Abstract
This paper is attempts to detail the relationship between the Patient Protection and Affordable Care Act (PPACA) and the workplace environment since its enactment into law. The paper shall delve into aspects of the relevance of the law in the author’s opinion and explicitly state the authors stand on the whole legislation. The paper shall examine the legislation in depth and determine its viability and potential benefits and hazards.
Public health is a field that is faced with various issues that need to be frequently addressed. There are various federal initiatives that have been place to address the current issues in public health care. The Department of Health and Human Services has developed an action plan aimed at reducing the racial and ethnic health issues. This department brings out the vision of a country that should be free from health disparities and develops the goals, actions and strategies towards achieving its goals. Examples of initiatives which are covered Health and Human Services department include health program initiative, local communities, private organizations and states (Kristen Boon, 2010).
There is also an established Affordable Care Act which has important changes in the health care system. This act brings about efforts health care for the populations vulnerable to diseases. The act increases coverage for the low and moderate earners populations. The provisions for this Affordable Care Act includes strengthening safety health delivery system, improved health access to the customers, strengthen collection of health care data and research efforts, and implement the prevention and public health initiatives
Affordable healthcare act
The Patient Protection and Affordable Care Act abbreviated as PPACA, commonly called the Affordable Care Act abbreviated as ACA or, colloquially, Obamacare, is a United States of America federal statute signed into law by President Barack Obama on March 23, 2010. It is the most significant regulatory overhaul of the U.S. healthcare system since the passage of Medicare and Medicaid in 1965. Under this act, hospitals and primary physicians are required to transform their practices technologically, financially, and clinically to drive better health outcomes, lower costs, and improve their methods of accessibility and distribution.
The act was enacted to increase the quality and affordability of health insurance. It is also targeted at lowering the rate of uninsured rate by expanding public and private insurance coverage. Finally the act aims to reduce the costs of healthcare for individuals and the government. It introduced mechanisms such as mandates, subsidies, and insurance exchanges. The law requires insurance companies to cover every applicant within new minimum standards and offer the same rates regardless of sex or pre-existing conditions.
The law essentially puts families, individuals and small business owners in control of their health care. It reduces premium costs for millions of working families and small businesses by providing subsidies and tax relief that go into hundreds of billions of dollars. This is the largest middle class tax cut for health care in history. Americans without insurance cover will be able to choose the insurance coverage that works best for them in an open, new, competitive insurance market. In fact, this is the same insurance market that every member of Congress shall be required to use for their insurance. The insurance exchange mechanism seeks to pool buying power and give Americans new affordable choices of private insurance plans which have to compete for their business on the basis of cost and quality. Small business owners will not only be able to choose insurance coverage through this exchange, but will receive a new tax credit to help offset the cost of covering their employee.
The mechanisms mentioned above help keep insurance companies honest by setting clear rules that reign in the worst insurance industry abuses. The law further bans insurance companies from denying insurance coverage because of a person’s pre-existing medical conditions and gives consumers new power to appeal insurance company decisions which deny doctor ordered treatments that are covered by insurance.
Medicaid has the social health care program for families and individuals who have a low income and limited resources. The Health Insurance Association of America describes it as a government insurance program for people regardless of age, whose income and resources are insufficient to pay for health care (Heyworth, 2015). It is the largest source of funding for health-related and medical services for people whose income is low in the United States. It is a means-tested program that is jointly funded by the state and the federal governments while managed by the states. Each state however, currently has broad leeway to determine the persons eligible for its implementation of the program. It is not mandatory for states to participate in the program, although all do as at the writing of this paper. Medicaid recipients must be United States citizens or legal permanent residents, and could include low-income adults with their children, and people with certain types of disabilities. Poverty alone does not necessarily qualify someone for Medicaid.
It is important to point out at this time that since 2014, the Patient Protection and Affordable Care Act was amended and now requires most individuals to maintain health insurance coverage or potentially to pay a penalty for not complying. The penalty is calculated as the greater of either;
- A percentage of applicable income, defined as the amount by which an individual’s household income 4 exceeds the applicable tax filing threshold for the tax year; or
- A flat dollar amount assessed on the taxpayer and his or her dependents.
In March 2015, the Centers for Disease Control and Prevention reported that the average number of uninsured during the period from January to September 2014 was 11.4 million less than the average in 2010. In April 2016, Gallup reported that the percentage of adults who were uninsured dropped from 18% in the third quarter of 2013 to 11% in the first quarter of 2016.
Penalties that taxpayers are required to pay for their dependents or themselves must be included in their federal income tax return for the taxable year. For those who file joint returns, they are jointly liable for the penalty.
