Health Policy in the United States

Health Policy in the United States

Health Policy in the United States 150 150 Peter

Health Policy in the United States

The Patient Protection and Affordable Care Act (PPACA) requires that U.S. citizens and legal residents obtain qualifying health coverage. Write a report of 4-5 pages that explores the individual mandate section of this health reform law and how current legislation impacts this. Complete the following:

Explain the individual mandate included in the PPACA including the tax penalties imposed if a person or family had not obtained qualifying health coverage.
How has mandated health insurance coverage under PPACA worked? What impacted its success? If you were required to make one policy change or enhancement to ensure success of an individual mandate such as included in the PPACA, what would you recommend?
Assess the historical relationship between the cost of health care and outcomes in the United States with the cost of health care and outcomes in another country. What policies could be considered to assist in changing the relationship between costs and outcomes to a more efficient relationship in the United States, if at all?
Note: Your report should use APA formatting, and you must include 4 references, 2 of which are peer-reviewed sources from health care journals and published within the last 5 years.

Reference

United States Census Bureau. (n.d.). http://www.census.gov/

Sample Paper

Health Policy in the United States

The US has experienced various healthcare reforms. One of them includes the Patient Protection and Affordable Care Act (PPACA). This health care reform legislation was signed into law in 2010 by President Obama. Its goals include increasing access to healthcare, improving health insurance and the quality of healthcare offered to patients, and reducing health-care-related spending in the US. This healthcare reform law comprises various provisions which focus on increasing health coverage across the nation. One of them is an individual mandate. This provision requires all citizens and legal residents in the US to have health insurance (Fiedler, 2018). This essay explains ACA’s individual mandate provision in the healthcare reform law and how current legislation impacts the provision.

Individual mandate is a provision within ACA that focuses on increasing coverage in the US. It requires uninsured individuals to acquire a health insurance plan. Those who fail to do so are subjected to a tax penalty. In 2014, the average tax penalty was around $ 210. In 2018, the middle-income family of four earning an income of $60 000 was to pay a tax penalty of $ 2085 (Fiedler, 2018). An individual was exempted from the tax penalty if he/she is considered eligible for set exemptions. However, the federal individual mandate was eliminated in 2018. Although some states still have their individual mandates and other related penalties. For instance, New Jersey, California, Massachusetts, and Rhode Island have implemented individual mandates. This provision affects those individuals who have not purchased the minimum essential coverage (Fiedler, 2018). Many Americans are currently under employer-sponsored health insurance or government-sponsored health insurance programs, including Medicaid and Medicare, which are the minimum essential coverage. Therefore, a small percentage of Americans have not purchased the minimum essential coverage in the US. This provision was included in PPACA to increase the number of healthy people enrolled in coverage.

The main aim of mandated health insurance coverage under PPACA was to make health insurance available to all people, regardless of their pre-existing conditions. However, it has worked in various ways. The federal mandated health insurance came into effect in 2010 and operated until the end of 2018. It was eliminated after enacting the Tax Cuts and Jobs Act in 2019 (Breed, 2018). However, there are still some states providing the mandated health insurance. They include New Jersey, California, Massachusetts, and Rhode Island. Mandated health insurance was established to minimize healthcare costs (Breed, 2018). It allows more people to be insured at a lesser rate per person. Therefore, as more people get insured, taxpayers will have lower monthly premiums on average. Since the establishment of ACA, the healthcare costs and the number of uninsured individuals have decreased. This can be attributed to various ACA provisions, including an individual mandate.

ACA has contributed to a decline in uninsured individuals. Currently, a small percentage of Americans who have not purchased the minimum essential coverage in the US. In 2020, 8.6 percent of US residents, or 28.0 million, did not have health insurance at any point during the year (United States Census Bureau, 2021). Several Americans are already under employer-sponsored health insurance or government-sponsored health insurance programs (Fiedler, 2018). Various ACA provisions have contributed to this positive change include the individual mandate. Besides, the effectiveness of this provision can be enhanced by increasing the tax penalty. Larger individual mandate penalties can lead to improved enrollment. Secondly, there is a need to reduce the groups of people exempted from this provision. Several groups exempted from ACA’s mandate meant fewer people would face the penalty. Thus, this reduced its effectiveness (Fiedler, 2018).

The US has been spending the highest percentage of its GDP on healthcare since 1980 up to 2018 compared to other OECD member countries, like the UK (The commonwealth Fund, 2020). In 2018, the US spent 16.9 of its GDP on healthcare, while in 1980, its expenditure was about  8.2 of its GDP. On the other hand, the UK spent 9.8% and 5.0% of its GDP on healthcare in 2018 and 1980. However, the US has been experiencing low outcomes despite its high healthcare spending. For instance, in 2017, the US recorded a life expectancy of 78.6 years, while the UK recorded 81.3 years, showing that the US recorded the lowest life expectancy compared to all OECD member countries (The commonwealth Fund, 2020). Also, US adults have a higher burden of chronic disease, the incidence of obesity, and avoidable mortality rate compared to the UK (The commonwealth Fund, 2020). Various policies ore measures need to be implemented to improve the relationship between healthcare spending and health outcomes in the US. One of them includes promoting the incentives to use effective care and policies that discourage ineffective care. Also, the US needs to strengthen access to care and primary care systems. This will help enhance the management of chronic conditions hence reducing the burden of chronic health conditions in the US.

In conclusion, healthcare reform laws such as PPACA have impacted the US healthcare system in various ways. For instance, this healthcare reform law comprises provisions like individual mandate that aims to enhance coverage in the US by imposing a tax penalty on the uninsured. However, the success of this policy has been undermined by policies, such as the Tax Cuts and Jobs Act that got it abolished. Therefore, its effectiveness can be improved by imposing larger individual mandate penalties to encourage enrollment in health insurance. Also, the US has been spending a higher percentage of its GDP on healthcare than the UK since 1980. However, the US is experiencing low health outcomes compared to the UK. This can be addressed by promoting the incentives to use effective care and strengthen access to care and primary care systems in the US.

References

Breed, L. N. (2018). Federal Updates Major Tax Reform Bill Signed, Repealing the ACA Individual Mandate. Policy1, 4. https://www.sfdph.org/dph/files/election/FederalStateLocalUpdate01-4-2018.pdf

Fiedler, M. (2018). How Did the ACA’s Individual Mandate Affect Insurance Coverage? Evidence from Coverage Decisions by Higher-Income People. Brookings Institution, Washington, DChttps://www.brookings.edu/research/how-did-the-acas-individual-mandate-affect-insurance-coverage-evidence-from-coverage-decisions-by-higher-income-people/

Fiedler, M. (2020). The ACA’s Individual Mandate In Retrospect: What Did It Do, And Where Do We Go From Here? A review of recent research on the insurance coverage effects of the Affordable Care Act’s individual mandate. Health Affairs39(3), 429-435. https://www.healthaffairs.org/doi/abs/10.1377/hlthaff.2019.01433

The commonwealth Fund. (2020). U.S. Health Care from a Global Perspective, 2019: Higher Spending, Worse Outcomes? https://www.commonwealthfund.org/publications/issue-briefs/2020/jan/us-health-care-global-perspective-2019

United States Census Bureau. (2021). Health Insurance Coverage in the United States: 2020. http://www.census.gov/