Delano Elementary School Staff, Clarkson-leigh Patriots, North Calloway Elementary, Articles H

The Trump Administration shored up the exchanges with a market stabilization rule that limited peoples ability to wait until they were sick to buy policies and approved state waivers for state reinsurance programs that lowered premiums and provided better access to care for those with chronic and expensive medical conditions. Besides the challenges with establishing care with private PCPs, administrators believed newly insured patients with Medicaid and the most affordable PHI plan experienced difficulties in accessing secondary care services. This issue is a nationwide problem, as scholars and policymakers in other states have identified the need to address it. How the Affordable Care Act Impacting Nurses | Maryville Online The PAF has provided funds to grantees in 32 states and seven tribal organizations, serving nearly 110,000 expectant and parenting young people. Northwestern Journal of Law & Social Policy. While local and state level policies may be an effective initial step in addressing this problem, a comprehensive national approach could better address this issue that could minimize different practices across states. J Ambulatory Care Manage. The Affordable Care Act established health insurance marketplaces, including Healthcare.gov and state exchanges at which people could sign up for coverage and potentially qualify for. Many patients required multiple treatments and referrals. Fact Sheet: The Affordable Care Act and The Disability Community The topic guide included questions that explored administrators perspectives on the impact of the ACA on their uninsured patients ability to gain coverage, their ability to meet patients healthcare needs, and challenges and opportunities with coverage expansion. CMS was able to award MFP grants to 16 additional states for a total of 47. https://doi.org/10.1186/s12913-021-06961-9, DOI: https://doi.org/10.1186/s12913-021-06961-9. [, Created the Health Home State Plan Option to provide comprehensive care coordination for individuals with chronic conditions, including mental and substance use disorders. The Affordable Care Act Reduced Income Inequality In The US But open enrollment comes as the Supreme Court is considering a case that could bring down the landmark health reform law. Getrich CM, Garca JM, Solares A, Kano M. Buffering the uneven impact of the affordable care act: immigrant-serving safety-net providers in New Mexico: buffering the uneven impact of the ACA. Nakamura et al. Provided by the Springer Nature SharedIt content-sharing initiative. Affrime is CEO of CommuniCare Health Centers. It largely failed. [, Extended protection for Americans with disabilities from being discriminated against by health insurance plans on the basis of medical history or pre-existing conditions; and eliminated lifetime dollar caps on essential health benefits. Your privacy choices/Manage cookies we use in the preference centre. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data. Book This was not a unique problem in this study as [13] found that FQHCs in Colorado, Connecticut, Kentucky, and Washington also had the same issue. 2015;314:36674. J Healthc Manag. The Affordable Care Act calls for all taxpayers to do at least one of three things: Have qualifying health insurance coverage for each month of the year; Have an exemption from the requirement to have coverage; Make an individual shared responsibility payment when filing federal income tax return. This is supported in Boccuti et al. CA Manager 2 believed, [taking] a large group of people who formerly didnt have any health insurance coverage and [are given] coverage overnight. AZ Director 2 stated, generally the well visits are covered but if [they] end up needing acute care [their] insurance may not pay much at all. The author would also like to thank the key informants that took part in the interview from the selected FQHCs in Arizona, California and Texas. The Patient Protection and Affordable Care Act (ACA) expands access to health insurance in the United States, and, to date, an estimated 20 million previously uninsured individuals have gained coverage. Toll Free Call Center: 1-877-696-6775, Note: All HHS press releases, fact sheets and other news materials are available at, Content created by Assistant Secretary for Public Affairs (ASPA), Fact Sheet: Celebrating the Affordable Care Act, Assistant Secretary for Planning and Evaluation, HHS Office for Civil Rights Settles Complaint with Florida Health Center that Failed to Provide Effective Communication for a Patients Caregiver, HHS Releases Proposal to Expand Health Care for DACA Recipients, HHS Finalizes Policies to Make Coverage More Accessible and Expand Behavioral Health Care Access for Millions of Americans in 2024, Required plans cover womens preventive health services, including birth control and counseling, well-woman visits, breast and cervical cancer