However, certain individuals and their dependents are exempt from the individual mandate and its associated penalties. These are; Religious Conscience, hardship, Health Care Sharing Ministry Membership, Indian Tribe Membership, Incarceration, Affordability, Unlawful Resident, Coverage Gap, Filing Threshold and Living Abroad. The Act also gives the Secretary of Health and Human Services (abbreviated as HHS) the authority to determine circumstances under which an individual may receive a hardship exemption (Griffith, 2000).
The Act protects and preserves Medicare as a commitment to America’s seniors. It is expected to save thousands of dollars in drug costs for Medicare beneficiaries by closing the coverage gap called the donut hole. Hospitals, doctors and nurses will be incentivized to improve care and reduce unnecessary errors that may harm patients. Beneficiaries in rural America shall benefit as the Act enhances access to health care services in deemed underserved areas.
The law is also designed to be flexible by permitting states, from 2017 onwards, to apply for a waiver for state innovation from the federal government. This allows the states to experiment with their own state-based system, provided that they meet certain criteria. To obtain this waiver, the said state has to pass legislation setting up alternative health care system providing insurance at least as comprehensive and as affordable as the one provided by Affordable Care Act, covers at least as many eligible persons and doesn’t increase federal deficit. Provided the particular state(s) meets these conditions, receiving a waiver can exempt states from some of the central requirements of the ACA. These include the individual mandate, the provision of an insurance exchange, and the employer mandate. The state would receive compensation equal to the total amount of any federal subsidies and tax credits for which its residents and employers would have been eligible under the Affordable Care Act plan, if they cannot be paid out due to the structure of the state plan (Blenko et al, 2010).
Among essential health benefits are aspects such as; preventive care, adult vaccinations and childhood immunizations, and medical screenings that are covered by an insurance plan’s premiums, and cannot be subject to any co-payments, co-insurance, or deductibles. Specific examples of services covered include: wellness visits, mammograms and colonoscopies, gestational diabetes screening, Human Papilloma Virus testing (HPV), Sexually Transmitted Infections (STI) counseling, HIV screening and counseling, FDA-approved contraceptive methods, breastfeeding support and supplies, and domestic violence screening and counseling.
The ACA funds scholarships and loan repayment programs to increase the number of primary care physicians, physician assistants, nurses, mental health providers, and dentists in the areas of the country that need them the most. With a comprehensive approach focusing on retention and enhanced educational opportunities, the Act aims to combat the critical nursing shortage. And through new incentives and recruitment, it increases supply of public health professionals so that the United States of America is prepared for health emergencies.
The Act provides state and local governments’ resources and flexibility to develop health workforce recruitment strategies (Avery, 2001). It also helps to expand critical and timely access to care by funding the expansion, construction, and operation of community based health centers throughout the United States of America. The Secretary reserves the authority to take action to strengthen existing programs that aid support the primary care workforce.
The act mandates, a workplace benefit incidental, and without direct relation to the job itself. The employer mandate is a penalty that shall be incurred by every employer with more than 50 employees and does not offer health insurance to their full-time workers. It then follows that no company with fewer than fifty full-time employees shall face the penalty. This raises concerns that the employer mandate creates a perverse incentive for businesses to employ people part-time instead of full-time. This phenomenon has sometimes been referred to by commentators on both sides of the political spectrum as The Obamacare Effect.
As a result of the new employer mandate some larger firms who have to provide insurance for employees for the year 2015/2016 are cutting back employee hours to part-time in order to avoid paying for their health coverage. Other employers have moved workers from part-time to full-time to embrace the law.
However, the legislation, ObamaCare, funds the creation of tens of thousands of new jobs in Government as well as healthcare sectors.
Conclusion
It is clear from this paper that the Obamacare has its strong points as well as its weak aspects. Of particular interest to this paper is its effect on the job environment. In my opinion the Act is relevant and does no such drastic things as setting a hazardous precedent. In fact from the discussion the act is far more beneficial than it is potentially harmful. Even in cases where the act seems anti-business, it has positive ramifications particularly for the small businesses. In fact it has been observed that over 85% of companies report that they are not changing their financial plans simply because the Act is in place. This is an indication that the obamacare is not killing jobs as several people seem to imply.
References
Avery, C. (2001). Teamwork Is an Individual Skill: Getting Your Work Done When Sharing Responsibility. San Francisco: Berrett-Koehler Publishers, Inc.
Blenko, Marica, Michael. C Mankins and Paul Rogers. “The Decision Driven Organization.” Harvard Business Review, June 2010, pp. 55-62.
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Griffith, J. R., & King, J. G. (2000). Championship management for healthcare organizations. Journal of Healthcare Management, 45(1), 17.
Heyworth, K. K. (2015). Vaccines: The Reality Behind the Debate. Retrieved 02 13, 2016, from Parents: http://www.parents.com/health/vaccines/controversy/vaccines-the-reality-behind-the-debate/
Kristen Boon, A. Z. (2011). United States Preparedness for Catastrophic Attacks. Oxford University Press.
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