ACA and Public Health Flashcards
health care system challenges
- high costs and poor outcomes
- # of Americans ages 65+ will be nearly 100 million by 2060
- growth of government funded programs is not sustained
- larger number of Americans are uninsured
- there is a shortage of primary care physicians
- health and health care disparities
Purpose of ACA
ACA was meant to insurance coverage and access to care- designed to expand insurance access
Pre-ACA the following groups faced barriers to insurance coverage
- young adults- (people 19 would be off insurance (22 students))
- childless adults (could not get on medicaid no matter what salary is)
- very sick individuals (limits on annual of lifetime coverage)
- people w/ pre-existing condition (denied insurance if they had a health condition prior to the start of a new insurance plan)
Who’s plan was the ACA built on?
Mitt Romney insurance expansion plan
Most Controversial ACA provisions
- Quality, Affordable healthcare for all Americans
- The role of Public Programs
The ACA mandate reforms for EMPLOYERS
- dependents can be on their parents health insurance until 26
- penalties for companies with 50+ employees that do not have insurance
- tax credits for companies with <50 employees who provide insurance
The ACA mandate for health insurance INDUSTRY- attempts to stop insurance companies adverse selection
- guaranteed issue: cannot exclude people with pre-existing conditions
- No recession: cannot kick sick people off of their pans
- no annual or lifetime caps to care
ACA Mandate on individuals with health insurance
- everyone must have health insurance or pay a penalty
- government assistance with new “marketplace” for purchasing publicly sub-sized private insurance a expansion of public programs
Market places are for people to purchase insurance
individuals and small employee groups can purchase private insurance exchanges
3 Types of Marketplaces/exchanges
state, federal, state/federal poverty level subsides and tax credits available to offset costs
Medicaid
pre-ACA: childless adults
post-ACA: Medicaid will cover everyone under 133% of FPL
Additional Major Features of ACA
essential health, benefits package limit on annual out-of-pocket spending
ACA address public health
insurance plan must cover evidence-based preventive service, creation of prevention of Public Health Fund and created National Prevention, Health Promotion and Public Health Promotion
Challenges of ACA
- did not want to call it a mandate- a law in 2012
- but medicaid expansion provision was unconstitutional - allow state choose
Where is ACA today?
was successful in reducing # of uninsured Americans (30 mil. insured)
the uninsured individuals include:
- low income in medicaid, those unable to afford market place coverage, undocumented immigrants, low income immigrants
Trump weakened ACA
eliminated the individual mandate, supported work requirements for medicaid beneficiaries, ended subsidies to insurance participating in exchanges