screenings, prenatal care, interpersonal violence screening and counseling, and HIV screening and STI counseling, with no cost-sharing to the woman. He is president of Blase Policy Strategies LLC and a research fellow at The Galen Institute and The Foundation for Government Accountability. Directors and managers from TX did not associate the increase in demand they continued to experience after the ACA took effect because of the limited impact of coverage expansion. The "Affordable Care Act" (ACA) is the name for the comprehensive health care reform law (passed in 2010) and its amendments. Your US state privacy rights, Another study found that states that expanded Medicaidhada significant slowdown in ambulance response time. Our findings suggest that many of the FQHCs were challenged to effectively meet the needs of their patients when they reach their maximum capacity. How does your research contribute to the field? 2006;51:22332. 20 million people have gained health insurance, including people with disabilities and other pre-existing coverage who became newly eligible. However, directors and managers believed the increase was determined by the proportion of uninsured patients in their community that met the new eligibility criteria for Medicaid. Artiga S, Rudowitz R, Tolbert J, Paradise J, Majerol M. Findings from the field: Medicaid delivery systems and access to Care in Four States in year three of the ACA: The Kaiser Commission on Medicaid and the Uninsured; 2016. https://www.kff.org/medicaid/issue-brief/findings-from-the-field-medicaid-delivery-systems-and-access-to-care-in-four-states-in-year-three-of-the-aca/. By using this website, you agree to our [. U.S: Department of Commerce, Economics and Statistics Administration; 1997. https://www.census.gov/prod/2/pop/p25/p25-1131.pdf. This study adds to the literature insights from FQHC administrators on their experience with the ACAs impact on their patient population and organization. Middle-income families without employer-provided coverage and small businesses and their workers have largely fared worse from higher health care costs as did the nations taxpayers who are responsible for funding all of the laws new spending. The Affordable Care Act's Impacts on Access to Insurance and - PubMed The Patient Protection and Affordable Care Act, referred to as the Affordable Care Act or "ACA" for short, is the comprehensive health care reform law enacted in March 2010. This issue brief explains how Medicaid eligibility and benefits. Med Care Res Rev. [28] found specialist shortages occurred in rural and urban areas across Michigan. How has the Affordable Care Act affected you? Share your story. N Engl J Med. History Review Flashcards | Quizlet The ACA enabled people to gain coverage by 1) expanding the publicly funded Medicaid program to cover adults with annual incomes up to 138% of the federal poverty level; 2) establishing the Health Insurance Marketplace for individuals and small businesses, allowing them to purchase private health insurance (PHI); and 3) enforcing an individual mandate that required eligible people to have federally approved health insurance coverage [1,2,3,4]. Understanding the law's impact on coverage, access, utilization, and health outcomes, especially Lam M, Grasse N. Community health centers (CHCs) under environmental uncertainty: an examination of the affordable care act of 2010 and early Medicaid expansion on CHC margin. While this provided unique insights into the impact of the ACAs coverage expansion on FQHCs, these insights do not reflect the experiences of patients and wider staff membersparticularly clinicians. A .gov website belongs to an official government organization in the United States. Health Aff. What the Affordable Care Act Has Meant for People with Mental - NAMI Polsky D, Richards M, Basseyn S, Wissoker D, Kenney GM, Zuckerman S, et al. Three-Year Impacts Of The Affordable Care Act: Improved Medical Care The findings of this study and others [13, 28] suggests newly insured Medicaid patients experienced an improvement in accessing care under the ACA. Barrack Obama's administration has been working on the Affordable Care Act throughout his entire term with the hopes of changing healthcare for the better. [, An estimated 58 million women with private insurance currently benefit from these preventive service provisions, in addition to 37 million children with access to free preventive care. Impacts of the affordable care act on community health centers: characteristics of new patients and early changes in delivery of care. Established vaccinations as a routine and expected part of the health care visit and required that people had a right to the full set of vaccinations recommended for them. However, it is unclear the extent of the policy's impact on Federally Qualified Health Centers (FQHC) and the patients they served. 