Health Insurance and Medicare

Topics: Health insurance, Health care, Medicare Pages: 10 (3478 words) Published: January 7, 2013
The Impacts of the Patient Protection and Affordable Care Act and Health Education and Reconciliation Act of 2010
I. Introduction
The Patient Protection and Affordable Care Act (PPACA) was signed into law on March 23, 2010 by President Barack Obama. Along with the Health Care and Education Reconciliation Act (HCERA), it represents the momentous transformation of the U.S. health care system. Its main goal is to decrease the amount of uninsured citizens as well as to reduce the overall costs of health care. It is a vastly complex reform that will affect many people in aspects of their health care, costs, and the country. There are many opinions about how this reform will affect the nation, some saying it will make us better off, others saying we will be worse off, and those who do not think it will make a difference. But regardless of these opinions, what the majority does agree on is that these laws may be difficult to understand and that many are not even aware of these changes.

There are many problems that the health care industry is facing. The cost of health care may arguably be the most important factor that people are concerned about. Many think that health care policies and premiums are too expensive. Coupled with the fact that our population is aging, meaning that there will be more elder people with more health problems, health care costs are rapidly growing and take up a huge chunk of the federal budget. There are also many loopholes within the current health care system. Individuals who are looking to buy insurance can be denied based on their pre-existing conditions. Some insurance policies even have a lifetime limit on benefits. What all these examples basically sum up is that the people who are in need of health care the most are those who are also the most unlikely to be insured, or are under insured.

In an attempt to address these issues, the PPACA and Reconciliation Act were established. The Health Care and Education Reconciliation Act was enacted to amend the PPACA. It is divided into two titles, one addressing the health reform and the other addressing student loan reform. It makes changes to some parts of the PPACA. That is why many people commonly refer to the overall health reform as just the PPACA. The most noted change this brings is that it requires almost all citizens to have health care insurance, or to pay a penalty. Some examples and cases regarding this issue will be discussed later on. The PPACA also considerably expands public insurance as well as funds private insurance coverage. It will close loopholes such as setting life time limits as well as making it illegal to reject coverage for those with pre-existing conditions. In terms of affordability, the PPACA will expand Medicaid to cover low-income families and individuals across the nation. It also aims to cut down and reconstruct Medicare spending, which will be the main focus of this paper. II. The Impacts of the PPACA and HCERA on Medicare and Health Physicians

The PPACA is made up of 10 titles. I will be discussing selected provisions in Titles II, III, IV, and V regarding Medicare. These include program modifications and payment to Medicare’s fee-for-service program, the Medicare Advantage, prescription drug programs, Medicare’s payment process, changes to address, waste, fraud, and abuse, and other miscellaneous Medicare changes. As for the HCERA, the first title has provisions detailing health care and revenues. Subtitle B of Title I involves provisions that change provisions PPACA relevant to those listed above (Medicare Advantage, fee-for-service, and prescription drug programs). Subtitle D has provisions regarding decreasing fraud, abuse, and waste in Medicare. Subtitle E discuses revenue related provisions such as a provision that changes Medicare tax provision in PPACA. A. Impacts on Medicare

According to the Congressional Budget Office (CBO), the provisions in PPACA as amended by the HCERA will reduce direct...

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