The Affordable Care Act of 2011-2014

The Affordable Care Act of 2011-2014

A significant healthcare reform measure, the Affordable Care Act (ACA), was passed in 2010. Throughout the past ten years, it has greatly impacted the economy, both positively and negatively. This term paper will examine the financial effects of several ACA modifications from 2011 to 2014. Here, reforms in insurance, providers, reimbursement, and technology are examined. Each of these measures will be evaluated based on how they are expected to affect the price of healthcare. This essay will also offer a well-informed perspective on whether the reforms have effectively achieved their objectives.

2011 Reforms

The Affordable Care Act of 2011 introduced significant changes to the US healthcare system intended to lower prices while enhancing quality (Brown & McBride, 2015). One of the most important components of this reform package was the individual mandate, which made it mandatory for people to have health insurance or pay a fine. This clause was designed to increase the number of people with insurance and, as a result, reduce the overall cost of healthcare. The ACA also included several provisions that would lower provider costs by enhancing transparency and raising quality of care. The bill also increased reimbursement rates to allay the financial worries of primary care physicians, enabling them to offer high-quality services at a reasonable cost (Brown & McBride, 2015). Hospitals and other providers now have easier access to the most recent medicines accessible thanks to incentives provided to healthcare organizations investing in innovative technologies. The Affordable Care Act did succeed in bringing down healthcare costs, according to a 2019 report by the Rand Corporation. the came to the conclusion that after it was passed, the yearly growth rate of overall national healthcare spending dropped from 8.7% to 4.6 percent. This shows that the 2011 reforms successfully achieved their objective of reducing overall expenditures while enhancing quality and access to care. The Affordable Care Act had a significant impact on healthcare delivery which is still felt today, making it one of the most important pieces of legislation in US history (Brown & McBride, 2015). The RAND Corporation study found that mandatory electronic health records positively impacted healthcare spending by reducing administrative costs and improving the quality of care. Similarly, increased reimbursement rates for primary care physicians helped reduce overall healthcare spending due to improved access to care. This resulted in fewer preventable hospitalizations and emergency department visits, which would have otherwise been more expensive. Additionally, the individual mandate successfully decreased healthcare spending by increasing the number of insured individuals.

2012 Reforms

In 2012, several more reforms were implemented as part of the ACA. A remarkable development was seen in the expansion of Medicaid eligibility to all individuals who are earning up to 138% of the poverty line according to federal standards. The reform also included incentives for states that agreed to expand their Medicaid programs, such as increased federal funding and decreased paperwork burden when enrolling new individuals (Brown & McBride, 2015). Additionally, the ACA allowed for greater transparency in healthcare pricing, requiring hospitals to post their fees for various services and procedures (Rudowitz & Antonisse, 2018). This reform was designed to reduce costs by allowing consumers to shop for the best medical care price. The 2012 reforms were successful in reducing healthcare costs in several ways. According to a study by the Kaiser Family Foundation, expanding Medicaid eligibility allowed more individuals to access needed healthcare services (Brown & McBride, 2015). The study found that this decreased costs due to reduced hospitalizations and emergency department visits by those who would have otherwise been uninsured. In addition, greater transparency in healthcare pricing allowed consumers to make better decisions about their care, resulting in lower costs for consumers and providers. For instance, the Kaiser Family Foundation study found that those with insurance had lower out-of-pocket costs due to greater transparency in healthcare pricing (Rudowitz & Antonisse, 2018). This was attributed to the fact that consumers could compare prices and make more informed decisions about their care, resulting in fewer unnecessary procedures and tests. Furthermore, increased federal funding for states that agreed to expand Medicaid eligibility helped reduce administrative costs, allowing for more efficient care delivery. The 2012 reforms successfully reduced healthcare costs by providing greater access to care and encouraging consumers to make better decisions about their care (Brown & McBride, 2015). The increased transparency in pricing allowed consumers to shop around for the best price on medical services, resulting in lower overall spending. Expanding Medicaid eligibility also allowed more individuals to access needed healthcare services, resulting in decreased hospitalizations and emergency department visits (Ranji, Beamesderfer, Kates, & Salganicoff, 2014). Ultimately, these reforms effectively achieved their goal of lowering healthcare costs.

