Ethica and Legal Aspects of Nursing Practice DQ 10 week 6
APA style and less than 10 % similarity
Please answer the following Discussion Question. Please be certain to answer the four questions on this week DQ and to provide a well-developed and complete answer to receive credit. Also, please ensure to have read the assigned chapters for the current week.
Case Study, Chapter 21, Health Care Reform: The Dismantling of the Affordable Care ActAs we entered 2018, millions of Americansstill relied onAffordable Care Act(ACA) subsidies, health premiums were soaring, and provider choice was more limited than ever.There was, however, momentum for reform. Health care was identified as the country’s leading priority for Democrats (54%) and the second highest priority for Republicans (42%) at the close of 2017. A group of registered nurses debate the issue of health care reform
.
1. The nurses debate whether the country feels that health care reform is really necessary. Discuss reasons why reform is needed and what that reform should address.
2. What were the 10 essential benefits guaranteed by insurance plans in the ACA Health Care Marketplace?
3. What are the successes of the ACA?
4. What are the failures of the ACA?
Chapter 2
1
Health Care Reform: The Dismantling of the Affordable Care Act
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1
Patient Protection and Affordable Care Act (PPACA)
Commonly known as the Affordable Care Act (ACA) or Obamacare
The relatively swift passage of the ACA came as a surprise to many
Over first six years of its implementation, partisan efforts to revoke it were almost constant
2016 election of Donald Trump as president placed efforts to repeal and replace ACA became front and center
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Why Is Health Care Reform Necessary
Costs are uncontrolled
Access is unequal
Quality health care rankings are poor
Medical errors permeate the system
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The Affordable Care Act: Successes #1
Provided the first real hope for Americans of significant reductions in numbers of uninsured
Provided great access to coverage for those with preexisting conditions
Mandated health-care insurance provision by employers
Critical strategies for ACA included bundled payments, accountable care organizations, value-based purchasing, and medical homes
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The Affordable Care Act: Successes #2
Businesses with more than 50 employees were required to provide health insurance or pay a fine
The individual mandate clause of the ACA required individuals to buy insurance or pay a penalty at tax time
Exemptions to this penalty were implemented in early 2018 (See Table 21.1)
With repeal of individual insurance mandate, the incentive for people to purchase health care insurance goes away in 2019
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The Affordable Care Act: Successes #3
New health insurance marketplaces (exchanges) were created as part of the ACA
Small businesses became eligible to buy affordable qualified health benefit plans in this marketplace
All exchange plans were required to provide 10 essential health benefits (see Box 21.1)
See Box 21.2 for a recap of the successes of the ACA
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Question #1
Is the following statement true or false
Under the mandates of the Affordable Care Act, all employers were required to provide health care coverage to their employees.
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Answer to Question #1
False
Only businesses with more than 50 employees were required to provide health insurance or pay a fine.
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The Affordable Care Act: Failures #1
The ACA was shrouded in confusion and misinformation
Broken promise that people who were satisfied with their previous coverage could remain on their plan
Consumers felt enrollment periods were too limited and the website was too complicated
Costs were often prohibitive for both the government and consumers
Despite the implementation of the ACA, the cost of health care insurance was out of reach for many
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The Affordable Care Act: Failures #2
The staggering cost of federal subsidies to insurers, and uneven allocation of their use was a concern
More Americans opposed the law than favored it by 2016
See Box 21.3 for a summary of ACA failures
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Legislative Efforts to Reform a Broken Health care System #1
Multiple bills to repeal and replace the ACA were introduced into the House or Senate in 2017 without legislative consensus (see Table 21.1)
Common theme was a reduction in mandates for individuals and businesses to buy or provide health insurance and defunding of government subsidies for vulnerable populations like the elderly or poor.
Every stakeholder organization weighed in to oppose repeal
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Legislative Efforts to Reform a Broken Health care System #2
The outcome of legislative efforts were highly partisan
Republicans tried to pass legislation to repeal portions of the ACA
Democrats unanimously held the line in opposition
The Medicaid program will be a prime target for reform in 2018
Deficit concerns created by the 2017 tax plan are influencing reform efforts
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Question #2
Which of the following agencies will be a prime target for reform in 2018?
A. Medicare
B. Medicaid
C. CHIP
D. Social Security Administration
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Answer to Question #2
B
The Medicaid program, which is projected to account for approximately $385 billion of federal spending in 2017, will be a prime target for reform in 2018.
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President Trump’s Incremental Dismantling of the ACA #1
President Trump has been successful in undermining what is left of the ACA by:
Cutting the 2018 open-enrollment period to half that of 2017
Cutting advertising by 90%
Reducing navigator funding by 40%
Closing the federal marketplace for maintenance several hours each week during open enrollment
Barring regional office staff members from cooperating in enrollment efforts
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President Trump’s Incremental Dismantling of the ACA #2
President Trump has been successful in undermining what is left of the ACA by:
Issuing an executive order endorsing approaches to siphoning off health individuals from the ACA market
Cutting of reimbursements to insurers to cover cost-sharing reductions for low-income individuals
Expanding access to association health plans
Easing restrictions on short-term health plans
Limiting consolidation within the insurance and hospital industries
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President Trump’s Incremental Dismantling of the ACA #3
President Trump has been successful in undermining what is left of the ACA by:
Increasing competition and choices in health care
Making cuts to the 340B Medicare drug discount program in 2017
Signing into law the Tax Cuts and Jobs Act passed by Congress
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What’s Ahead? #1
It appears that some things will stay the same:
Every county will have an insurer in their ACA marketplace in 2018
Health care consumers will still be able to sign up on the federal exchange or their state marketplaces
Subsidies will be available to help lower premiums or reduce deductibles and copays
If qualified consumers will be able to shop and compare coverage options
As of May 1, 2018, the uninsured rate remained at 9.1%
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What’s Ahead? #2
It appears that some things will change:
Young, healthy individuals should mean lower costs and the elimination of the individual mandate penalty
Healthy individuals would be eligible to purchase short-term association plans that would cost less but not guarantee unlimited annual or lifetime benefits
Health costs will rise for consumers with chronic illnesses
Cost will skyrocket for seniors who lose Medicaid coverage
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What’s Ahead? #3
It appears that some things will change:
Fewer people will be enrolled in the health care exchanges in 2018
Premiums for the benchmark silver health exchange plan in 2018 will soar 37% on average
Increases will occur in the gold plan as well though at a lower level
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Question #3
Is the following statement true or false?
Under Trump’s health care reform plan, if you have a chronic illness, you will most likely pay more for health care insurance.
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Answer to Question #3
True
Under Trump’s health care reform plan, if you have a chronic illness, your costs will rise because you will have to rely on the ACA plans on the exchanges. As health customers leave those plans, the companies will raise prices to remain profitable, resulting in rising health care cost nationally.
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End of Presentation
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