Health Care Utilization Paper

Health Care Utilization Paper

Miriam Jamero

HCS/235

April 15, 2014

Donna Ferguson

Health Care Utilization Paper

I chose the Option 1 for my utilization paper because I want to know more about The Affordable Care Act or the Obama Care and actually this is one of my burning question I would like to ask during our first day of class. I will try to expound this paper according to my research and knowledge but I would like to know and to learn more information in this course.
The Patient Protection and Affordable Care Act which was signed into law on March 23, 2010. Obama Care's health care reform does a number of important things including offering Americans a number of new benefits, rights, and protections to their health care and setting up a Health Insurance Marketplace where Americans can purchase federally regulated and subsidized health insurance. This new health care reform law in America, increases the quality, availability and affordability of private and public health insurance to 44 million uninsured. The law also works to curb the growth in healthcare spending in the U.S. which has been rising at an unsustainable rate.

This recent health care reform, its effort to decrease the number of uninsured Americans, making it a legal requirement for every American to get health insurance or pay a fine. The expansion of Medicaid, the creation of health insurance exchanges, and financial incentives for small businesses are some measures to name a few in expanding access to care. Medicaid program was created in 1965 to provide insurance for the poorest Americans and children. When the Medicaid open wide in 2014, all the new people who sign up above the federal government’s old income thresholds will be classified as “new eligible.” According to Tate (2013), “In the first year three years of Obama Care, the federal government will pay for 100 percent of all newly eligible people in Medicaid, with the level reduced to 90 percent by 2020” (p. 79). These levels of financial support for the states are much higher than the current contribution the federal government makes to each state to support Medicaid. Currently, the states only get between 50-75 percent of their Medicaid costs covered by the federal government. Today, on average, the federal government picks up 57 percent of the cost of Medicaid for each state.

Secondly, creating Health Insurance Exchange is one of their goal and they’re government regulated, meaning that the insurance sold to consumers has to meet specific quality standards. On the other hand, for some people who shop at the exchange will be provided money by the government to reduce the price they pay for insurance. Tate (2013) stated, “By 2019 roughly 25 million people are expected to use the exchanges to obtain quality coverage at an affordable cost” (93). This includes 16 million people who would otherwise be uninsured plus an additional 9 million Americans from the private and employer-based insurance markets who will be attracted by the lower cost and high value of exchange insurance plans.

Thirdly, the Obama Care’s help for small business goes beyond tax credit, meaning it will no longer will a small business have to buy insurance from a weak and isolated position as a single entity with only a handful employees. Buying through new business healthcare exchanges will allow them to become part of a much larger risk pool and eliminating on of the big reasons small firms have paid more for their health insurance than larger companies.

In contrast, with this Obama Care reform, I think it will be more expensive; with a higher premium and higher deductible to pay compared to our current insurance. One other example, if you are sick, you have to go to a hospital that is within your network and sometimes not the one close to where you live because it is mandated by the government. We should all want as many Americans as possible to have health insurance because everyone needs it but also be able to obtain the quality healthcare at a reasonable price. Given the emphasis that the new law puts behind decreasing the uninsured population, and the massive amount of money that the government has to spend, by expanding Medicaid benefits and providing subsidized health insurance through exchanges, is a long way for the Obama care to achieve.

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