Health Care Reform Matrix
With your learning team, complete the Health Care Reform matrix below. Listed in this matrix are some of the topics addressed by the Patient Protection and Affordable Care Act policy. You are required to describe the issue, in your own words, and list 2-3 points about each topic under each heading in the matrix.
Describe the issue:
Key concerns regarding the issue:
How is this issue addressed in the current health care environment?
How will this issue be addressed by the Patient Protection and Affordable Care Act?
Patient Bill of Rights
A newly implemented set of protections that apply to health coverage starting on or after September 23, 2010. The patient bill of rights was implemented to end common insurance abuses such as discrimination against children with preexisting conditions, ban on insurance companies dropping or limiting coverage for individuals in their utmost time of need, and coverage for preventive care.
In the past insurance companies were known to deny coverage for people with preexisting conditions including children. Also in the past insurance companies were allowed to deny coverage for preventive treatments.
Currently in the health care environment insurance companies are no longer allowed to discriminate against children with preexisting conditions and are not allowed to deny or limit coverage. Individuals are now entitled to coverage regardless of their health status.
The affordable care act has implemented the patient bill of rights which makes it mandatory for insurance companies to accept individuals and provide coverage regardless of their health status and regulates coverage for certain preventive testing mandatory such as cancer screening, immunizations and hearing and vision test for children and newborns
Medical Loss Ratio
Medical loss ratios are defined as when an insurance company spend a substantial portion of consumer premium dollars on administrative costs and profits
References: About.com. (2013). Retrieved from http://patients.about.com/od/AffordableCareAct/a/Pre-Existing-Conditions-And-The-Affordable-Care-Act.htm CFDA, (N.D). Affordable Care Act (ACA) – Consumer Assistance Program Grants. Retrieved from: https://www.cfda.gov/index?s=program&mode=form&tab=core&id=a8b2f9cc8e4dee31438c7bf8cf918532 Healthcare.gov. (2014). Retrieved from https://www.healthcare.gov/health-care-law-protections/pre-existing-conditions/ Healthcare.gov. (2014). Retrieved from https://www.healthcare.gov/health-care-law-protections/grandfathered-plans/ Health Policy Briefs. (2013). Retrieved from http://www.healthaffairs.org/healthpolicybriefs/brief.php?brief_id=84 Kaiser Family foundation, (Feb, 29, 2012). Explaining Health Care Reform: Medical Loss Ratio (MLR). Retrieved from: http://kff.org/health-reform/fact- sheet/explaining-health-care-reform-medical-loss-ratio-mlr/ Marketplace insurance categories. (2014). Retrieved from https://www.healthcare.gov/choose-a-plan/plans-categories/ Medicaid Expansion Good for the States?. (2014). Retrieved from http://www.usnews.com/debate-club/is-medicaid- expansion-good-for-the-states U.S Department of Labor. (2014). Retrieved from http://www.dol.gov/ebsa/faqs/faq-dependentcoverage.html