Affordable Care Act and Insurance

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Affordable Care Act was passed by Congress in 2010 as an attempt to increase access to health care at a reduced cost. The Affordable Care Act offers lower cost of health care insurance while quality of care is still maintained with the use of regulations, taxes, and subsidies. The main purpose of the Affordable Care Act was not to take the place of private insurance but to regulate and lower the cost of health insurance for every US citizen in the country who was not able to pay health coverage. Universal coverage is a primary benefit brought within the Affordable Care Act to the American population, allowing people from different social status, gender and health conditions to be eligible for health insurance plans without being charged extra or being denied treatment. According to the Center of Health Research and Transformation (2012) more than one-third of the Affordable Care Act grant funding was awarded for state implementation of health insurance plans. This care act has subsidized premiums along with lower taxes without generally rising prices, leading to conclusions that indicate insurance companies would be forced to spread cost among other clients if state funding is not sufficient.

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Before the Affordable Care Act was enacted insurance companied had the right to denied coverage to those people who had a pre-existing condition, affecting about 50 million American people including children. People with pre-existing conditions often were either find their condition excluded from the plan, charged with a higher premium, or even denied coverage by private insurances. The denial of insurance coverage to those with pre-existing conditions led to higher cost in health care, as the lack of treatment results in frequent visits to the emergency department which expenses ended up being paid by Medicaid or taken by the hospitals. As the Affordable Care Act mandate that the entire population must be insured, insurance companies and state governments understand the mandatory coverage will include healthy consumers who will not submit claims, compensating for the cover of those who present pre-existing conditions (Amadeo, 2018). Affordable Care Act has proved to be an expensive plan to the insurance companies, the government and the healthy population as people with pre-exiting conditions require costly treatments.

According to the Kaiser Family Foundation (2012) the Affordable Care Act provides funding through financing new programs, extension of existing grant programs, new tax credit options and rebates to consumers to contribute to state and local governments, employers and providers with sufficient resources. Since the passage of the Affordable Care Act in March 2010 to April 2012, $12.1 billion had been awarded through ACA programs across the states. Affordable Care Act funding is divided across states ranging from 22.3% of funds going to entities in the West up to 27.9% of funds going to entities in the South (p.3). Over 47% of funding has been obtained through programs or tax credits for employers, along with projects in Medicaid and Medicare obtaining $984 million in each state aiming to approach care for population with pre-existing conditions. An advantage of this funding support intents to improve health and decrease chronic conditions among the population.

Patient and State Stability Fund is part of the Affordable Care Act that would divide $100 billion over a period of 10 years among states to help stabilize insurance markets. States that would receive the first 85% of the funds are those states with higher insured population presenting conditions that require treatments with higher cost rather than those states with lower enrollment and spending. The rest of the funds would be distributed to the states that have an increase in uninsured population or have less than three insurance companies in the market (Pearson & Sloan, 2017).

Affordable Care Act is intended to make insurance accessible to the American population. People with pre-existing conditions requiring high cost treatments are now being covered by insurance companies. Funding has been a concern when high cost treatments and pre-existing conditions have been discussed, however, state funding has been planned to cover and compensate the expenses of the treatments needed by the population. The expansion of Medicaid and Medicare along with the Patient and State Stability Fund bring advantages to maintain people covered even when presenting chronic conditions. Funding is expected to be distributed for a 10-year period among states given every American the opportunity to obtain health insurance even with pre-existing condition.

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Affordable Care Act and insurance. (2020, Mar 10). Retrieved November 29, 2022 , from
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