Question

Briefly describe the impact of the ACA on health insurance and payments to providers. What are some challenges that have arisen?

Answer 1

The Affordable Care Act has enabled millions more Americans to receive healthcare coverage than ever before, reducing the uninsured rate to 8.6%. But the landmark legislation has brought payers some problems. Because of the fact that they now have to handle healthcare premiums for those with pre-existing medical conditions and pay the whole cost of preventive services, revenues for insurance providers have fallen dramatically. While the Affordable Care Act has begun to help alleviate the disparities in health care among US citizens, the exchanges of state and federal insurance have not made payers very happy.

Younger adults and healthier people were more likely to accept the individual mandate's tax burden than to buy health insurance policies on exchanges due to high premiums that left payers with a pool of older and sicker populations. In reaction to those obstacles, some regional payers have started to step back from working in the public marketplace.

Health care providers have adapted to the increasing demand for ACA-caused services. They responded by hiring more personnel, relying more on advanced clinicians in practice, and expanding facilities and hours. However, following increases in provider capacity, there are still areas of unmet need and ongoing shortages of skilled workers, which have been worsened by the expansion of coverage by the ACA.

Health insurance companies that operate through the exchanges have found themselves serving a more expensive consumer base than initially predicted by the Obama administration. Insurers take on more costs of health care than in previous years while receiving fewer premiums from healthier populations.