Brian Steensen
HCS 571
January 14, 2014
Theresa Pichelmeyer
Affordable Care Act, Helps or Hurts
The Affordable Care Act (ACA) is the most radical health care change through legislation by the United States government as Medicare. The Affordable Care Act has given over to the United States government the right to strictly regulate the whole of the health care system. The definition of socialism by Merriam-Webster is “any of various economic and political theories advocating collective or governmental ownership and administration of the means of production and distribution of goods” (Merriam-Webster An Encyclopedia Britannica Company, 2014). If this act is allowed to monopolize the health care industry …show more content…
as it has been designed to do health care within the United States will have to go to a single-payer system. The current health care system is a capitalist system the United States was founded on and cannot withstand the thousands of new regulations which various bureaucratic departments in the federal government have put in effect in the three years this bill was passed. It is been this goal that the Democratic Party has worked on for many years and is still working towards. Ex-president Bill Clinton made a speech September 3, 2013 that supported the act prior to the disastrous implementation in October 2013 (Eilperin, 2013). The act has plans to extend coverage to an estimated 30 million Americans who do not have medical coverage, make it easier for individuals to qualify for Medicaid, and help individuals paying for their medication by establishing protective tariffs (U.S. Department of Health & Human Services, 2014).
Consumer Implications
The act applies to all health insurance plans no matter if the consumer purchases it through the employer or purchases it themselves beginning in September 23, 2013 (U.S. Department of Health & Human Services, 2014).
In 2014 the act institutes an individual penalty for citizens who do not have the minimum coverage described in the act. It suggests that the distribution of wealth throughout the financial system will allow the care to be affordable but in reality creates financial hardships on health care organizations and individuals. The reduction of reimbursement through the Medicare and Medicaid systems is already having a financial impact on many of the smaller health care organizations. This in turn has affected the quality of care given to patients both in the inpatient setting and outpatient settings.
One of the benefits of the act is that consumers cannot be denied insurance because of pre-existing conditions. This allows previously uninsured consumers to receive health insurance that it previously been denied them (CMS.gov, 2013).
The act also allows families who make less than $22,000 a year to be eligible for Medicaid and to receive larger tax credits during the year (CMS.gov, 2013).
There are also specific procedures that health insurance companies are unable to charge deductibles for as immunizations, mammograms, and colonoscopies CMS.gov, 2013).
In certain states consumers will be able to purchase the health insurance plan through their state exchange that is cheaper than one through an insurance company. This is one way that the act is helping to create a monopoly on the health care organizations it interacts.
Employer Implications
The act has multiple regulations and directives throughout that deal with directives to employers with timelines all the way up to 2024. One of the major directives aimed at small businesses of 50 employees is that they will be penalized for not supplying health insurance by 2014 (CMS.gov, 2013). This is already an economic hardships on many small businesses and their employees because these businesses have converted many of the full-time employees to part-time to get to the less than 50 employee mandate. There is also the reporting requirement of the act that the employer has to report the value of any health benefits given to …show more content…
employees.
This this mandate cuts into many of the franchise businesses, such as the local U-Haul’s whose owners may own three or four different sites throughout a geographical area, and they have made employees cut down to 28 hours a week rather than the 30 to 40 hours they had previously worked.
In many cases employees who have worked for one employer now have to reenter the workforce looking for a second job.
In other areas Centers for Medicare and Medicaid Services has new regulations that mandate major changes in the way durable medical equipment company contracts are let throughout the United State (Durable Medical Equipment (DME) Center, 2013). This is led to national companies in the past few months in California releasing up to 50% of their workforce into the unemployment lines. The new policy of budget-neutral fee schedules has created problems for many the national and local contractors. There are still negotiations going on with Centers for Medicare and Medicaid Services for these continuing problems.
The nonprofit Blue Cross organizations now have a requirement for a medical loss ratio of 85% or higher to take advantage of IRS tax benefits (IRS, 2014). This is the total money spent on a procedure over the amount of money that will be incoming for Blue Cross to take advantage of any IRS tax benefits. This will impact the quality of care of the consumer and the bottom line of many Blue Cross
organizations.
Funding of the Act
When the Affordable Care Act was passed the estimated cost was $940 billion dollars. This money was to come from the taxation on the rich but 85% of that amount would come from families who earned $250,000 per year. There are also taxes that are not called taxes built into the bill such as a 10% tax imposed on cosmetic surgery which is what became effective after July 1, 2010 (CMS.gov,2013). There is also the medical device tax that has received so much press on the national news. Many of the new regulations that the various federal departments were charged with implementing the Affordable Care Act deal with methods to increase the money for running of the regulations and bureaucracy needed to implement this Act. There is also a new additional Medicare tax that went into effect January 1, 2013 of .9% on individuals wages (IRS, 2014). There are many more IRS regulations that have been created to fund this Act which are listed on the IRS sites but buried in many different areas of the tax codes.
Changes to the Act
The major change needs to be made to this act is to repeal it entirely and go back to the drawing board as it was poorly thought out. The thousands of new regulations thought up of by bureaucrats and politicians make it totally unrealistic to implement. This will probably not happen because too many politicians have their careers tied to the Act so the individual States need to exercise their constitutional rights in limiting the effects that the federal government is attempting to take over. The Acts intentions are admirable as the healthcare industry in the United States does need reform but to pass a law that was not even read prior to passing should be a criminal act. The United States was not set up on socialistic ideals, and as we have seen in the past socialism does not work, eventually bankrupts the countries who follow it. In the past few months since this Act has been implemented we now have politicians and leaders who are pitting the citizens of this nation against one another type of class warfare. This Act has greatly divided this nation and one of the smartest things that individuals do is to put pressure on federal politicians come up with viable alternatives to this Act.
References
CMS.gov. (2013, November 25). The Center for Consumer Information & Insurance Oversight. Retrieved from http://www.cms.gov/cciio/resources/Regulations-and-Guidance/index.html
Durable Medical Equipment (DME) Center. (2013). CMS.gov. Retrieved from http://www.cms.gov/Center/Provider-Type/Durable-Medical-Equipment-DME-Center.html
Eilperin, J. (2013, September 3). Bill Clinton make the case for Obamacare. Washington Post. Retrieved from http://www.wahingtonpost.com/blogs/post-politics/wp/2013/09/04/clinton-makes-the-case-for-obamacare/
IRS. (2014, January 9). Affordable Care Act Tax Provisions. Retrieved from http://www.irs.gov/uac/Affordable-Care-Act-Tax-Provisions
Merriam-Webster, An Encyclopedia Britannica Company. (2014). Merriam-Webster. Retrieved from http://www.merriam-webster.com
U.S. Department of Health & Human Services. (2014, January 12). HHS.gov/HealthCare. Retrieved from http://hhs.gov/healthcare/rights/sbc/index.html