Mandatory Health Insurance Research Paper

Rising health insurance premiums have made healthcare unaffordable in the United States. Health insurance premiums in this country have undergone a steady rise over the past few years while incomes have remained the same. More than 50% of individuals with low incomes holding private insurance in the United States are unable to afford their healthcare costs (Collins, Gunja, Doty & Buetel, 2015). In addition, costs related to healthcare are equally unaffordable to 25% of working-age individuals who hold private health insurance policies (Collins et al., 2015). According to the Kaiser Family Foundation/Health Research and Educational Trust (Kaiser/HRET) survey on employer health benefits, employer-sponsored health insurance plans have also had moderate rises in premiums in 2013 for both individuals and family coverage (Claxton et al., 2013). While

Recently, a Consumer Driven Health Plan (CDHP), was created. There are many variables to a CDHP, such as benefits covered and coinsurance amounts, however there is one thing that all CDHP’s have in common – a high deductible. By having a high deductible, such as $1,200, it forces the plan participant to think about the medical services they are seeking. Do they really have to go to the emergency room for that cough or can they go to urgent care, or better yet, their physician the next day. When the plan

Large populations of Americans are uninsured mainly because of the high cost of insurance. Majority of the uninsured are the low-income working families’. The adults represent a higher percentage of the uninsured than children. Before the law, you could be denied coverage or treatment because you had been sick in the past, be dropped mid-treatment for making a simple mistake on your application, hence, the Affordable Care Act was implemented into law on March 23, 2010 by President Barrack Obama to make sure that every American irrespective of their status will be insured and have full access to proper health care benefits, rights and protection(1). To understand the

The term “individual mandate,” as a component of the Affordable Care Act, is a mandatory requirement according to which the majority of people in the United States has to have some kind of health insurance. Most specifically, according to the fundamentals of this regulation, any individual who can afford a health insurance policy, but chooses not to do so, will have to pay a fine. Prior to the existence of the individual mandate, health insurance companies had the choice to reject people with health conditions that would potentially incur high costs. Because of this reason, a significant number of people did not have any health coverage. In order to maintain insurance premiums reasonably steady and sustain government cost balanced,

Another downside to High Deductible Health Plan (HDHP) is the apprehensiveness to use the insurance, even the benefits that are free or at a low cost. “Enrollees in high-deductible health plans are likely to reduce the preventive care use and are largely; because they are unaware of the fact that preventive care benefits are free or at a low cost (Dolan February 2016).” Recent analysis showed that low-income workers were more likely than higher earners to avoid certain kinds of care when they were enrolled in high-deductible plans coupled with savings accounts. The analysis from the Employee Benefit Research Institute, found that low-income people even skipped free preventive services like flu shots and cut back on doctors’ visits. Primary and preventive

Healthcare is essential to the nature of our well- being, it provides some financial relief to individuals or families during doctor or hospital visits. Medical care is very expensive, and without health insurance it can be even more of a financial burden. However, being able to afford health insurance has been a challenge for a lot of family’s. For some, they must choose whether to feed their families, pay utility bills or make monthly health insurance payments; so, they allow the insurance to laps. The

Healthcare in the United States is in a crisis situation. Healthcare costs are rising to the point where people are required to pay their health insurance premiums and deductibles over having enough money to cover groceries to feed the family. It seems our government is at odds in terms of the success with the Affordable Care Act and the outcomes we are witnessing from its’ implementation in our country. Many Americans understand the incentives of having healthcare insurance coverage and the benefits it can provide. With so many more individuals entering the healthcare insurance marketplace due to the guidelines of the Affordable Care Act we also see an impact to the supply and demand of healthcare availability and healthy outcomes.

In the current U.S. system the free market prevails and companies, in this case, major insurance providers “compete” for business. This competitive business approach should in theory drive costs down. For some reason, however, an argument can be made that it has produced the opposite result in profiteering. The nation’s largest insurer, UnitedHealth, boasted over a 10 percent revenue increase in 2013 according to Forbes (2013). Health insurance affordability contributes to the disparity in access to health care, as evidenced by the fact that there are millions that are still uncovered. A greater majority of certain minorities lack both health insurance and the financial resource to seek out either health care or insurance. While insurance companies reap huge profits the percent of private sector companies offering health insurance has dropped to less than 50 percent (Kaiser, 2013). There is decidedly a lack of coordination of care for this at risk population as well, since treatment is rendered sporadically and with continuously changing providers. The last major challenge is that of improving the quality of health care. According to a 2010 report by the U.S. Department of Health and Human Services, Office of Inspector General (OIG), an estimated 13.5 percent of Medicare beneficiaries experienced adverse events during their hospital stay and an additional 13.5 percent experienced a temporary