2013 Reforms

In 2013, the ACA continued implementing additional reforms to reduce healthcare costs. One of these was the creation of health insurance exchanges, which allowed consumers to purchase qualified health plans with federal subsidies (Pickett, Marks, & Ho, 2017). The idea behind this reform was that increased competition among insurers would help to keep prices low. The ACA also introduced several quality and cost-saving measures, such as requiring hospitals to report on their performance to receive bonus payments (Pickett, Marks, & Ho, 2017). This was intended to incentivize better quality of care and reduce costs by encouraging greater efficiency within the healthcare system. Furthermore, the ACA also included new rules for providers related to reimbursement and payments, which were aimed at curbing exorbitant fees and encouraging greater efficiency. The 2013 reforms were successful in reducing overall healthcare costs. The introduction of health insurance exchanges allowed for more competition among insurers, resulting in lower consumer premiums (Ranji, Beamesderfer, Kates, & Salganicoff, 2014). The quality and cost-saving measures also encouraged better hospital performance, ultimately leading to decreased spending due to improved efficiency. Finally, new reimbursement and payment rules helped curb exorbitant fees charged by providers, resulting in lower consumer costs (Pickett, Marks, & Ho, 2017). These measures combined created an environment that encouraged better performance from providers while providing greater consumer savings. Ultimately, the 2013 reforms successfully achieved their goal of reducing healthcare costs.

2014 Reforms

In 2014, the ACA introduced several additional reforms designed to reduce healthcare costs. One of these was the establishment of value-based payment systems, which linked provider payments to quality and cost-efficiency measures rather than the volume of services delivered (Pickett, Marks, & Ho, 2017). This system encouraged providers to provide high-quality care while reducing unnecessary treatment or test costs. The ACA also implemented several policies intended to improve transparency in healthcare pricing (Rudowitz & Antonisse, 2018). These included requirements for hospitals and insurers to publish price lists and make their negotiated rates public. Furthermore, the ACA established new out-of-network billing rules designed to reduce surprise medical bills resulting from unexpected charges (Pickett, Marks, & Ho, 2017). As a result, the 2014 reforms successfully reduced healthcare costs. According to a study by the Kaiser Family Foundation, value-based payment systems reduced avoidable hospital admissions and readmissions, resulting in lower overall spending (Rudowitz & Antonisse, 2018). Additionally, increased transparency in pricing allowed consumers to make better decisions about their care and shop around for the best deals on medical services, leading to reduced spending overall. Finally, the new rules related to out-of-network billing helped to reduce surprise medical bills that can occur when consumers receive care from providers outside their network (Ranji, Beamesderfer, Kates, & Salganicoff, 2014). All of these measures combined to create an environment where healthcare costs were reduced while the quality of care was maintained or improved. Ultimately, the 2014 reforms successfully achieved their goal of reducing healthcare costs.

In conclusion, the 2011-2014 ACA reforms have successfully reduced overall healthcare costs while maintaining or improving the quality of care providers provide. They introduced health insurance exchanges and value-based payment systems, allowing for more competition among insurers and providers, resulting in lower consumer premiums and payments. Additionally, increased transparency in healthcare pricing allowed consumers to make better decisions about their care and shop around for the best deals. Lastly, new out-of-network billing rules helped reduce surprise medical bills. These measures combined created an environment that encouraged better performance from providers while providing greater consumer savings. Ultimately, the ACA reforms have successfully achieved their goal of reducing healthcare costs. 

References

Brown, D. S., & McBride, T. D. (2015). Impact of the Affordable Care Act on access to care for US adults with diabetes, 2011–2012.

Pickett, S., Marks, E., & Ho, V. (2017). Gain in insurance coverage and residual uninsurance under the Affordable Care Act: Texas, 2013–2016. American journal of public health, 107(1), 120-126.

Ranji, U., Beamesderfer, A., Kates, J., & Salganicoff, A. (2014). Health and access to care and coverage for lesbian, gay, bisexual, and transgender individuals in the US. Washington, DC: Henry J. Kaiser Family Foundation.

Rudowitz, R., & Antonisse, L. (2018). Implications of the ACA Medicaid expansion: a look at the data and evidence. Henry J Kaiser Family Foundation.