2015;372:53745. Participants completed a written consent form at the start of the interview and were aware that their participation was voluntary, with no compensation. Texas has said that they are not going to expand Medicaid, but I dont think that means they are not going to do anything, right? This impacted approximately 30.4 million enrollees in insurance plans and helped reduce stigma while supporting treatment for vulnerable populations. The Affordable Care Act's Impacts on Access to Insurance and Health The limited capacity of secondary care providers affected their ability to meet demand for care, particularly in regions with high specialist provider shortages. J Health Care Poor Underserved. ; Under the Tax Cuts and Jobs Act, taxpayers must continue to report coverage, qualify for an . 10 Ways the ACA Has Improved Health Care in the Past Decade It was unclear, however, whether PCPs would continue accepting new Medicaid patients and offer appointments after the temporary payment increase ended. CNN . The patient volume served at all sites varied. All FQHC administrators in the three states acknowledged their organization struggled to meet demand because of their limited capacity even before the ACA took effect. The ACA's employer shared responsibility provision (employer mandate) requires employers with 50 or more full-time equivalent employees to offer affordable health insurance to their employees who work at least 30 hours a week. Executive directors were selected given their oversight of the strategic and financial management of their respective organizations [23]. CA Manager 1 stated someone might attempt to schedule an appointment to establish care, and for those type of appointments it can take as long as three months. Below is the fact sheet highlighting some of the accomplishments of the ACA: Health of Older Adults and People with Disabilities, Health of LGBTQI+ and Communities of Color. Key informants were selected to be interviewed if they held an executive director and mid-level manager position in the selected FQHCs. New York: The Commonwealth Fund; 2014. https://doi.org/10.15868/socialsector.17267. They believed expanding the program would have enabled many of their low-income uninsured patients to gain coverage from Medicaid and reduce the proportion of patients without coverage they served. In 2019, the cost of the ACAs Medicaid coverage provisions amounted to roughly $130 billion$50 billion on exchange subsidies and $80 billion on Medicaid expansion. 1-40 All Arizonan and Californian administrators acknowledged their uptake of newly insured patients with PHI was minimal. Health insurance markets are only afloat because of massive federal subsidies and premiums and out-of-pocket obligations significantly increased for families. Cite this article. Administers in this study believed it caused patients to experience longer waiting period for appointments, travel farther distances to receive care, or could not access secondary care altogether. Long SK, Masi PB. Furthermore, Artiga et al. Twenty-two semi-structured interviews were conducted with administrators from FQHCs in urban counties in 2 Medicaid-expanded states (Arizona and California) and 1 non-expanded state (Texas). Access And Affordability: An Update On Health Reform In Massachusetts, Fall 2008: Access, affordability, and coverage have improved since 2006, but rising health costs have eroded some gains in affordability of care. Many individual attributes that differ systematically across racial and ethnic groupssuch as income and education levelslikely affect . The Affordable Care Act (ACA), or Obamacare, was principally intended to improve health insurance markets for individuals and small businesses, lower health costs, and increase the number. Newly insured patients ability to access primary healthcare services relied on FQHCs capacity. An FQHC was selected if they were classified as a Health Resources and Services Administration grantee and a community health center. BMC Health Services Research Ten FQHCs in two Medicaid expanded-states (AZ, CA) and one non-expanded state (TX) were selected to be part of this study. However, they observed that newly insured patients with Medicaid or marketplace PHI plan continue to struggle to access secondary care services given the very narrow network of specialists willing to accept their coverage. For general media inquiries, please contactmedia@hhs.gov. The Affordable Care Act filled in the gaps. The impact of the Affordable Care Act on patient coverage and access to care: perspectives from FQHC administrators in Arizona, California and