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Journal articles on the topic "United States. Patient Protection and Affordable Care Act"
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Schultz, David. "The Implementation and Evaluation of the United States Affordable Care Act." Medicine, Law & Society 12, no. 1 (2019): 17–38. http://dx.doi.org/10.18690/mls.12.1.17-38.2019.
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In 2010 the United States Congress adopted the Patient Protection and Affordable Care Act (“ACA”), more commonly referred to as Obamacare. The ACA was proposed by President Barack Obama while running for president and it was passed with a near straight party-line vote of Democrats in the US House and Senate in 2010. The ACA was meant to address several problems with the American health care delivery system, including cost, access and outcomes. This article describes the major features of the ACA including the context of the US health care system, evaluates the ACA’s implementation history and assesses its fate and future reforms throughout the presidency of Donald Trump. The overall conclusion based on its implementation is that while the ACA made significant reforms in terms of access to health care, it is not clear that it addressed affordability or began to improve health care outcomes in the US.
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Hoffmann, Jeffrey. "Preemption and the MLR Provision of the Affordable Care Act." American Journal of Law & Medicine 40, no. 2-3 (2014): 280–97. http://dx.doi.org/10.1177/009885881404000207.
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This Note focuses on the medical loss ratio provision (“MLR Provision”) of the Patient Protection and Affordable Care Act (ACA). The MLR Provision states that health insurance companies must spend at least a certain percentage of their premium revenue on “activities that improve healthcare quality” (in other words, meet a minimum threshold medical loss ratio) and comply with reporting requirements determined by the Secretary of the United States Department of Health and Human Services (HHS). Because states have historically had authority over the regulation of health insurance, there is an outstanding question as to whether or not the MLR Provision has legal authority to preempt conflicting state MLR regulations.Part II of this Note outlines the major requirements in the MLR Provision and discusses the history of MLR regulation in the United States. Part III discusses the likelihood that the courts will soon resolve the question of preemption regarding the MLR Provision.
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Gable, Lance. "The Patient Protection and Affordable Care Act, Public Health, and the Elusive Target of Human Rights." Journal of Law, Medicine & Ethics 39, no. 3 (2011): 340–54. http://dx.doi.org/10.1111/j.1748-720x.2011.00604.x.
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The passage of the Patient Protection and Affordable Care Act (ACA) in March 2010 represents a significant turning point in the evolution of health care law and policy in the United States. By establishing a legal infrastructure that seeks to achieve universal health insurance coverage in the United States, the ACA targets some of the major impediments to accessing needed health care for millions of Americans and by extension attempts to strengthen the health system to support key determinants of health. Yet, like many newly passed legislative provisions, the ultimate effects and significance of the ACA remain uncertain. Those charged with implementing the ACA face formidable obstacles — indeed, some of the same obstacles that have been erected to impede other major pieces of social legislation in the past — including entrenched political opposition, constitutional challenges, and what will likely be a prolonged struggle over the content and direction of how the law is implemented. As these debates continue, it is nevertheless important to begin to assess the impact that the ACA has already had on health law in the United States and to consider the likely effects that the law will have on public health going forward.
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Pratt, William Robert, and Jerry D. Belloit. "Hospital costs and profitability related to the Patient Protection and Affordable Care Act." Journal of Hospital Administration 3, no. 3 (2014): 100. http://dx.doi.org/10.5430/jha.v3n3p100.
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On March 23, 2010, President Barack Obama signed into law the Patient Protection and Affordable Care Act (PPACA). This law was one of the most controversial and transforming pieces of legislation impacting health care delivery in recent history. The legislation was created in response to rising health care costs and the belief that, in part, cost shifting of indigent uninsured care to paying patients would reduce the overall costs of health care. The recent Supreme Court decision upholding the individual mandate portion of the law is expected to significantly reduce the number of uninsured. Using operational data from 212 hospitals in California, this study examines the anticipated impact on hospital costs, profitability, and some patient outcome benchmarks from the restructuring of health care delivery in the United States by the PPACA.
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K. Quaye, Randolph. "The Patient Protection and Affordable Care Act (ACA) of 2010 and Ohio physicians." Leadership in Health Services 27, no. 2 (2014): 116–25. http://dx.doi.org/10.1108/lhs-10-2012-0037.
