Question

discuss the current/ upcoming activities of the U.S Supreme Court related to the Affordable Care Act. Examine the expected impact on each of the following Constituencies: Provider, Payer, and Patients (Consumers).

Answer 1

Ans) Before the Patient Protection and Affordable Care Act (ACA) became law on March 23, 2010, the healthcare industry faced a number of obstacles particularly in terms of providing medical care and health insurance to many low-income families and patients with serious illnesses.

The Affordable Care Act has been able to bring healthcare coverage to millions more Americans than ever before, reducing the uninsured rate to 8.6 percent. But the landmark legislation has brought some problems to payers.

Profits have largely decreased for insurance companies due to the fact that they must now manage healthcare costs for people with pre-existing medical conditions and cover the entire costs of preventive services.

While the Affordable Care Act has started to help alleviate healthcare disparities among US citizens, the state and federal insurance exchanges have not made payers very happy.

Younger adults and healthier patients have been more likely to take on the tax penalty of the individual mandate than to purchase coverage on the health insurance exchanges, due to high prices, which has left payers with a pool of older and sicker populations. Some national payers have started to step back from operating through the public marketplace in response to these challenges.

In 2012, a Supreme Court ruling further complicated the landscape by allowing states to choose whether or not to expand their Medicaid coverage to insure more low-income individuals.

Currently, nineteen states have still not expanded their Medicaid programs, which is causing disparities in healthcare access and leaving millions of patients with few coverage options.