Legislation Proposal on Healthcare: Affordable Care Act and Medicaid

Abstract

This proposal is focused on healthcare legislation and how to allow equal and unbiased access to healthcare coverage for everyone. It will explain a variety of issues that are currently in our healthcare system today and will give ideas on how some changes need to be made for this healthcare system not to fail in the future. Issues that will be discussed and outlined in this proposal are, Affordable Care Act (ACA), Medicaid, fair enrollment, insurance and healthcare providers, and many others that play a role in our system. The main goal of this legislative proposal is to find a way to make healthcare more equally fair for all.

Introduction

Healthcare has been an issue that has been around for ages though so many presidents trying to change the system in the way they think and believe is fair for all Americans. Our current healthcare policy has only had a small difference due to the changes that have been made to the Patient Protection and the Affordable Care Act which was introduced to America, but even with this law that was passed on our system still has much more to change for it to be better. This proposal will discuss our current healthcare policy and also what our future holds when it comes to healthcare and actually making a difference in our policy. In conclusion, this legislative proposal will speak on new ideas and better decision-making that will help make this healthcare policy in America better.

Current healthcare system

The current healthcare system is based on a fee-for-service structure that is controlled by complex payment controls implemented by third-party payers (Steiner, 2014). The systems’ economy to this day is a very closed free market system something that has not changed. The government has a big part of control over the healthcare insurance policy and also the provider markets (Steiner, 2014). Many are against the idea of making insurance coverage universal because of reasons such as state, local, and federal government spending account for over a certain percentage of national health expenditures (CMS, 2015). One of the main questions that have always been a challenge in our current healthcare system today is whether healthcare coverage is a basic right or a privilege. (Bauchner, H., 2017). This is when Obama passed and wanted to make changes to our healthcare system and learn from previous presidents on how to make certain changes to this system. The Affordable Care Act was used to increase some of the health insurance competition within themselves by putting insurance exchanges and controlling the provider's profit using the Medical Loss Ratio (Feldman, Buysse, Hubner, Huffman,& Loe,2015). The Medical Loss Ratio is used for a specific percentage of health insurance that is well spent on medical care to improve health care quality (Feldman, Buysse, Hubner, Huffman,& Loe,2015). The Affordable Care Act is continually working to make changes and improve the quality of care for individuals.

Problems with the current system

There are still current issues with our healthcare system, this includes on the Patient Protection and Affordable Care Act which they were unable to resolve. The current healthcare system is based on a fee-for-service that is controlled by complex payment controls implemented by a third-party payer (Steiner, 2014). Improving the quality of the services provided can decrease revenues for healthcare providers, which is greater than the cost savings that they are able to achieve (Nix & O’Shea, 2015). The PPACA has taken precautions to reward providers who improve their quality of healthcare, but there hasn’t been the same for rewarding the patients who make sure to receive good quality healthcare (Nix & O’Shea, 2015). An issue that has also not yet been resolved with our healthcare policy system has been the competition among healthcare providers (Barros, Brouwer, Thomson, & Varkevisser, 2015). There are those that don’t think about the quality of care for their patients and only think about the cost and other things (Barros, Brouwer, Thomson, & Varkevisser, 2015). These providers should think more about their patients and how they care for them and try to make things the least costly, this can have a huge impact on healthcare. We would want to give all Americans the opportunity to have insurance, but these current issues need to be paid more attention to.

Future of Healthcare

If the healthcare policy is left as it is currently, the future is not looking so good for the generation to come. Especially when it comes to making changes to the current healthcare market due to the economy failing in the future. There needs to be a change with healthcare providers cutting down the ability to charge higher rates, large insurers, and cutting down the cost for that public payers as well as small insurers (Zeng, Liu, Ma, & Fu, 2018).

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Legislative proposal

This legislative proposal's main goal is to focus on what are the necessary things that need to be improved to ensure that our healthcare policy becomes better not only for today but also for the future. I will speak on different topics to elaborate more on each of them and speak on both insurance providers and healthcare providers. In order to make sure we improve the quality of healthcare insurance. Policymakers should take what has been given already which is the Affordable Care Act and continue off this policy (Obama B., 2016). They should continue to apply the health insurance marketplaces, and delivery system, reform, and increase federal financial assistance for those that enroll in the marketplace (Obama B., 2016). Making a public plan in areas where the healthcare policy is lacking and making prescription drugs a bit less costly (Obama B., 2016). This proposal will touch base on some areas where our healthcare policy could improve.

Insurance providers

For the part of insurance providers, it comes down to what would be more beneficial when it comes to The Affordable Care Act and the people in order to take action for the insurance companies and what they should be following with healthcare coverage (Bhatt & Beck-Sague, 2018). These insurance companies can first look into the stabilization of the common cost of living for the people, this should be taken into consideration because healthcare coverage should look beyond this when it comes to patient health. The medical loss ratio is used to see the quality care of healthcare, and a specific percentage needs to be used for the improvement to follow (Bhatt & Beck-Sague, 2018). Insurance providers should take action to look beyond these points for better healthcare quality care in the future.