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Purpose – This paper aims to explore the perspectives of Ohio physicians on the Patient Protection and Affordable Care Act (ACA) of 2010. While much has been debated about ACA, relatively few studies have focused on how ACA will impact on physicians' practice behavior. Design/methodology/approach – The research data came from a mailed survey of ninety physicians randomly selected from the Cigna Directory of Physicians practicing in Ohio. Study examined how informed were physicians about ACA, and explored how much the effect of ACA has been discussed in their practice, how they think ACA will impact their practice, and whether or not they are in favor of the provisions under the Act. Findings – Overwhelmingly, while the physicians surveyed were familiar with the specific provisions of ACA, almost half of them opposed it. Primary care physicians reported generally favorable opinions about ACA. All but one of the physicians concluded that ACA, much like managed care provisions, has undermined and will continue to reduce the autonomy and professional independence of physicians. Research limitations/implications – This study is limited by its small sample and reliance on a small set of physicians. Practical implications – This study has practical implications for examining how Ohio physicians are responding to the new health care reform in the United States. It has broader implications for addressing the problem of the uninsured and the role of the federal government in health care provision. Social implications – If physicians are opposed to this reform as the study seems to suggest, it might have broader implications for future career aspirations for physicians. Originality/value – So far as we can tell, there has not been any exploratory study in Ohio examining the perspectives of physicians on ACA.
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Rovin, Kimberly, Rebecca Stone, Linda Gordon, Emilia Boffi, and Linda Hunt. "Better Than Nothing: Participant Experiences in Using a County Health Plan." Practicing Anthropology 34, no. 4 (2012): 13–18. http://dx.doi.org/10.17730/praa.34.4.754915t6lkh712q1.
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The United States health care system has reached a crisis point, with 49.9 million Americans now living without health insurance (DeNavas-Walt, Proctor, and Smith 2011). The United States government has responded to this crisis in a variety of ways, perhaps the most visible being the enactment of the Patient Protection and Affordable Care Act (ACA) in March 2010. With a goal of expanding access to health insurance to 32 million Americans by 2019, the ACA marks an important moment in the history of United States health care reform with the potential to drastically change the United States health insurance landscape (Connors and Gostin 2010). The law delineates only general categories of required benefits and leaves it to each state to decide the specific benefits that will be provided by the insurers in their state (Pear 2011).
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Thoene, Michael. "Unintended Consequences : the Financial Assumptions and Economic Theory of Obamacare : the Patient Protection and Affordable Care Act." Olsztyn Economic Journal 9, no. 3 (2014): 251–63. http://dx.doi.org/10.31648/oej.3180.
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This article examines the Patient Protection and Affordable Care Act (ACA,) often referred to colloquially as Obamacare, from a financial and economic perspective in order to analyze the potential efficacy of the system. Research was gathered pertaining to the stated objectives of the program, and economic theory was applied in order to reveal if the aims of the program are congruent with economic theory. It was found that the authors of the ACA did not anticipate or under-anticipated several economic effects of the legislation, which will hamper the implementation and effectiveness of the program. Furthermore, the economic theories employed by the Obama administration relied heavily upon classical economic theory, with little or no attention given to Transaction Cost Economics (TCE). Moreover, the law itself is overly complex and controversial due to a myriad of provisions added through the intercession of lobbyists from the healthcare, insurance and special interest sectors. The end result is that Americans may obtain a slightly improved healthcare system, but the United States will most likely still lag behind the rest of the industrialized world in many key health statistics.
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Moffit, Robert E. "Expanding Choice through Defined Contributions: Overcoming a Non-Participatory Health Care Economy." Journal of Law, Medicine & Ethics 40, no. 3 (2012): 558–73. http://dx.doi.org/10.1111/j.1748-720x.2012.00689.x.
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The Patient Protection and Affordable Care Act of 2010 (the Affordable Care Act) is the law of the land. But it faces an uncertain future.During congressional deliberations on the 2,700-page legislation leading up to its enactment, from February to March 2010, not one major survey recorded majority support for the legislation. Since its enactment, popular opposition to the Affordable Care Act has hardened, and was a significant factor in the 2010 congressional election, in which Democrats lost 63 seats and Republicans regained the majority in the House of Representatives. Ballot initiatives in Missouri and Ohio, showcasing popular opposition to the individual mandate, passed in 2010 with overwhelming majorities. While the United States Supreme Court in National Federation of Independent Business et al. v. Sebelius, 132 S. Ct. 2566 ( 2012), declared the mandate on the states to expand Medicaid unconstitutionally coercive, the majority of the Justices also upheld the individual mandate as a permissible tax. The new law thus emerged as a central topic in the 2012 election.
