Patient Protection and Affordable Care Act
Patient Protection and Affordable Care Act
In 2010, President Barack Obama enacted the Patient Protection and Affordable Care Act, providing for a comprehensive system of mandated purchasing of health insurance over a four-year period of time. This article focuses on the pros and cons of this landmark health care reform bill.
Luther and Hart (2014) wrote about the Patient Protection and Affordable Care Act (ACA) that President Obama signed on March 23, 2010. The act was about comprehensive health care and health insurance reform. It was designed to create a patient bill of rights and to encourage the use of evidence-based practices.
The hospitals are reimbursed for how closely they follow best clinical practices, instead of being reimbursed for the number of services provided (Sherwood and Barnsteiner, 2017).
Pros of the Bill
Some pros to the bill include having preventive care costs covered, insurance companies are no longer to deny coverage due to a pre-existing condition, children are covered under their parent’s insurance until they reach the age of 26, it offers drug discounts to seniors, and it removes lifetime limitations (Kearney-Nunnery, 2015).
Cons of the Bill
Some cons to the bill include if an uninsured person did not buy coverage, they are taxed. Millions lost employment-based health insurance. There was an overall increase in health care costs related to the fact that people who had gone without preventive care were now having care done. Because they had let issues go, the cost to fix was even higher.
Pharmaceutical companies pay out billions and have passed on their share of the cost to the consumer. Also, the family deduction medical cost went from 7.5% to 10% (Vittana.org, 2018).
It is 2018 and controversy still surrounds this bill. It was meant to reshape the delivery of care in our healthcare system. I think each person may have a pro and a con to how their insurance may have changed. I do think it has set forth increased use of evidence-based practices. Soon we will find out if the bill continues or will be overturned.
Case Example
I work in a long-term care/rehab facility. Currently, for October, we have admitted 53 residents. Out of those, 19 have been sent back to the hospital within the first few days or week of being discharged. I do not believe the hospital always follows best clinical practices. Since the Affordable Care Act (ACA) passed, the hospitals are paid for how closely they follow best clinical practices, instead of being reimbursed for the number of services provided (Sherwood and Barnsteiner, 2017).
The hospitals are eating many costs related to sending patients home too early. Under the ACA hospital readmission and reduction program, the goal was to reduce the rate of readmissions. Reducing the rate was considered a high priority of the reform. The hospitals are receiving financial penalties related to Medicare patients having needless readmissions (Alper, O’Malley, and Greenwald, 2017).
References
Alper, Eric., O’Malley, T., and Greenwald, J. (2017, December 19). Hospital discharge and readmission. https://swanvalleymedical.com/wp-content/uploads/2022/03/56-Hospital-discharge-and-readmission-UpToDate.pdf
Kearney-Nunnery, R. (2015-09-15). Advancing your career concepts of professional nursing, 6th Edition. F.A. Davis Company.
Luther, B. and Hart, S. (2014). What does the affordable care act mean for nursing? Orthopedic Nursing, 33(6), 305-309. https://doi.org/10.1097/NOR0000000000000096
Sherwood, G., & Barnsteiner, J. (Eds.). (2021). Quality and safety in nursing: A competency approach to improving outcomes. John Wiley & Sons.
Vittana. (2018). 19 Key Obamacare pros and cons. https://vittana.org/19-key-obamacare-pros-and-cons