Answer

The Affordable Care Act

Introduction

The Affordable Care Act increases the coverage of uninsured Americans as well as those that are already insured. The ACA is estimated to expand coverage to about 30 million uninsured Americans who would be covered through subsidies to the Medicaid program or employer provided insurance. The ACA shall build on the existing Medicaid coverage as well as providing subsidies to make private insurance more affordable as well as facilitating employer-provided insurance coverage.

Explain the impact of the Affordable Care act on the population that it affected

Currently, the uninsured nonelderly adult population ranks at about 47.5 million individuals with over half of this population earning below or equal to 138% of the federal poverty level. These individuals shall be covered under the expanded role of Medicaid in the states that shall accept to expand their Medicaid programs (Lawson, 2014). Forty percent of the uninsured adult population has incomes between 139% and 400% of the federal poverty levels and such individuals are targeted by the subsidies provided under the newly created Health Insurance Marketplaces. The ACA requires all states to expand Medicaid coverage to all uninsured individuals with income at or below 138% FPL, which should increase Medicaid coverage to about 24 million adults. Children are also covered in the expanded role of Medicaid as they will continue to be covered up to 2019 when all the provisions of Medicaid shall come into full effect.

States are required by the ACA to streamline their Medicaid enrollment systems to be easily accessible for the uninsured who want to enroll in the Medicaid program. The new Medicaid enrollment systems should allow individuals to register for Medicaid easily using their phones, through mail and also in-person. The simplified enrollment systems are not enough to increase Medicaid coverage as outreach programs are also important in ensuring that those eligible for Medicaid are enrolled in the program. The federal government has promised to provide funding for the streamlining and the enrollment in the Medicaid program. The enrollment programs in each state are dependent on the decisions of each state on whether to expand Medicaid coverage or not (Mucenski-Keck & Smoker, 2015). 26 states have decided not to implement the expansion, which might deny coverage to at least half of those with incomes below the 138% poverty level. Despite these people being eligible for Medicaid coverage, they might not get the coverage based on their states refusal to expand their Medicaid programs. The eligibility requirements for parents will increase in at least 18 states from 106% FPL to 138% FPL, while for adults without children, the eligibility criteria will increase from 0% to 138% in about 25 states.

Explain the impact of the economics of providing care to patients from the organization’s point of view.

Many healthcare facilities will face the critical challenge of catering to the needs of an increased number of patients who are newly covered under the ACA provisions. The healthcare profession has been suffering from a shortage of professionals for several decades and the influx of patients into the system will stretch the limited resources of the healthcare system even much further. Organizations will also be burdened with the responsibility of filling up copious amounts of paperwork for the newly covered given the requirements of the ACA and the Insurance Marketplaces created following the enactment of the ACA. Healthcare organizations that were already suffering from a shortage of staff will be forced to cater to the needs of an influx of patients who are newly covered and this shall stretch hospital resources even further. The staff at these healthcare facilities will be stretched in the provision of care to patients, which might affect the quality of care provided to individual patients. Organizational resources shall also suffer as their limited scope in servicing the needs of eth increased patient base would lead to malfunctions or other unforeseen complications based on the frequency of use of crucial hospital resources. Most public healthcare facilities are operating at maximum capacity and the new influx of patients is bound to stretch their staff and resources to the limit.

Organizations already suffer from a shortage of medical staff and the training of new doctors, nurses and physician assistants usually takes years before such staff can join the workforce. Therefore, the current staff has to deal with the increased paper work created by the ACA as well as the increased number of patients that each physician has to attend to. This will cause more stress on the physician and within the entire system in general, which will impact the quality of care provided to Americans (Beck, 2015). Therefore, the ACA in its good intentions to increase the number of Americans who have access to quality healthcare will have resulted in lower quality care for most Americans in the public healthcare system. There is also the issue of the distribution of healthcare professionals across the United States where most of the healthcare professionals are heavily concentrated I the urban areas with only a fraction of healthcare workers being based in the rural areas. This unequal distribution of healthcare workers leads to the rural populations being highly underserved combine with other factors such as having to drive for long distances to get to healthcare facilities. This situation is made worse by the fact that a quarter of the US population lives in rural areas, which have facilities that are highly understaffed and with minimal resources.

How will patients be affected in relationship to cost of treatment, quality of treatment, and access to treatment?

The relationship between the cost of treatment and the quality of treatment will be a directly proportional relationship where the cost of treatment will have been drastically reduced by the ACA, while the quality of treatment will also decrease due to the increased burden on the healthcare system. The cost of treatment will be lower based on the increased subsidies for adults whose income is between 139% and 400% of the FPL, while the costs will also be lower for those with income at or below 138% FPL. There will be a surge in the number of uninsured who get insurance coverage under Medicaid for all those with incomes at or below 138% FPL in at least 25 states, while the insurance shall also be cheaper for those at higher income levels due to the subsidies created for the new Insurance Marketplaces (Pratt, 2015). Therefore the cost of treatment shall reduce even as the quality of treatment also decreases due to the increased burden placed on the system.

Access to treatment shall have an inverse relationship with both cost of treatment and quality of treatment given that even as the cost of treatment decreases, the access to treatment will increase as the uninsured get access to insurance for the first time in decades.  The previously uninsured will have greater access to treatment options at various public health facilities as they will now be covered by Medicaid. The subsidies for the Insurance Exchanges shall also increase the access to treatment at both public and private healthcare facilities for individuals and families that can afford insurance under the new system. Therefore, there shall be increased access to treatment options across all income brackets based on Medicaid cover as well as the insurance subsidies provided through the insurance exchanges.

What are the ethical implications of this act for both the organization and the patients?

The ethical implications of the ACA for the organization and the patient include the fact that organizations can no longer deny medical care to individuals because their insurance has run out, which is illegal under the ACA. Insurers are also prohibited from denying patients coverage for pre-existing conditions, while employers are given incentives to provide health insurance for their employees. Insurers are also not allowed to drop patients once they become ill according to the provisions of the ACA. There are ethical and legal ramifications for insurers that go against the ACA’s provisions as well as organizations that might deny patients the right care because they do not have insurance (Schildkraut, Baker, Cho & Reuss, 2015). The patients also have an ethical duty to register for Medicaid, if they are qualified, or the other insurance packages based on their income brackets. Organizations are supposed to treat the uninsured even if they have not registered for Medicaid insurance as they can register at the healthcare facility as they undergo treatment. It is the duty of individuals to register for Medicaid well in advance as well as to capitalize on the insurance subsidies provided through the insurance exchanges before getting ill and seeking medical attention.