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Orentlicher, David. "Rights to Healthcare in the United States: Inherently Unstable." American Journal of Law & Medicine 38, no. 2-3 (2012): 326–47. http://dx.doi.org/10.1177/009885881203800204.
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Although international covenants have long recognized a fundamental right to healthcare, and other countries provide healthcare coverage for all of their citizens, rights to healthcare in the United States have been adopted only grudgingly, and in a manner that is inherently unstable. While a solid right to healthcare would provide much benefit to individuals and society, the political and judicial branches of the U.S. government have granted rights that are incomplete and vulnerable to erosion over time.Unfortunately, enactment of the Patient Protection and Affordable Care Act (ACA) does not change these fundamental weaknesses in the regime of U.S. healthcare rights. Millions of Americans will remain uninsured after ACA takes full effect, and rather than creating a more stable right to healthcare, ACA gives unstable rights to more people. As a result, even if ACA survives its constitutional challenges, access to healthcare still will be threatened by the potential for attrition of the rights that ACA provides.
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Kominski, Gerald F., Narissa J. Nonzee, and Andrea Sorensen. "The Affordable Care Act's Impacts on Access to Insurance and Health Care for Low-Income Populations." Annual Review of Public Health 38, no. 1 (2017): 489–505. http://dx.doi.org/10.1146/annurev-publhealth-031816-044555.
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The Patient Protection and Affordable Care Act (ACA) expands access to health insurance in the United States, and, to date, an estimated 20 million previously uninsured individuals have gained coverage. Understanding the law's impact on coverage, access, utilization, and health outcomes, especially among low-income populations, is critical to informing ongoing debates about its effectiveness and implementation. Early findings indicate that there have been significant reductions in the rate of uninsurance among the poor and among those who live in Medicaid expansion states. In addition, the law has been associated with increased health care access, affordability, and use of preventive and outpatient services among low-income populations, though impacts on inpatient utilization and health outcomes have been less conclusive. Although these early findings are generally consistent with past coverage expansions, continued monitoring of these domains is essential to understand the long-term impact of the law for underserved populations.
Dissertations / Theses on the topic "United States. Patient Protection and Affordable Care Act"
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Leimbigler, Betsy. "Mixed Frames of Obamacare: a Critical Discourse Analysis of the Intertwining of Rights and Market Framing Discourse Surrounding the Patient Protection and Affordable Care Act." Thesis, Université d'Ottawa / University of Ottawa, 2014. http://hdl.handle.net/10393/31780.
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This thesis investigates the complex relationship between political institutions and health care policy through framing techniques employed in political discourse in the Patient Protection and Affordable Care Act (PPACA). It addresses how rights and market framing interact in the development, passage and further discourses on the PPACA. President Obama’s discourses are analyzed using qualitative critical discourse analysis of five remarks and addresses given between 2009-2013. These speeches are unpacked and catego-rized to illustrate the change in framing techniques over time. Three main findings are presented after the analysis portion: market framing is used more frequently in the developmental stages of the PPACA, mixed rights and market framing are largely conveyed through anecdotes, and the “right to affordable health care” is forwarded as an argument. These findings support the main argument that rights and market frames have a high level of interaction in the development of the PPACA.
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Howard, Steven W. "Medicare managed care : market penetration and the resulting health outcomes." Thesis, 2011. http://hdl.handle.net/1957/26133.
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Managed care plans purport to improve the health of their members with chronic diseases. How has the growing adoption of Medicare Advantage (MA), the managed care program for Medicare beneficiaries, affected the progression of chronic disease? The literature is rich with articles focusing on managed care organizations' impacts on quality of care, access, patient satisfaction, and costs. However, few studies have analyzed these impacts with respect to market penetration of Medicare managed care.
The objective of this research has been to analyze the relationships between the market penetration of MA plans and the progression of chronic diseases among Medicare beneficiaries. The Chronic Disease Severity Index scale (CDSI) was constructed to represent beneficiaries' overall chronic disease states for survey or claims-based data, when more direct clinical measures of disease progression are not available. Using the CDSI on the MEPS survey dataset from AHRQ, we sought to assess the impacts of MA market penetration and other covariates on the overall chronic disease state of Medicare beneficiaries from 2004 through 2008.
