Impact of the Affordable Care ACT

Topics: Health care, Health economics, Health insurance Pages: 8 (1561 words) Published: December 27, 2014


Impact of the Affordable Care Act
Donna Proctor
Walden University
NURS-6050N Section 1, Policy & Advocacy for Population Health October 2, 2014

Impact of the Affordable Care Act
The Affordable Care Act (ACA) was signed into law by President Barack Obama early in 2010. The ACA was introduced into law to help provide access to affordable and quality health insurance to more Americans than ever before. The goal was to reduce health care cost for individuals and government. It has allowed more adults to be eligible for Medicaid by increasing income eligibility to 138 percent of the Federal Poverty Level (FPL). (Milstead, 2013) However, by ruling of the Supreme Court in June of 2012, states had the option to implement the expansion of Medicaid eligibility to cover more low-income adults. As of January 2014, North Carolina (NC) was one of the states that chose not to implement the expansion of Medicaid making the eligibility for Medicaid for low-income adults very limited. How does this affect the population, economy, cost, and quality of health care? North Carolina’s Right to Refuse

According to Knickman and Kovner (2011, p. 110), “the 10th Amendment to the U.S. Constitution gives states the primary responsibility for public health. Medicaid is administered and overseen by each state but governed by various federal guidelines with the federal government contributing 50%-78% of its costs. (2011) After long debate and review of advantages and disadvantages to implementing the new laws, the North Carolina’s government elected not to adopt the new legislation. Caroll (2013) indicated the decision was based on NC’s current Medicaid system, indicating that is was broken and needing to be revised. There was concern the ACA would cause an increase in taxpayer’s contribution due to the long term costs. As of September 2014, there are 21 states that are following North Carolina’s decision not to adopt the new health care reform. This would leave millions of Americans that would be eligible for Medicaid under the ACA without access to health care. (StateReforum, 2014) Impact on the Population

One of the initiatives of the ACA was to provide more than 32 million uninsured Americans with insurance coverage. This was to be done by increasing the FPL to 138 percent and lifting or altering certain limitations for eligibility to Medicaid. This meant that all Americans whose income was at or below the FPL would be eligible for Medicaid. For example, an unemployed, single, 26-year-old male without any other income would be eligible for Medicaid. Medicaid would no longer be limited to specific categories such as the disabled, children and their parents, or pregnant women whose income was below the FPL. North Carolina’s current Medicaid program “eligibility for non-disabled adults is limited to parents with incomes below 43% of poverty, or about $10,000 a year for a family of four, and adults without dependent children remain ineligible regardless of their income” (How Will the Uninsured, 2014). Currently, there are over 319,000 uninsured adults in NC that are not eligible for Medicaid, by the current NC guidelines, which would be eligible under the Affordable Care Act. This can lead to increased health care costs and weighs heavily on the economy. Who is to take up the slack? Economic Effects of Doing Nothing

Dorgan (2009), Chairman of the Democratic Policy Committee, indicates that the current health care system in NC has “led to higher health care costs, reduced access to care, and inconsistent quality of care”. The Gross Domestic Product in 2013 for North Carolina, based on millions of dollars spent, was $471,365 million, an increase of over $50,000 million since 2010. (Department of Labor and Workforce, 2013) In 2013, North Carolina’s State Auditor Beth Wood indicated that the state’s Medicaid program had gone over budget for the past three years, costing taxpayers about $1.2 billion. (Hoban, 2013) This leaves businesses...


References: Caroll, B. (2013). North Carolina Thumbs its Nose at Obamacare. Retrieved from http://watchdogwire.com/northcarolina/2013/02/12/north-carolina-thumbs-its-nose-at-obamacare/
Dorgan, B. (2009). Health Care Reform: The Cost of Doing Nothing in North Carolina. Democratic Policy Committee. Retrieved from http://www.dpc.senate.gov/docs/states-fs-111-1-87/nc.pdf
Hoban, R. (April, 2013). Cost of Care: How ‘Broken’ is NC Medicaid?. North Carolina Health News. Retrieved from http://www.northcarolinahealthnews.org/2013/04/15/how-broken-is-nc-medicaid/
How Will the Uninsured in North Carolina Fare Under the Affordable Care Act. (2014). The Henry J. Kaiser Family Foundation. Retrieved from http://kff.org/health-reform/fact-sheet/state-profiles-uninsured-under-aca-north-carolina/
Kovner, A. R., & Knickman, J. R. (Eds.). (2011). Health care delivery in the United States (10th ed.). New York, NY: Springer Publishing.
Milstead, J. (2013). Health Policy and Politics: A Nurse’s guide. (pp. 202-204). Burlington, MA: Jones & Bartlett Learning, LLC
Sorell, J. (November 9, 2014). Ethics: The Patient Protection and Affordable Care Act: Ethical Perspectives in 21st Century Health Care. The Online Journal of Issues in Nursing 18(1). doi: 10.3912/OJIN.Vol18No02EthCol01
StateReforum. (2014). Map: Where States Stand on Medicaid Expansion Decisions. Retrieved from https://www.statereforum.org/Medicaid-Expansion-Decisions-Map
What is an Accountable Care Organization (ACA)?. (2011). Accountable Care Facts. Retrieved from http://www.accountablecarefacts.org/topten/what-is-an-accountable-care-organization-aco-1
White House. (2014). Myths and Facts: Get the Facts Straight on Health Reform. Retrieved from http://www.whitehouse.gov/healthreform/myths-and-facts
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