On September 17, 2009, President Barack Obama proposed a new plan for healthcare, known as the Affordable Care Act, and on March 23, 2010, the new plan was signed into law, making health insurance a requirement (United States Department of Health and Human Services). The Affordable Care Act was proposed with the intent to lower the costs of health care, making it more available to everyone. The law also aims to improve coverage and prohibit insurance companies from dropping customers or denying coverage to people with pre-existing health conditions. The Affordable Care Act requires almost every U.S. citizen to either seek coverage or pay a fine. The law expands Medicaid in an effort to help the uninsured become insured as well. At first,

The affordable care act was passed into law by congress and the president in 2010. This plan was established to help all individuals obtain health insurance, regardless of having a pre-existing condition through the government marketplace as an affordable amount, or if you did not meet the set standards, was offered a state based health care coverage (HHS, 2015). Those individuals who did not have qualified medical coverage for the majority of the tax year, they would be penalized and have to pay a certain amount or a percentage based off of their income. Also under the ACA employers are now responsible, depending on how many employees are employed with their company, to offer their full time employees health care coverage, or also face a

“But insurers in many counties are offering such a dizzying array of health insurance plans with so many subtle differences that consumers have struggled to determine which plan is best for them” (Pear, 2015). One of the attractive features of affordable coverage is the low monthly premium. With these attractive numbers, some people might even choose to give up their employer coverage to save the extra money. Naturally, consumers would most likely be fond with the low premiums rather than the quality of the plan. However, low premium is only worth the price that is paid for. The high deductibles lie within these low cost plans could cost the patients a fortune when they receiving the care. As this happen, the Affordable Care Act is no longer serve its purpose in helping to increase the quality and affordability of health insurance as well as reducing the cost of healthcare. Instead, the Obama Care only succeeds in reducing uninsured rate of the population. The lack of understanding about the healthcare coverage could become financially burden to the consumers’ family if they choose to use the plan.

Healthcare coverage is a contentious issue for the United States and affects everyone, those with low income and individuals with higher income. The common complaint among individuals is the cost of care. The US is notorious for having a higher cost for medical care than other developed countries. Up to this point finding, suitable plans have been fruitless therefore it’s time to explore other options. Universal health coverage is indeed to beneficial to the country. According to Herzlinger, Richman & Boxer (2017), The main reason for a delay in the implementation of affordable universal coverage is that of the high costs to treat individuals with a pre-existing condition since they are accounting for a significant portion of health care spending

Problem: The Patient Protection and Affordable Care Act (ACA) leaves coverage gaps for millions of Americans. The ACA focuses on individuals without insurance, but in the meantime, increases the spread in those underinsured. Before the ACA the number of adults underinsured age 19-64 in 2010 was, 16 percent, or 29 million (The New Health Care). New estimates in 2014 indicate that 23 percent of adults 19-64 who were insured, or 31 million, had such high out-of-pocket costs or deductibles relative to their incomes that they were underinsured (The Problem of Underinsurance). “The share of continuously insured adults with high deductibles has tripled, rising from 3 percent in 2003 to 11 percent in 2014. Half (51%) of underinsured adults reported problems with medical bills or debt and more than two of five (44%) reported not getting needed care because of cost” (The Problem of Underinsurance). The goals of the ACA are accessibility and affordability to healthcare coverage and treatment, so why has the number of underinsured increased?

The changing landscape of the current health care system in the United States has caused new methods of insurance to gain in popularity. The High-deductible health plan (HDHP) is increasingly favored by employers and offered on the exchanges created under the Affordable Care Act (ACA). According to the Centers for Medicare & Medicaid Services (CMS) a HDHP is “a plan that features higher deductibles than traditional insurance plans. High deductible health plans (HDHPs) can be combined with a health savings account or a health reimbursement arrangement” (2015). In the HDHPs premiums are lower, offset by the higher deductible. The health reimbursement arrangement (HRA) the employer contributes to a fund for medical expenses while in the health savings account (HSA) which employees pay into but is not required of the employer (Shi & Singh, 2012, p. 208). The growing popularity of these plans is important as it will have effects on the healthcare costs as well as how consumers use healthcare.

By going to an in network physician I am eligible to receive my insurance company discount which will help to reduce my overall out of pocket cost for any services that are provided. This is particularly important to me for the plan that I have is a HDHP, which stands for high deductible health plan. This year’s minimum deductible for single person is $1,300. Which is the amount that I have to pay out of my pocket before my plan will begin to pay. However, my out of pocket cost don’t stop there. Once I meet my annual deductible of $1,300, I am still required to pay 10% of all cost. So it’s important to me to maximize every health care dollar that I spend. In fact, I am seeing more and more employer sponsored health plans move away from HMO and PPO based plans to HDHP/ CDHP plans. This was particularly prevalent in 2014 and 2015. Per article in Health Day, “More employers moving to high-deductible health plans and consumer cost-sharing is also like to increase by 5 percent in 2015.” The thought is that health-plan participants will become better health care consumers. In actually this is not happening, for consumers are choosing to forgo necessary care because of the cost