Though the model explains much of the variation in CDSI change, the author expected the multilevel model would show that MA penetration explains a significant level of variation in CDSI change. However, this hypothesis was not substantiated, and the findings suggest that unmeasured factors may be contributing to additional unexplained heterogeneity.
Policymakers should explore opportunities to refine the current MA program. The MA program costs the federal government more than the Traditional Fee-for-Service Medicare program, and there is no definitive evidence that outcomes differ. Within both programs, there is opportunity to experiment with different models of payment, healthcare service delivery and care coordination.
The Patient Protection and Affordable Care Act (ACA) contains provisions for innovative demonstration projects in delivery and payment. The effectiveness of these ACA initiatives must be monitored, both for impacts on health outcomes and for economic effects. This research can inform future approaches to outcomes assessment using the CDSI, and multilevel modeling methodologies similar to those employed here.
Firms offering MA health plans would be prudent to proactively demonstrate their value to beneficiaries and taxpayers. They should explore means of better monitoring and reporting the longitudinal outcomes of their enrolled beneficiaries. Demonstrating that they can bring value in terms of improved health outcomes will help insure their long-term survival, both in the marketplace and in the political arena.<br>Graduation date: 2012
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Eliason, Erica Linn. "The Effects of Health Insurance Eligibility Policies on Maternal Care Access and Childbirth Outcomes." Thesis, 2021. https://doi.org/10.7916/d8-bwaq-kf37.
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This dissertation examines three health insurance eligibility policies and their impact on reproductive health outcomes for low-income women of reproductive age. The first paper examines the effects of expanded eligibility for Medicaid under the Affordable Care Act (ACA), on fertility among low-income women of childbearing age.
The second paper explores the effect of presumptive eligibility policies in Medicaid for pregnant women on access to prenatal care and health insurance coverage. Finally, the third paper exploits state-level differences in eligibility for public versus private insurance under the ACA, and the effects on perinatal coverage patterns, childbirth outcomes, and access to care.
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McCaslin, Brianna Jean. "Thou Shalt Not: Experiences of Contraceptive Use and Religious Identity Negotiation Among Married Catholic Women." Thesis, 2015. http://hdl.handle.net/1805/8363.
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Indiana University-Purdue University Indianapolis (IUPUI)<br>The Catholic Church is widely known for its opposition to birth control. Yet statistics show that the vast majority of American Catholics use birth control. While multiple studies have been conducted on a larger quantitative scale about the use or attitudes of American Catholics toward birth control, there have not been qualitative studies to understand the experiences of Catholics who use contraception. This study is particularly timely given the recent Catholic opposition to the Affordable Care Act’s mandate of employee healthcare provided birth control as well as, the extraordinary synod of bishops to discuss pastoral challenges to family life in October 2015. Fourteen married Catholic women were interviewed about their religious identities and experiences using contraception. Analysis demonstrated how these women constructed a religious identity by maximizing certain aspects, such as prayer and service, while minimizing other aspects, such as individual autonomy and denominational distinctions, of their religious identity. However in order to cope with the tension between their salient religious identity and their contraceptive decision making women utilizing multiple mechanisms. Specifically, they made boundaries around which types of contraception were acceptable and limits to church or individual authority; they justified their decisions based on medical necessity or betrayal they felt from the church; they legitimated their decisions by discussing God’s control and their husband’s perceptions of NFP; and they normalized their decisions through their desire to care for their children and be sexually intimate with their husbands. This research illuminates unique challenges that religious women face in their sexual decision making and sexual health practices that can help sex educators and health care providers care for women. Additionally, the Catholic Church and American Catholics make up huge forces in education, health care, charity, politics, and employment. However, not all Catholics follow the rules of the church. Those members who remain an active part of the Catholic Church, such as the practicing Catholics in this study can influence the way the church changes. By better understanding the experience of these dissenters, social researchers may be able to better understand the future of the Catholic Church.
Books on the topic "United States. Patient Protection and Affordable Care Act"
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Schmidt, Paul L. Medicare and the Patient Protection and Affordable Care Act. Nova Science Publisher's, 2011.
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Kipp, Raphael. Rules and rulemaking in the Patient Protection and Affordable Care Act. Nova Science Publishers, 2011.
