Question

Health policies must undergo policy processes of analysis prior to implementation. Pre-process, intra-process, and post-process all have major impacts on healthcare organizations and consumers. Based on the policy many people may face economical or social change, which could either be just/unjust. In a minimum of 250 words, discuss the following: Evaluate the ACA’s impact on healthcare quality and cost. How does the ACA impact society as a whole? Highlight the relevance of the Federal Medicaid Assistance Percentage (FMAP), as it relates to the ACA.

Answer 1

The ACA’s impact on healthcare quality and cost

The analysis of the ACA’s effects on cost containment and quality of healthcare rests on three concepts: first, that any provisions affecting only the individual market can have little effect on overall health spending, because only 6% of people under age 65 are in that market; second, that the slowing of the trajectory of health care spending predates the ACA and complicates analysis of its effects; and third, that while increased utilization of health care due to the ACA’s coverage expansion drove cost growth in the early years, health care prices will likely exert a powerful influence on the trajectory of health care costs over the long run.

One of the most immediate and direct ways that the ACA produced savings was through reductions in provider payment updates and Medicare Advantage (MA) payments. The ACA includes a slew of new regulations affecting the private insurance market, both on and off the exchanges. These include a prohibition on lifetime and annual caps on coverage, a mandate to cover “essential health benefits,” premium rate review, and the Medical Loss Ratio (MLR) provision, which required insurers to provide a customer rebate if they spend too high a percentage of premium dollars on non-medical expenditures.

The ACA has reduced the number of uninsured people to historically low levels and helped more people access health care services, especially low-income people and people of colour. However, the law’s effects on the cost and quality of health care services are difficult to discern given the complexity of our health system.

ACA impact on society

The Affordable Care Act has the potential to increase access to coverage for millions of people primarily through three mechanisms: 1) the implementation of market reforms; 2) the establishment of new health insurance marketplaces and 3) the expansion of Medicaid eligibility for low-income adults.

The Affordable Care Act’s effects the society in many ways:

o Improve the quality of healthcare and patient safety

o Make coverage more secure for those who have insurance, and extend affordable coverage to anyone that is uninsured

o Ensure access to quality, culturally competent care for all American demographics

o Reduce the growth of healthcare costs while promoting high-value, effective care

o Emphasize primary and preventive care associated with community prevention services

o Promote the adoption and usefulness of health information technology

The relevance of the Federal Medicaid Assistance Percentage (FMAP)

The ACA provides initial FMAP rates of up to 100% for certain "newly eligible" individuals. The ACA contains a number of provisions affecting FMAP rates. ACA provides increased FMAP rates for certain disaster-affected states, primary care payment rate increases, specified preventive services and immunizations, smoking cessation services for pregnant women, specified home and community-based services, health home services for certain people with chronic conditions, home and community-based attendant services and supports, and state balancing incentive payments. The ACA included a provision providing a disaster-recovery FMAP adjustment for states that have experienced a major, state-wide disaster. Thus, The FMAP rate is used to reimburse states for the federal share of most Medicaid expenditures. Exceptions to the regular FMAP rate have been made for certain states, situations, populations, providers, and services.