Is Obamacare Still In Effect – Ten years after the passage of the Patient Protection and Affordable Care Act of 2010, evidence is emerging that major health care legislation has contributed to a slowdown in the growth of US health care costs.
The analysis, published in the March issue of the journal Health Affairs, coincides with the 10th anniversary of the law’s passage and shows how the law has affected health care costs, which now consume nearly a fifth of the US gross domestic product.
Is Obamacare Still In Effect
“It’s clear that several provisions of the ACA are reducing costs,” said lead author Melinda Bantin, MD, Mike Kerba Professor of Health Policy and Chair of Health Policy at Vanderbilt University School of Medicine. “We have to see if there is a will to continue these measures.
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The analysis examines key policy reforms included in the ACA, including Medicaid coverage expansion, Medicare payment reforms, and reforms to the private insurance markets. There have been extensive studies and evaluations of the law’s impact on health care costs in the country, but as of 2010 there are few accurate sources related to health care costs.
The study, authored by John Graves, Ph.D., associate professor of health policy, highlights areas where savings were found, including lower Medicare reimbursement rates and slower growth in areas where insurance exchanges are more competitive.
“While the ACA has made its mark, it’s also important to us that further action will be needed across all sectors and at multiple levels of government to sustain the relatively slow growth we’ve seen since the passage of the ACA,” Graves. said.
However, the biggest savings may come from cost-based payment initiatives that aim to create incentives for doctors and hospitals to provide high-quality care while controlling costs.
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“In our view, the increased emphasis on cost-based payers by non-Medicare payers, namely states and private insurers, is likely the primary driver of the slower growth in per capita spending that we have seen over the last decade,” the study said.
“It is virtually impossible to separate the exact impact of the underlying law from the underlying trends, but it is also nearly impossible to deny that the ACA has had a far-reaching impact on the costs of the entire health care industry,” Bantin and Graves. wrote “The most politically significant examples of high health care costs, including those related to the introduction of new drugs and out-of-network billing, have little or no connection to the ACA, while rising health care costs in Medicare, Medicaid, and even Marketplace plans appear to be coming to a ‘new normal’ at a slower pace.” Maureen Stewart believes the Affordable Care Act (ACA) saved her family. In 2014, Stewart was diagnosed with HELLP syndrome, a rare disease that causes problems with the heart, liver and the lymphatic system. As a result, she could not continue to work at full capacity, which meant losing her employer-paid health insurance. But luckily, she says, that same year her home state of West Virginia participated in the expansion of Medicaid coverage under the Affordable Care Act of 2010, and she was eligible.
Over the next few years, as the bad news continued to roll in, ACA advocacy continued to keep the Stewart family afloat. When Stewart was diagnosed with breast cancer, when her sister was diagnosed with a brain tumor, and when her daughter Peyton began having seizures, ACA continued to offer affordable treatment. Stewart and her sister were covered by the Medicaid expansion, and Peyton was covered by the Children’s Health Insurance Program, which was strengthened by the ACA.
Stewart says the ACA not only gave her and her family access to the treatment they needed, but it also changed their mindset about when to seek professional help first. When she and her siblings were growing up in California in the 1980s and 1990s, Stewart said they couldn’t afford medical care. “The criteria for going to the doctor was: ‘Are you bleeding?’ Have you lost a limb? According to Stewart, her father and brother never gave up on the idea. Even though they passed the ACA, they never got insurance. They thought it would be too expensive. Therefore, in recent years, when both of them began to have serious health problems, neither of them went to the doctor regularly. By 2016, both men had died: her father from prostate cancer and her 19-year-old brother from a massive pulmonary embolism.
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“My father and my brother are dead; my sister, my daughter, me, we all lived,” Stewart says. “The common denominator,” she says, “was health insurance.
It’s been 10 years since President Barack Obama signed the Affordable Care Act and proudly adopted its once pejorative name, Obamacare. But Law’s legacy remains as layered and complex as the Stewart family’s medical history. Thanks to the ACA, 20 million people in the US gained health insurance, and early studies show that the law has improved the health of Americans in several ways. It also helped reduce racial, gender, and ethnic disparities in enrollment. Between 2013 and 2018, the uninsured rate dropped by 10 percent for black adults and by more than a third for Hispanic adults. Other groups, including women and youth, have also made significant gains.
But the law also has serious gaps. Despite the high hopes of its creators, many health outcomes have not improved, marketplace-based insurance plans remain too expensive, and while national health care costs are lower than projected, the ACA’s report on cost containment is controversial.
In many ways, the ACA serves as a kind of socio-political Rorschach test for the US today. For many mainstream Democrats, the legislation is a partial victory: They won the House majority in 2018 in part on a platform of protecting and improving the ACA. Meanwhile, progressives say the law doesn’t go far enough.
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Many Republicans dislike the law. Republicans in Congress spent at least 70 seconds voting to repeal, repeal or replace the ACA, and conservatives filed three major challenges to the law at the Supreme Court. Fourteen states, most of them with Republican governors, continue to refuse to accept Medicaid expansions, and the Trump administration has successfully rejected several of the law’s most important provisions. But in 2017, when Republicans had the chance to kill the ACA outright, they balked. Despite holding majorities in the House and Senate, they could not agree on a replacement, and the late Senator John McCain prevented a full repeal that would have left most Americans without access to insurance. According to the latest Kaiser Family Foundation poll, 55% of Americans now support the law, a very large percentage.
One of the most popular provisions of the ACA ensures that people with pre-existing conditions cannot be denied coverage or charged higher premiums. Before its passage, insurers could charge higher prices or deny coverage entirely to all categories of people, including pregnant women and people with cancer. The ACA also eliminated annual and lifetime coverage limits that protect people with pre-existing health conditions.
Perhaps not surprisingly, researchers have found that good insurance is directly related to better access to health care, which in turn often leads to better health. Increased coverage through the ACA has led to a dramatic increase in early cancer diagnosis; improved treatment rates for diabetes, high blood pressure and kidney disease; and better self-rated health, research shows. There were other highlights: Some studies show that Medicaid expansion has helped people get evidence-based treatment for opiate addiction and quit smoking. More generally, the researchers found that the ACA reduced medical debt nationwide, reducing bankruptcy and poverty rates.
These improvements helped reduce the annual death rate for infants and people with heart disease, especially in states that opted for expanded Medicaid. One study found that if all 50 states expanded Medicaid as envisioned by the ACA’s framers, it would likely save 15,600 lives between 2014 and 2017.
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The main idea behind the ACA was to preserve free market competition by creating public marketplaces where people could buy private health insurance. It just turned out not to be the case. After the ACA went into effect, sick people who needed the most expensive care flooded the market, and many healthy people didn’t join at all. The results were frightening: premium costs rose and many insurers, finding the markets unprofitable, dropped out. This meant that customers in many regions were left with only a few, often very expensive, plans to choose from.
And then it got worse. Under the ACA, people with incomes up to 400% of the federal poverty level received subsidies to help them afford expensive insurance plans. But many middle-class Americans earn too much to qualify for this assistance and too little to afford to pay for it themselves. High deductibles in the marketplace and employer-sponsored plans have resulted in fewer than half as many people being insured than 10 years ago.
The Trump administration has been persistent in its push to dismantle the ACA. He succeeded in having the individual mandate declared unconstitutional; permitted plans that circumvent ACA coverage requirements; cut the funds that helped people subscribe
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