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Gray, Benjamin J., and Kevin C. Sullivan. Provisions in the Patient Protection and Affordable Care Act (PPACA). Nova Science Publisher's, Inc., 2011.
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Dupont, Arthur T., and Sarah L. Peeters. Medicaid, children's health insurance, and the Patient Protection and Affordable Care Act. Edited by Library of Congress. Congressional Research Service. Nova Science Publishers, 2011.
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US GOVERNMENT. Compilation of Patient Protection and Affordable Care Act: As amended through November 1, 2010 including Patient Protection and Affordable Care Act health-related portions of the Health Care and Education Reconciliation Act of 2010. U.S. Government Printing Office, 2010.
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(Firm), Wolters Kluwer, ed. Law, explanation and analysis of the Patient Protection and Affordable Care Act: Including Reconciliation Act impact. CCH, 2010.
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Medicine, North Carolina Institute of. Implementation of the Patient Protection and Affordable Care Act in North Carolina: Interim report. North Carolina Institute of Medicine, 2011.
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Medicine, North Carolina Institute of. Implementation of the Patient Protection and Affordable Care Act in North Carolina: Interim report. North Carolina Institute of Medicine, 2011.
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Werner, David C. Enrolling in health insurance through the Affordable Care Act: A Texas case study / a project directed by David C. Werner, Samuel S. Richardson, A. Elizabeth Colvin. Policy Research Project on the Affordable Care Act, 2014.
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Citizen's guide to health care reform: Understanding the Afforable Care act. The Author, 2012.
Find full textBook chapters on the topic "United States. Patient Protection and Affordable Care Act"
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Knepper, Hillary. "Healthcare in the United States." In Advances in Public Policy and Administration. IGI Global, 2018. http://dx.doi.org/10.4018/978-1-5225-4177-6.ch007.
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Healthcare in the United States is a dynamic mix of public and marketplace solutions to the challenge of achieving the maximum public good for the greatest number of people. Indeed, in the U.S. the healthcare industry generates over $3 trillion in the economy. This creates a uniquely American paradox that is examined here. The basic structure of the U.S. public-private healthcare delivery system is explored. The dynamics of public sector involvement in healthcare delivery is reviewed, with particular emphasis on the impact of the Patient Protection and Affordable Care Act. Economic impact, employment indicators, and recent cost estimates of public revenue investment will be considered. Finally, a discussion about the future implications of healthcare for public administration in the 21st century is presented. Eight tables and figures present a visual and detailed explanation to accompany the narrative.
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Knepper, Hillary. "Healthcare in the United States." In Research Anthology on Public Health Services, Policies, and Education. IGI Global, 2021. http://dx.doi.org/10.4018/978-1-7998-8960-1.ch021.
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Healthcare in the United States is a dynamic mix of public and marketplace solutions to the challenge of achieving the maximum public good for the greatest number of people. Indeed, in the U.S. the healthcare industry generates over $3 trillion in the economy. This creates a uniquely American paradox that is examined here. The basic structure of the U.S. public-private healthcare delivery system is explored. The dynamics of public sector involvement in healthcare delivery is reviewed, with particular emphasis on the impact of the Patient Protection and Affordable Care Act. Economic impact, employment indicators, and recent cost estimates of public revenue investment will be considered. Finally, a discussion about the future implications of healthcare for public administration in the 21st century is presented. Eight tables and figures present a visual and detailed explanation to accompany the narrative.
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Franklin, Sekou, Pearl K. Ford Dowe, and Angela K. Lewis-Maddox. "Barack Obama and the Racial Politics of the Affordable Care Act." In After Obama. NYU Press, 2021. http://dx.doi.org/10.18574/nyu/9781479807277.003.0011.
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This chapter examines the Obama presidency, the politics of race and health care, and the role that African Americans played in shaping the Affordable Care Act (ACA). We argue that race—and specifically the elimination of racial and health disparities—was very much part of the ACA’s development. From the perspective of Black lawmakers health equity and patient protection advocates, who worked hand-in-glove with the Obama administration, the ACA was not race-neutral or indifferent to Blacks and the working poor. The law had special significance for African Americans despite Obama publicly discussing its impact in deracialized terms. Daniel Dawes, a leading advocate for health equity and author of the groundbreaking book 150 Years of Obamacare, called the ACA the “most comprehensive minority health law” and the “most inclusive [health] law” in the history of the United States. He identified sixty-two provisions that “directly address inequities in health care” that are embedded in the ACA.” This chapter thus argues that Obama’s ACA was substantively accountable to the coalition of Black lawmakers and activists—what we refer to as a policy ecosystem—who were purposeful about incorporating provisions in the bill designed to reduce racial disparities and income-based inequities in health care.
