patient may be eligible. According to the 2007 requirements, Medicaid only enrolls the follow mandatory group: children, pregnant women, seniors, and disabled individuals. Since the Affordable Care Act, states have the ability to continue enrolling patients under the old mandatory guidelines, and additionally enroll patients that have an annual income below the federal poverty line. With Obama healthcare reform, state officials have been given a higher authority in enrolling individuals without the specific mandatory requirement. Such authority results in higher enrollment of individuals with low annual income, but without the mandated requirement to qualify. However, in many states like California, where budget is an issue, there has not been an increase in enrolling individuals onto Medicaid. Hence, many individuals will be enrolled based on the pre-Obama’s healthcare reform, while other will have some sort healthcare insurance by the new reform.

In addition to enrolling more individuals through Medicaid, the new healthcare reform made enrollment of patients with pre-existing conditions mandatory. This mean insurance companies and healthcare providers cannot turn down any patients with any sort of medical conditions. Prior to the new healthcare reform, insurance companies and healthcare providers had the rights to refuse insuring patients with pre-existing conditions. For example, if a patient has been diagnosed with cancer, there will be zero healthcare insurance coverage by any company or healthcare providers. This is due to the fact that the possibility of surviving is low; therefore, insurance companies and healthcare providers cannot sustain the cost for treatment. The insurance companies or the healthcare providers believe the amount of money paid by the patient is not equal or greater than what the overall cost of the treatment may be. Hence, 99% of the time, pre-existing condition patients are turned away. However, with the new healthcare reform, it is illegal for any insurance company or healthcare provider to reject any patient with any pre-existing conditions. Even though if a patient is diagnose with cancer, and is not expected to survive, that patient must be treated by any healthcare provider of their choice. In addition, all cost must insured within the tier similar to other patients who are insured prior to an existing condition. Lastly, if the patient indeed passes away with the pre-existing condition, all cost must be deducted by half or may be paid in full by the healthcare provider. This is one of the few reforms that are benefiting for all people in the United States. No matter how sick a person may be, there are treatments available and no one will be turned away.

Overall, Obama’s healthcare reform is revolving under one major goal, affordable healthcare insurance for all individuals in the United States. Although, there are many new individuals are now insured by the new reforms, such as: the new Medicaid regulation and all pre-existing condition patients must be insured. However, there are many more remains uninsured with any sort of healthcare insurance. Thus, the primary portion of this reform is to provide low costing healthcare insurance. Since the passing of the Affordable Care Act, there are various insurance and healthcare companies competing to offer the lowest cost to the individuals. This is a significant breakthrough for many individuals who can afford healthcare insurance. Even though the Affordable Care Act provides healthcare insurance to all individuals in the United States, there should not be any problems. However, the main issue now is how the healthcare system can provide all individuals with healthcare services. If every patient is insured and is constantly using the healthcare system for emergency and non emergency services, the system will be overwhelmed.  Prior to any reforms, there is a demand in increase of nurses, doctors, and any medical staff. After the reform, patients grew in numbers, while the number of nurses, doctors and medical staff stayed the same. Hence, the overwhelming demand for medical services does not meet with the number of staff that can provide the necessary medical aid. In short, there are millions of new insured patients using their medical insured services, but the healthcare system remains the same. Hence, there are more patients than healthcare system personnel and resources. In conclusion, the Affordable Care Act may provide affordable insurance to individuals, but the healthcare systems cannot sustain overwhelming needs of service.

The Affordable Healthcare Act is an act that had both the Republican and Democratic parties fighting and debating. There are many people who oppose this act and at the same time there are many people who are in favor of this act. No matter how strong one person’s take on this act may be, the act have passed and the people of United States will now have to live by it. The act may have benefited many people in the United States, but at the same time the act have harmed many others. For example, majority of the uninsured population are now able to be insured, but the negatives are the increase of workload and overwhelming patient in the healthcare provider. Hence, poor quality services, and patients are not receiving the full medical attention they deserve. However, vice versa, healthcare providers are now required to serve all people with or without insurance, which would benefit patients with pre-existing conditions. Nevertheless, the Affordable Healthcare Act has positives and negative affects in our country, but in the end, all comes down to our economics and politics in play.       

