Affordable Care Act GOVT 2305. Module 16

Cost Comparison Compared with other nations, is healthcare in America inexpensive, expensive, or about average?

Healthcare Costs Are High No country spends more on healthcare per person than the United States.

Cost trends Are healthcare costs in the United States increasing, decreasing, or holding steady?

Rising Healthcare Costs

Quality How does the quality of healthcare in the United States compare with that in other countries?

Life Expectancy

Infant mortality (deaths per 1,000 live births) Japan—3.2 Canada—4.8 France—4.2 USA—6.3 It is a reflection of the availability and quality of pre-natal and post-natal care. How is this statistic an indicator of healthcare?

Health Insurance Coverage Coverage before the ACA.

Summary (before ACA) U.S. healthcare most expensive in the world But life expectancy and infant mortality rates lag Healthcare costs rising rapidly Millions of Americans lack coverage Rising healthcare costs are a budget buster because of Medicare and Medicaid

Goals of Healthcare Reform Control costs Improve outcomes Cover uninsured

Healthcare Reform The Patient Protection and Affordable Care Act of 2010 significantly affect almost all elements of American healthcare.

Insurance Reform Insurance companies are no longer able to refuse coverage based on pre-existing conditions or to drop coverage of people who become ill. Companies can no longer impose lifetime coverage limits. Young people can stay on their parents’ insurance until age 26.

Business mandate Businesses with 50 or more workers must provide health insurance coverage for their employees or pay a fine to the government. Small businesses can receive tax credits to help cover the cost of insuring their employees.

Medicaid Expansion The measure expands Medicaid to cover childless adults earning at least 133 percent of the federal poverty level ($32,319 for a family of four in 2016, $15,800 for a single person), adding 10 million to 14 million people to Medicaid rolls. Although the federal government initially pays the entire cost of the additional enrollees, state governments will be required to pick up 5 percent of the extra cost in 2017, 7 percent by 2019, and then 10 percent from 2020 going forward.

Medicaid Expansion by State Notice anything interesting about the distribution? Most Democratic states have expanded; Most Republican states have not.

Individual Mandate Most people who are not already covered will be required to purchase a health insurance policy or pay an additional tax. Families earning less than four times the federal poverty level, which was $97,200 a year in 2016 ($47,520 for a single person), qualify for federal financial assistance to help them cover the cost.

Insurance Exchanges State governments were to set up health insurance exchanges, online marketplaces where businesses and individuals can shop for insurance policies. The exchanges will allow insurance companies to compete for customers by providing quality products at affordable prices. Undocumented immigrants will not be able to purchase from the exchanges even if they pay entirely with their own money.

Insurance Exchanges by State

Cost Control Mechanisms Insurance companies will pay a 40 percent tax on policies worth more than $27,500 for families and $10,000 for individuals, not counting the cost of dental and vision plans. These expensive plans are known as Cadillac plans because they require very low co-payments. With little or no out-of-pocket expense, beneficiaries have no incentive to control costs. The bill also includes a number of experimental approaches to cost-cutting designed to identify approaches that work. The tax on so-called Cadillac plans would take effect in 2018.

Funding The estimated cost of healthcare reform is $940 billion over the next decade, which will be covered by increasing tax rates on families making $250,000 a year ($200,000 for individuals). The measure raises additional revenue by taxing the so-called Cadillac insurance plans and from a 10 percent tax on indoor tanning services.

Trump Promises to sign ACA repeal

What You Have Learned How does healthcare in the United States compare with healthcare in other nations in terms of cost and effectiveness? What are the goals of the Affordable Care Act? What are the main features of the Affordable Care Act? What is the future of the ACA?