Texas, https://doi.org/10.1186/s12913-021-06961-9, https://doi.org/10.15868/socialsector.17267, http://files.kff.org/attachment/issue-brief-health-center-patient-trends-enrollment-activities-and-service-capacity-recent-experience-in-medicaid-expansion-and-non-expansion-states, https://www.kff.org/health-reform/state-indicator/state-activity-around-expanding-medicaid-under-the-affordable-care-act/, https://www.cdc.gov/nchs/data/nhis/earlyrelease/earlyrelease201605.pdf, https://www.athenahealth.com/~/media/athenaweb/files/pdf/acaview_tracking_the_impact_of_health_care_reform, https://www.kff.org/medicaid/issue-brief/findings-from-the-field-medicaid-delivery-systems-and-access-to-care-in-four-states-in-year-three-of-the-aca/, https://bphc.hrsa.gov/sites/default/files/bphc/about/healthcenterfactsheet.pdf, https://www.kff.org/medicaid/issue-brief/community-health-centers-recent-growth-and-the-role-of-the-aca/, https://www.census.gov/prod/2/pop/p25/p25-1131.pdf, https://www.kff.org/medicare/issue-brief/primary-care-physicians-accepting-medicare-a-snapshot/, https://www.kff.org/health-reform/issue-brief/year-two-of-the-aca-coverage-expansions-on-the-ground-experiences-from-five-states/, http://creativecommons.org/licenses/by/4.0/, http://creativecommons.org/publicdomain/zero/1.0/, bmchealthservicesresearch@biomedcentral.com. Health insurance challenges in the post-affordable care act (ACA) era: a qualitative study of the perspective of low-income people of color in metropolitan Detroit. According to CA manager 4, its not like [a patient] comes in here today and get a flu shot. 2020. https://www.kff.org/health-reform/state-indicator/state-activity-around-expanding-medicaid-under-the-affordable-care-act/. Effects of the Affordable Care Act on Health Care Access and Self Some administrators described that there were only a handful of secondary care providers in their region willing to accept patients with Medicaid. [, Strengthened the safety net of HIV care and treatment services to people with HIV served by HRSAs Ryan White HIV/AIDS Program by helping cities, states, counties, and locally-based community organizations stretch their resources to build a comprehensive system of HIV care. For example, some private PCPs in AZ and CA did not accept newly insured Medicaid patients to establish care with them. Ward B, Clarke T, Nugent C, Schiller J. It has been estimated that FQHCs served one in 11 people in the nation [15]. Cuts in CHC funding would disproportionately affect access for low-income individuals and . More than 70 percent of exchange enrollees have incomes below 250 percent of the federal poverty level ($31,900 for a single individual and $65,500 for a family-of-four). Premiums and deductiblesspikedfor plans that covered fewer providers and hospitals. AE conducted all the interviews and took place during the selected timeframe of the study from July and September 2014. Medicaid expansion adopted by 38 states and Washington DC, as of March 2022, has connected people to coverage and improved health outcomes for women of color and families. Americans can now sign up for Obamacare coverage for 2021. . Additional policies are required to better address the gaps in the depth of covered services in Medicaid and the most affordable PHI plans and capacity of providers to meet demand to ensure beneficiaries can fully access the health care services they need. TX Director 3 acknowledged limited capacity meant, the [staff] have to explain to patients that [they] are not accepting new patients. Effects on health. Although healthcare law is always evolving, the ACA has shifted the landscape and provided new . 2018;75:63350. NVivo 10 software was used to conduct this process. Health Affairs. Google Scholar. An early look at rates of uninsured safety net clinic visits after the affordable care act. 12 Years of Advancing Health Equity for All Americans. Med Anthropol Q. People have access to essential health benefits, including preventive and rehabilitative care, prescription drugs, wellness visits and contraceptives, mental health and substance use treatment, among many others. Findings have suggested that newly insured FQHC patients may have continued to experience limitations in accessing care. However, the laws effects on the cost and quality of health care services are difficult to discern given the complexity of our health system. Arizona director 3 described their site as experiencing a 10% increase of newly insured Medicaid patients. The author read and approved the final manuscript. Colorado policy makers considered increasing reimbursement rates for providers that accepted Medicaid [13]. Gray J, Zink A, Dreyfus T. ACAView tracking the impact of healthcare care reform: effects of the affordable care act through 2015: Athenahealth and the Robert Wood Johnson Foundation; 2016. https://www.athenahealth.com/~/media/athenaweb/files/pdf/acaview_tracking_the_impact_of_health_care_reform. Choices plummeted. Arizonan and Californian administrators were particularly positive about Medicaid expansion, as their state enacted the provision. All the administrators in the three states viewed the Medicaid program as an effective form of coverage for their low-income patients. All administrators from the three states acknowledged that referring Medicaid patients to specialists pre-ACA was a challenge, as not all specialists accepted the coverage. PHI from the marketplace remained