            

Blog 3: Cutting Edge in Protecting Individual Health in America

Healthcare reform has never settled with a strong structure of medical coverage for the people of the United States. Until 1965, President Lyndon B Johnson enacted a law that would change the course of medical coverage and health insurance. The new cutting edge programs were called Medicaid and Medicare.  Medicaid and Medicare were created for the American people providing a primary solid structure of American health insurance. The signing of Medicaid and Medicare into law is a historical landmark event that changed people lives significantly. Since the signing of the original signing of Medicaid and Medicare, many presidential administrations continue to reconstruct the coverage to be more beneficial to patients. This blog will primary focus on the differences between the two types of insurance, and the affect on patients and the healthcare system.

Medicaid and Medicare are two different medical insurance policies, and both insurances are based on different group of people in the United States. Medicaid is a federal funded program that requires states to cover a mandatory group of people. Included in this mandatory group are: children, pregnant women, seniors, and individuals that are with some kind of disabilities. Although this is the mandatory group of people that the federal government required; the federal government also gave the states the authorization to insure certain groups that is not within the mandatory group, such as orphan children, or single individuals that lives below the poverty level. Even though the mandatory group of people are eligible, this group must also pass the two exceptional standards that are set by both the federal and state government.  First, each individual or family must show proof of an income that is below federal poverty level and second, providing proof of significant financial need to the state. However, states may give admission to groups that does not satisfy the eligibility requirement (disabilities), because the group satisfied with the two exceptional standards set forth by the federal and state. Medicaid is not meant for individuals who are above the poverty level, without disabilities, or for those who could afford medical insurance. Medicaid is for the population with disabilities, and for those who cannot survive to pay for their own medical insurances.

Medicare is also a federal funded insurance program that serves three types of population. Medicare serves the population of citizens who are sixty-five and older, sixty-five and older with disabilities, and all ages with end-stage renal disease. Medicare is a premium package that allows eligible group to choose the best package for their health. Medicare is divided into four parts, and each part has different type of medical coverage. Part “A” is hospital coverage; all expense that is allocated within a certain amount days will be insured and no extra cost to the participant. For example, if an individual is hospitalized for two weeks for whatever reasons, all medical expense will be covered. The individual will not receive a bill to pay, because Part “A” of Medicare covers 100% of all cost up to sixty days. Part “B” is outpatient coverage; all expense that is allocated through programs, treatments, devices, and related items are insured. For example, an individual with hip replacement requires physical therapy, and a wheel chair for recovery, therefore all of these costs would be considered out of hospital cost, which are covered by Part “B” of Medicare. Part “A” and “B” are the premium package that all individuals have the rights to use when individuals are eligible. In addition, individuals would have the option to enroll in Part “C” and Part “D” coverage. Part “C” is a plan that is similar to both Part “A” and “B”, but instead of receiving and paying for all services. Part “C” allows the individual to pick and choose the private insurance company, type of services, and type of cost to be covered. This part is considered as the advantage plan which helps save money on services that will never be used. However, Part “C” will not cover any services that are not purchased; therefore individual will be billed when a service is not coved. Lastly, Part “D” is a plan that subsidizes the cost for prescription medications. For example, a prescription medication of thirty Zantacs pills would originally cost $60.00, but with Part “D”, the cost results at $10. Part “D” is a significant addition to the premium package. Medicare is an insurance plan that would insure many more individuals, and insure individuals to the best of each individual needs.

Medicaid and Medicare are two different types of insurance policies. When Medicaid and Medicare were created, healthcare systems prefer to accept one over the other.  Hence, individuals have limited choices and preference in selecting a suitable healthcare provider. However, over the years, through many presidential administrations, limitations, regulations and policies are enacted to prevent healthcare system from avoiding treatments. For example, under President Ronald Reagan, COBRA was implemented requiring employers to provide medical insurance to employee, and required all healthcare system to accept any type of health insurance coverage. With such changes, individuals can select their preferences in healthcare provider. In addition, individual can receive the best qualities and services by healthcare professions. In present day, under President Obama new healthcare reform, many individuals can expect to be accepted in all sorts of medical insurance policies including Medicare and Medicaid. Even with such changes, Medicare and Medicaid have already changed the lives of many people in the United States and will continue to change the lives of many more.