Health Care Reform Legislation Chapter

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Quality of Care: Healthcare Reform

Health care reform legislation is expected to reduce health care spending by $590 billion over 10 years and lower premiums by nearly $2,000 per family by slowing the annual growth rate in national health expenditures. Discuss how this savings will be accomplished and what potential sacrifices in health care delivery may be experienced. Is the figure of $590 billion when calculated over a ten-year period really a significant savings?

The Affordable Care Act (ACA) was designed to make healthcare more accessible to a wider array of Americans and also more equitable in its method of delivery. Some of its provisions included requiring all adults (with some hardship exemptions) to have healthcare or pay a penalty. The hope was that expanding the risk pool of young, healthy insured who might otherwise forgo coverage would support the costs of some of the other provisions of the bill, such as prohibiting insurance companies from denying coverage based upon preexisting conditions. Insurance premiums are also subsidized for many Americans and Medicaid eligibility is expanded as a result of the Act (Sorrell 2012).

However, the benefits of the ACA were not universally enjoyed. Some found that their health insurance plans had been canceled because they did not meet the minimum standards of the ACA, including providing pediatric dental care, maternity care, and other provisions that individuals did not necessarily need or want; others found their monthly premiums go up and their deductibles likewise balloon (Keefe 2014).

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While some individuals found cheaper plans while shopping on the health insurance marketplace, this was not true of everyone living in all locations. Also, some patients were upset that their new plans were not accepted by their old physicians. "We have no choice to opt out of the required pediatric dentistry or maternity coverage we'll never use, so we'll eventually have to settle for less generous policies, with higher deductibles and out-of-pocket maximums" said one woman (Keefe 2014). Healthier individuals who were happy with relatively minimalistic plans now find they must purchase more comprehensive coverage, even if they are not particularly affluent.

Supporters of the ACA note that by expanding coverage, including preventative care visits, the hope is that early detection of serious illnesses combined with encouraging people to make meaningful lifestyle changes will foster cost savings by reducing the amount of heroic and expensive surgeries and interventions required to treat chronic diseases. Quite….....

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