unaffordable for most uninsured FQHC patients. Sometimes patients were referred to specialists outside their county because of lack of appointment availability. AE also drafted and completed the manuscript revisions. Fact Sheet: Celebrating the Affordable Care Act | HHS.gov [, Reduced the uninsured rate among LGBTI+ populations by nearly half since 2010. Recent events have changed this fine, and beginning . Lowered the share of adults with disabilities under age 65 who were uninsured for a full year by nearly half. The Impact of the Affordable Care Act on the Health Care Workforce I think most our patients are making the decision whether they want to buy groceries or go to the doctor. Shartzer A, Long SK, Anderson N. Access to care and affordability have improved following affordable care act implementation. How the Affordable Care Act transformed our health-care system - CNBC 11 Continuing Progress on The Opioid Epidemic: The Role of The Affordable Care Act. The team met several times to discuss the themes as related to the research question until consensus was reached. Some newly insured Medicaid patients, therefore, had limited choice of PCPs and, to an extent, relied on establishing care with FQHCs when no other providers would accept them. In 2016, Brookings Institution scholar Stuart Butler referred to the ACA as The Medicaid Expansion Act, primarily because premiums and out-of-pocket exposure make exchange plans unattractive to many US residents. This is despite the Supreme Court decision making Medicaid expansion optional and about a quarter of states refusing to expand. [SAMHSA], Established the Offices of Minority Health within six agencies at HHS: Agency for Healthcare Research and Quality (AHRQ); Centers for Disease Control and Prevention (CDC); Centers for Medicare & Medicaid Services (CMS); Food and Drug Administration (FDA); Health Resources and Services Administration (HRSA); and Substance Abuse and Mental Health Services Administration (SAMHSA). The Affordable Care Act | Policy and Law | HIV/AIDS | CDC The interview lasted for 60minutes, conducted in English, and was guided by a topic guide (see Supplementary A). Several other administrators in AZ, CA, and TX acknowledged that patients immigration status was a major barrier to gaining Medicaid. Secure .gov websites use HTTPS Nonprofit Policy Forum. Google Scholar. 2016;39:2908. In March 2018, the White House Council of Economic Advisers released a report on health insurer profitability since the ACA took effect, finding that health insurance stocks outperformed the S&P 500 by 106 percent. According to CBOs baseline, the ACA will cost American taxpayers $1.8 trillion over the next decade. Fiscella K, Geiger HJ. . However, few studies have explored this topic. [, Created the Maternal, Infant, and Early Childhood Home Visiting Program (MIECHV), which has appropriated over $4.7 billion in grants to states, territories and tribes to support home visiting services to pregnant people and parents with young children who live in communities that face greater risks and barriers to achieving positive maternal and child health outcomes. This is wonderful for people with health needs, but it certainly has put more of a strain on working nurses. The ACA is an extremely expensive program. The impact of the Affordable Care Act on patient coverage and access to While TX has yet to adopt Medicaid expansion, most directors believed their state would expand the program eventually in some form that best meets the needs of their population. Bethanne Fox, Vice President, Outreach and Strategy, The Commonwealth Fund, David Blumenthal, Sara R. Collins, and Elizabeth J. Fowler, The Affordable Care Act at 10 Years Its Coverage and Access Provisions, New England Journal of Medicine, published online Feb. 26, 2020. https://doi.org/10.26099/5d64-x278, Delivery System Reform, Health Equity, Uninsured, Health Reform, Affordable Care Act, Affordable Care Act at 10, Coverage and Access, Costs and Spending, Affordability, Out-of-Pocket Health Care Costs, 2023 The Commonwealth Fund. For some people with pressing medical conditions, this slowdown could be life-threatening. [, Supported 33 states with grant funding to plan and implement a No Wrong Door System, a partnership between the ACL, the Centers for Medicare & Medicaid Services (CMS), and the Veterans Health Administration, to make it easier for consumers to learn about and access Long Term Supports and Services (LTSS). Blumenthal D, Abrams M, Nuzum R. The affordable care act at 5 years. 2013;9:117. However, Arizonan and Californian administrators were concerned that fewer non-FQHC primary care providers (PCPs) (e.g., private providers) accepted new Medicaid patients to establish care with them. It underscores the need for additional policies in these plans to be widely accepted as to prevent patients from having health insurance coverage but unable to establish care with a provider or access to affordable health care services.