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Shim, Janet K., Jamie Suki Chang, and Leslie A. Dubbin. "Cultural Health Capital." In Understanding Health Inequalities and Justice. University of North Carolina Press, 2016. http://dx.doi.org/10.5149/northcarolina/9781469630359.003.0010.
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The 2010 Patient Protection and Affordable Care Act promulgated a number of fundamental changes to the United States health-care system. Less visible and controversial aspects included the creation of institutions and strategies to reduce health disparities and enhance the quality and patient-centeredness of health care. In this chapter, we offer the concept of cultural health capital (CHC) as a sociological intervention for analyzing these changes aimed at making health care more patient-centered, particularly for historically underserved populations. In particular, we use the notion of CHC to illustrate how patient-centered care is accomplished or undone through complex interpersonal and interactional work that is highly dependent on access to stratified cultural resources that both patients and providers bring to health-care interactions. In so doing, we aim to contest that racism in health care is the primary source of health inequalities. Instead we argue that patients’ and providers’ cultural assets and interactional styles—themselves the product of complex social, cultural, historical, political, and economic contexts—influence their abilities to communicate with and understand one another.
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Ruffin, T. Ray. "Reflections and Understanding of Quality Management in Healthcare." In Optimizing Health Literacy for Improved Clinical Practices. IGI Global, 2018. http://dx.doi.org/10.4018/978-1-5225-4074-8.ch009.
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Healthcare organizations (HCOs) leadership must be involved with patient safety inventiveness and healthcare strategy. Leadership is essential to implementing and sustaining continuous performance quality improvement for patient-centered care. Quality management is of extreme significance to the United States (U.S.) healthcare industry and patients. Included are an introduction and background of the U.S. healthcare systems as well as the joint commission and government mandates. One of the primary focuses of the chapter is to enhance health literacy by developing a robust lexicon of fundamental healthcare terms and concepts. Healthcare reforms such as Patient Protection and Affordable Care Act (PPACA) are explored. The quality of healthcare delivery, involuntary reporting, patient safety indicators (PSIs), prevention quality indicators (PQIs), and inpatient quality indicators (IQIs) are explained. The chapter culminates with a discussion focusing on transformational leadership and the strategies for quality management implementation, along with a conclusion.
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Reich, Adam D. "Conclusion." In Selling Our Souls. Princeton University Press, 2014. http://dx.doi.org/10.23943/princeton/9780691160405.003.0010.
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This book has examined the commodification of hospital care in the United States. It has looked at PubliCare Hospital, HolyCare Hospital, and GroupCare Hospital to highlight the contradictions between the mission of hospital care and the market for it. If PubliCare is reminiscent of the hospital's past, and HolyCare is indicative of health care's present, then GroupCare seems to anticipate health care's future. This concluding chapter considers some of the changes in the U.S. health care market and cites the impact of the Patient Protection and Affordable Care Act (PPACA, 2010). For example, the law imposes important new regulations on the insurance industry and promotes and incentivizes “evidence-based” medicine. The chapter argues that while PPACA certainly changes the market for hospital care, it does not resolve the market's contradictions. It also reflects on future prospects for hospitals and hospital care.
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Hershkoff, Helen, and Stephen Loffredo. "Health." In Getting By. Oxford University Press, 2019. http://dx.doi.org/10.1093/oso/9780190080860.003.0004.
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This chapter addresses the issue of health care for low-income people. The United States, virtually alone among developed nations, does not offer universal access to health care, leaving many millions of individuals without health insurance or other means of obtaining necessary medical services. In 2010, Congress enacted the landmark Patient Protection and Affordable Care Act (ACA)—popularly known as “Obamacare”—marking an important but incomplete response to the nation’s health care crisis. This chapter examines the ACA in detail, including its impact on Medicaid and Medicare, the major government health programs in the United States, its creation of Health Insurance Exchanges and tax credits to help low-income households obtain private health coverage, and the reform of private health insurance markets through a patient’s bill of rights, which, among other measures, prohibits insurance companies from refusing coverage for preexisting medical conditions. Perhaps the most critical aspect of the ACA was its expansion of Medicaid to cover virtually all low-income citizens (and certain immigrants) who do not qualify for other health coverage. Although several states opted out of the ACA’s Medicaid expansion, the Medicaid program nevertheless remains the largest single provider of health coverage in the United States. This chapter also provides a detailed description of Medicaid, its eligibility criteria and scope of coverage; the Child Health Insurance Program (CHIP), a government-funded health insurance program for children in households with too much income to qualify for Medicaid; and Medicare, the federal health insurance program for aged, blind, and disabled individuals.