Healthcare providers

In this section, I will explain how the healthcare providers which include those who work with patients, can improve the quality of care that patients receive from these places. There are programs that can reduce costs and show appreciation for not only healthcare providers but also patients. The program's main focus will be on quality care, how the practitioners work, and establishing a student loan repayment program. The purpose of a healthcare provider is to focus on their patients and make sure they receive the best care. In our current healthcare policy there is one program that has been enforced to practiced healthcare quality care which is the Patient Protection and The Affordable Care Act, these programs have taken the steps to address issues such as cost, mandates for efficiency, and all Americans to purchase health insurance and the new funds to expand Medicaid funding (Travis, Morris, Mayer, Kenter, Breaux, 2016). Lastly, tax incentives could be another good use to benefit our healthcare reform, but this will all depend on how it is being used because it can also be something negative as not motivating people to get health insurance. The Affordable Care Act has taken into use tax incentives when it comes to the reduction of healthcare costs (Morrow, Stinson, Doxey, 2018). This option would be more useful for a certain age group in this case the elderly when it comes to injuries or any sickness.

Medicaid

Expanding Medicaid in America would be something very essential and useful for our current healthcare policy. Many would not agree with this due to many different reasons. Medicaid expansion has been used in The Affordable Care Act but has definitely been talked about due that politicians want to shut it down (Courtemanche, Marton, Ukert, Yelowitz, & Zapata, D, 2016). In order to improve quality care for maternal and child health Medicaid expansion is a huge part of The Affordable Care Act (Courtemanche, Marton, Ukert, Yelowitz, & Zapata, D, 2016). Medicaid is offered only to a certain qualified group, which covers most expenses such as maternal services that is beneficial for women. This insurance coverage at times is taken for granted for many reasons, which should change there should be a stricter requirement to have this type of health insurance. One way that it can be checked on more with who gets Medicaid there should be a drug screening test in order to qualify for this insurance. There are many people who fraud and take advantage of using Medicaid that does not deserve to have this type of insurance. Some of these people don’t even need Medicaid it should be offered to those who truly need and deserve it.

National Board of Practice

Patients should be receiving the best care and quality when it comes to their health. The national board of practice needs to consider the best care for the patients this is where they fail to pay attention when it comes to our current healthcare policy. The National Health Policy should be advanced in this due that they usually attend many different conferences around the state on becoming better providers for patients (National Health Policy, 2018). For better quality and to improve this for our current policy, there should be surveys for patients to either take at clinics or be able to take home so the national board of practice can view and see what they need to improve on. Patients should be the number one importance to these practices and be more of a focus to better their quality care. Lastly, quality is something very important when it comes to these patients and the usefulness of the insurance.

Summary

In conclusion, we need to step in changing our current healthcare system because if we don’t take this seriously our future generation when it comes to healthcare coverage is not looking good. We should look into other states and grab some ideas from each other to better ourselves as one, both parties need to work together to come up with a better healthcare policy for all Americans. This proposal speaks on some major issues, but not as a whole on what really is going on with our current healthcare system. This proposal attempts to give some ideas on how to make things better for us all. The quality of care is a very important thing we should start with in improving healthcare. One of the major issues of making health coverage available for all is the cost and how to overcome this challenge should be the main focus.

References

1. Bauchner, H. (2017, January 03). Health Care in the United States: A Right or a Privilege. Retrieved from https://jamanetwork.com/journals/jama/fullarticle/2595503
2. Barros, P. P., Brouwer, W. B., Thomson, S., & Varkevisser, M. (2015). Competition among health care providers: helpful or harmful? The European journal of health economics: HEPAC: health economics in prevention and care, 17(3), 229-33.
3. Bhatt, Chintan B,M.B.B.S., M.P.H., & Beck-Sagué, C. M., MD. (2018). Medicaid expansion and infant mortality in the united states. American Journal of Public Health, 108(4), 565-567. doi:http://dx.doi.org.ezproxy.liberty.edu/10.2105/AJPH.2017.304218
4. Courtemanche, C., Marton, J., Ukert, B., Yelowitz, A., & Zapata, D. (2016, November 07). Early Impacts of the Affordable Care Act on Health Insurance Coverage in Medicaid Expansion and Non‐Expansion States. Retrieved from https://onlinelibrary.wiley.com/doi/full/10.1002/pam.21961
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6. Morrow, M., Stinson, S. R., & Doxey, M. M. (2018). Tax Incentives and Target Demographics: Are Tax Incentives Effective in the Health Insurance Market? Behavioral Research In Accounting, 30(1), 75-98. doi:10.2308/bria-51929
7. Nix, K. A., & O’Shea, J. S. (2015). Improving healthcare quality in the United States: A new approach. Southern Medical Journal, 108(6), 359-363. Retrieved from 10.14423/SMJ.0000000000000299
8. Obama B. (2016). United States Health Care Reform: Progress to Date and Next Steps. JAMA, 316(5), 525-32.
9. Steiner, E. (2014). The changing world of family medicine: The new view from Cheyenne Mountain. Annals of Family Medicine, 12(1), 3-5. Retrieved from http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3896529/pdf/0120003.pdf
10. Travis, R., Morris, J. C., Mayer, M., Kenter, R., & Breaux, D. A. (2016). Explaining State Differences in the Implementation of the Patient Protection and Affordable Care Act: A South/Non-south Comparison. Social Science Quarterly, 97(3), 573-587.
11. Zeng, X. X., Liu, J., Ma, L., & Fu, P. (2018). Big Data Research in Chronic Kidney Disease. Chinese medical journal, 131(22), 2647-2650.
12. 2018 National Health Policy Conference. (2018, February). Retrieved August 15, 2018, from http://www.academyhealth.org/events/site/2018-national-health-policy-conference