Overview of Health Care

It is not just the poverty-stricken population that can’t afford insurance. The cost of U.S. health care and insurance is out of reach even for those who do not live in what we technically classify as “poverty”. By the 2003 Federal Poverty Guidelines, released by the U.S. Department of Health and Human services, poverty

Money plays a huge role in access, therefore it is a vital issue to discuss. Within the current system, lack of money results in lack of health care, which leaves thousands of people without any health care coverage. Between 2001 and 2005, the number of people paying for health insurance increased 30%, however income only raised 3% (Health Care Problems). Adequate income is a necessity and unfortunately that is not present. According to the National Conference of State Legislatures, the average annual premium across the country is $16,000. Currently, the average annual income in the United States is $51,107. Mint Money Management suggests that about 4-6% of one’s total income should be spent on insurance, including life, disability, and health insurance. However, the averages in the United States show that the average person spends about 31% of their income on health insurance, which is not financially beneficial. When this rise in health insurance is not parallel to the inflation of income, innocent people are left without a method to achieve health care. There is a program for those who can’t afford health insurance out of pocket nor have access to it, and that is called Medicaid. Issues still exist with the program. There is only so much funding, which leaves many still uninsured. Additionally, people with Medicaid have difficulty

Cleverley, W.O., Cleverley, J.O., & Song, P.H. (2012). Essentials of health care finance (7th ed.). Sudbury, MA: Jones & Bartlett Learning.

Cherry, B., & Jacob, S.(1997). Chapter 7 Paying for Health Care in America: Rising Costs and

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

Medicaid is a social health care program that covers nearly 60 million Americans, including children, pregnant women, seniors, parents and individuals suffering with disabilities. Medicaid is the biggest source of funding for health related services and medical needs for the people with low income in the United States. This program is funded jointly by the state and federal level governments, but it is the state’s responsibility to manage this program. The Medicaid program is not a required program that states have to use, but all 50 states have implemented this program. With the introduction of the Affordable Care Act (ACA), and its passing in 2010, the ACA unveiled its plans to expand Medicaid eligibility to nearly all low-income adults as an addition to the other groups that fall into the Medicaid eligibility. The Medicaid program had “many gaps in coverage for adults” because it was only restricted to the low income individuals and other people with needs in their own specific category. In the past, the majority of the states who had adults that did not have children dependent on those parents were not eligible for Medicaid. These low income adults without dependent children would be without medical insurance assistance before the ACA was introduced. Medicaid is now available to all Americans under the age of 65 whose family income is at or below the federal poverty guideline of “133 percent or $14,484 for an individual and $29,726 for a family of four in 2011” (NSCL).

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 Affordable Care Act has made many positive changes for uninsured and underinsured citizens. With the addition of a program called Health Insurance Marketplace, it is now possible for uninsured people in every state to purchase private insurance plans, those making under 400% or less of the Federal Poverty Level will be able to have tax credits making insurance more affordable (Lathrop & Hodnicki, 2014). Insurance companies are no longer allowed to cancel a policy or raise rates when a client gets sick. Insurance companies cannot refuse coverage to individuals with preexisting conditions such as cancer (“Quality Improvement,” 2015). Insurance companies now must cover preventive care and screenings allowing diseases like cancer to be caught early (“Quality Improvement,” 2015). Research has shown that through health screenings

Health insurance is provided by Medicaid and Medicare to elderly and disabled people and poor children. People working for large companies receive health insurance through their employer. Unfortunately, people working for small businesses, those self-employed, and the working poor are left without options to purchase health insurance at an affordable cost. This creates a divide between the haves and have-nots in terms of health care. Those who have health insurance will access the care they need, but those who do not have insurance will go without. This may include primary care interventions such as immunizations and regular health screenings. Rising health care costs have a direct effect on the number of uninsured individuals and, therefore, a direct effect the number of individuals that can access care.

Although the ACA have made progress, many still question whether or not this new law is working. The law is too complicated for people to understanding their coverage. "The ACA is not perfect", "but at least" the U.S. has taken one step toward reducing the disparities between rich and poor and providing health coverage to everyone (Gruber, 2011). In this paper I will discuss the benefit of the ACA and the affect it will have on provider reimbursement.

Most people do not know how the Affordable Care Act (ACA) will affect them because the main groups of people that are affected are the uninsured population and vulnerable population. The number of vulnerable populations is increasing and if the establishment of policies and programs fail to improve the health of this population, then it will be extremely difficult to contain the cost of care in the United States (Knickman & Kovner, 2015). The goals of the ACA are to significantly

In 2010, the Affordable Care Act, hereafter referred to as the ACA, was signed into law. Even though the reformed healthcare system allowed more Americans to access to quality affordable health insurance, it still has many flaws. We focus on solving the problem that the current health care policies are based on a hierarchal system, where the higher one is placed in the socioeconomic status, the better quality and access to healthcare him or her will get. As a result, people who are in the lower socioeconomic status will more likely to be stuck in a cycle that continues to perpetuate itself. This group of people is most

Obamacare has drastically raised health care costs for individuals and families. One of the reasons Obamacare was established was to reduce family premiums by $2,500 a year (Anderson 1). However, this goal has not been accomplished yet, the typical family premiums are increasing at rapid rates (Anderson 2). From 2015-2016, Family Silver, one of the most popular family insurance plans, had a ten percent increase on their premiums price. Some states even rose by forty percent (Furchtgott-Roth 3). Middle class families cannot keep paying an arm and a leg for health insurance. Health insurance should not be a major issue for Americans, it should be

Middle-income earners, those who “had incomes ranging from about $42,000 to $125,000 in 2014” (Fry & Kochhar, 2016), are often hit the hardest by what one could deem a coverage gap. This gap exists because many middle-income households do not qualify for Medicaid or sufficient subsidies and cannot afford to purchase plans in the top two, Gold and Platinum, insurance tiers. They are instead

The Affordable Care Act started changing the country’s health-care system almost from the moment it was signed into law in March 2010. It has already expanded coverage of young adults by allowing them to stay on their parents’ plans until they turn 26, outlawed lifetime limits on what insurance will cover, lowered the cost of drugs for seniors on Medicare, caused 13 million consumers to get premium rebates totaling some $1.1 billion, and expanded access to free preventive care for patients of all ages. Last summer it survived a challenge in the U.S. Supreme Court.