- Published: November 15, 2021
- Updated: April 21, 2022
- University / College: Queen's University Belfast
- Language: English
- Downloads: 11
Affordable Care Act
The health care sector is one of the important sectors, which explains why the sector takes a significantly large percentage of the government spending budget each year. Besides, various acts have been enacted to ensure effective and efficient health care provision of health care services. The Affordable Care Act is the most significant health care legislation after the enactment of Medicare in 1965. The act focuses on three major provisions namely: Control of health care costs, expanding health insurance Coverage, and improving health care delivery system. After its enactment, the act was to be implemented progressively, with set goals and objectives to be attained at a predetermined time period.
According to the Affordable Care Act, young adults are allowed remain on family health insurance plans until they turn 26 years old. It also provides that no children should be denied coverage as a result of the pre-existing conditions. Other provisions covered in the act include eradication of the copayments and deductibles for certain preventive services, disallows medical underwriting as well as gender rating, and eradication of yearly and lifetime limits on health coverage.
Preventive Services
Funding prevention is a vital strategy of reducing the costs of health care. It is helpful in controlling cancer, cardiovascular disorders, and sexually transmitted diseases. Other preventive health care services include obesity screening and counseling, tobacco use screening and intervention, screening of domestic violence and counseling. High risk behaviors are associated with chronic diseases. Examples of high risk behaviors include smoking, physical inactivity, alcohol use, poor diet, and unsafe sex. Lately, a large number of people in the America die prematurely from diseases that could easily be prevented. In addition to reducing the increasing health care costs, prevention is also designed to maintain healthy communities.
Uninsured Consumers
Health insurance is very important way of enhancing health care accessibility. Uninsured consumers encounter a number of challenges when it comes to accessing health care services. For instance, they are unlikely to obtain care services in time. Besides, there are high chances that they will get care that is not fitted for their personal needs. The other challenges faced by uninsured consumers include paying relative higher cure costs, receiving late diagnosis, and getting less care.
Health Insurance Marketplace
Health insurance marketplace entails a resource guide which helps people in learning about their health coverage options; in addition to helping them in making comparisons of insurance plans in terms of costs and benefits associated with various plans. It is also helpful when it comes to selecting a plan and enrolling in health coverage. Health insurance coverage is compulsory, and unless exemption is granted, failure to have one may attract a penalty. The main objective of making it compulsory is to increase the number of the insured through covering more than 30 million uninsured Americans. Insurance takes into consideration people who have no access to other types of coverage. The premium to be paid is determined based on age of the applicant, location, tobacco use, and rating for families cap at 3 children.
Metal Level Benefit Plans
Under this category, there are four types of plans: platinum, Gold, Silver, and Bronze. Some of the benefits if these plans include: access to emergency services, ambulatory services, hospitalization, drug prescription, maternity and newborn care, rehabilitative and habilitative services and devices, preventive services, laboratory services, as well as pediatric services.
Small Business Health Options Program (SHOP)
It mainly focuses on women, and it is very common in businesses owned by women. Besides, it is accessible by the self-employed people. Moreover, the plan allows tax credit for samll employers.