Synthesize the effect healthcare reform Affordable Care Act (ACA) has on stakeholders

Synthesize the effect healthcare reform Affordable Care Act (ACA) has on stakeholders
When President Obama took over in 2008, he introduced the Affordable Care Act (ACA) or “Obamacare”, which was enacted in March 2010. The ACA would provide affordable health insurance to more people, expand the Medicaid program such that all adults with income below 138% of the federal poverty level are covered, and lastly, support medical care delivery methods that are designed to generally lower the costs of health care (Buchmueller et al., 2016). This paper therefore takes a look at the impact of the ACA on a number of stakeholders, with a focus on financial impact, benefits and drawbacks the reform had on the respective stakeholders.

Groups of Stakeholder Impacted by the ACA

Different stakeholders were affected differently by implementation of the ACA. The first major stakeholder impacted by the reform are insurance companies, both private and public. A number of provisions were directly aimed at the insurance companies, as the reform sought to solve the root cause as to why millions of American citizens were without health insurance. The other group affected are the health care institutions. The ACA, in tackling the high health care costs, effectively ensured that health care institutions were compliant with a number of provisions to ensure that patients are protected from high health care bills.

The third group, and probably the largest beneficiaries of the ACA, are members of the public. The reform was meant to benefit American citizens and therefore, members of the public stood to gain the most from implementation of the act. From provision of subsidies and reduction of health care costs, to affordable insurance plans, the U.S. members of the public stood to gain from all aspects of the reform.

Financial Implications

Each of the groups of stakeholders mentioned above were affected differently financially. Some stood to gain while others incurred a number of losses. The largest gainers were the members of the public. Numerous groups of members of the public gained financially from the reform. A good example is the young American adults. The dependent coverage provision allowed young American adults to utilize their parents’ insurance coverage plans until they got to their 26^th birthdays. The coverage for these young adults was to remain the same as when they were children, hence preventing additional costs of coverage. Since the ACA was introduced, women of reproductive age have saved an average of $255 every year on oral contraceptives alone, as a result of health plans being required to cover certain preventive services without cost-sharing (French et al., 2016).

Insurance companies that provided health coverage stood to lose financially in the short term, but gain in the long term. This is due to the fact that in a number of years, the number of U.S. citizens with health insurance cover was set to increase two-fold, due to subsidies provided by the government (Liaropoulos & Gorantis, 2015). The short term losses would arise from coverage of certain preventive services without cost-sharing. Health care institutions would also lose financially as the government reduced the cost of health care. Sources of revenue for these facilities, specifically insurance claims, were set to take a hit temporarily before returning to the normal.

Benefits and Drawbacks of the ACA

The ACA majorly benefited the American members of the public as it tackled increasing costs of healthcare, provided subsidies and ensured no denial of insurance coverage due to certain factors such as pre-existing conditions and gender. However, the act needed low-income families to subscribe to a health insurance coverage, without considering how such families would afford and sustain such an expense. Some families have been plunged into economic turmoil on account of taking out a health insurance coverage plan (Reisman, 2015).

Insurance companies made numerous losses initially due to provisions such as no denial of coverage due to certain factors, the dependent coverage provision and covering certain preventive services with no cost-sharing (Sommers et al., 2017). However, they stood to benefit in the long-term as the number of individuals with health insurance was set to massively increase, which translates to income for the insurance companies.

Health care facilities, just like the insurance companies, incurred a number of initial drawbacks before later finding their feet on account of the ACA. Health care institutions were set to lose out on a number of their revenue streams as well as the challenge of dealing with an increased number of patients, as a result if increments in insurance coverage. They would however recover and benefit over the long-term due to increased revenue from insurance companies as a result of increase in the number of patients with insurance coverages.

Conclusion

Implementation of the ACA benefited a number of stakeholders, with the largest gainer being the common U.S. citizen. Insurance companies and health facilities, among other stakeholders, incurred initial finances initially but stood to gain in the long-term. The ACA therefore benefited a majority of the stakeholders involved.

References

Buchmueller, T. C., Levinson, Z. M., Levy, H. G., & Wolfe, B. L. (2016). Effect of the Affordable Care Act on Racial and Ethnic Disparities in Health Insurance Coverage. American Journal of Public Health. Retrieved from https://doi:10.2105/AJPH.2016.303155

French, M., Homer, J., Gumus, G., & Hickling, L. (2016). Key Provisions of the Patient Protection and Affordable Care Act (ACA): A Systematic Review and Presentation of Early Research Findings. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5034214/

Liaropoulos, L., & Goranitis, I. (2015). Health care financing and the sustainability of health systems. International Journal for Equity in Health. Retrieved from https://doi:10.1186/s12939-015-0208-5

Reisman, M. (2015). The Affordable Care Act, Five Years Later: Policies, Progress, and Politics. Pharmacy and Therapeutics; 40(9): 575-578, 600.

Sommers, B., Gawande, A. A., & Baicker, K. (2017). Health Insurance Coverage and health-what the recent evidence tells us. The New England Journal of Medicine, 377(6),586-593 Retrieved from https://www.nejm.org/doi/pdf/10.1056/NEJMsb1706645m

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