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Lupia, Arthur. "Complexity and Framing." In Uninformed Why People Seem to Know So Little about Politics and What We Can Do about It. Oxford University Press, 2016. http://dx.doi.org/10.1093/oso/9780190263720.003.0016.
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Politics includes issues of varying complexity. By complex, I mean issues that have multiple and possibly interrelated attributes. While it is arguable that all issues have multiple parts, I use the notion of issue complexity to draw attention to the fact that some issues have so many attributes that educators must make decisions about which parts to emphasize. Consider, for example, the Patient Protection and Affordable Care Act, which the United States passed in 2010. If you haven’t heard of this bill, you may know it by another moniker: “Obamacare.” One measure of this law’s complexity is its length. It is 906 pages long. The law’s table of contents alone is nearly 12 pages. At 906 pages, and given its frequent use of technical language, it is likely that few citizens, including many candidates for office, are knowledgeable about every part of it. It is inevitable that many, and perhaps most, of the people who express public opinions on this issue base their arguments on knowledge of only a few of the law’s many attributes. (This fact, by the way, does not stop people from labeling as “ignorant” others who disagree with them about this law.) In all such cases, experts, advocates, and interested citizens encourage their audiences to weigh certain attributes of the law more (or less) than others when making decisions about it. Insights from previous chapters can help educators make choices about which of a policy’s or candidate’s many multiple attributes to emphasize when attempting to improve others’ knowledge and competence. From chapter 5, for example, we know that just because an issue is complex, it does not mean that an audience’s decision task is complex. Suppose that the task is whether to vote for a specific candidate for office who promises to defeat the healthcare law in its entirety or a candidate who makes the opposite promise. Suppose that we have consulted the relevant range of values and from that consultation we can define a competent choice in the election as the vote that a person would cast if they understood a specific and large set of facts about the law.
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Schmeida, Mary, and Ramona Sue McNeal. "Long-Term Care Spending Relevant to U.S. Medicaid Expansion." In Chronic Illness and Long-Term Care. IGI Global, 2019. http://dx.doi.org/10.4018/978-1-5225-7122-3.ch041.
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The U.S. population is living longer, placing a demand on long-term care services. In the U.S., Medicaid is the primary player in funding costly long-term care for the aged poor. As a major health reform law, the 2010 Patient Protection and Affordable Care Act, Public Law 111-148, gives financial incentive for states to expand Medicaid, transitioning long-term care services from facilities toward community care. Facing other funding obligations and recent recessions, not all states expanded their Medicaid long-term care program using the financial incentives. Some states continue to spend more dollars on traditional nursing facility care despite legislation. This chapter explores why some states spend more revenue on nursing facility long-term care despite enhanced federal funding to reform, while others are spending more on home and community-based services. Regression analysis and 50 state-level data is used.
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Schmeida, Mary, and Ramona Sue McNeal. "Long-Term Care Spending Relevant to U.S. Medicaid Expansion." In Sustainable Health and Long-Term Care Solutions for an Aging Population. IGI Global, 2018. http://dx.doi.org/10.4018/978-1-5225-2633-9.ch003.
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The U.S. population is living longer, placing a demand on long-term care services. In the U.S., Medicaid is the primary player in funding costly long-term care for the aged poor. As a major health reform law, the 2010 Patient Protection and Affordable Care Act, Public Law 111-148, gives financial incentive for states to expand Medicaid, transitioning long-term care services from facilities toward community care. Facing other funding obligations and recent recessions, not all states expanded their Medicaid long-term care program using the financial incentives. Some states continue to spend more dollars on traditional nursing facility care despite legislation. This chapter explores why some states spend more revenue on nursing facility long-term care despite enhanced federal funding to reform, while others are spending more on home and community-based services. Regression analysis and 50 state-level data is used.