In Chapter 9, you saw that the majority of individuals with private insurance in the United States are covered under their employers’ health plans that are governed by ERISA. In Chapter 10, the discussion turns to public health care financing including a discussion of Medicare, which covers individuals over the age of 65 and those with certain disabilities, and Medicaid and CHIP, which cover the financially needy and children. This is a very fragmented system of coverage.

The Patient Protection and Affordable Care Act (ACA) attempted to cure certain deficiencies in this system by establishing 3 coverage mechanisms: 1) the ACA exchanges, 2) the employer mandate, and 3) expanding Medicaid and extending CHIP.


Discuss each of these 3 ACA approaches to increase insurance coverage answering each of the following questions within the following 5 topics:

  1. Include in your answer the basics of the ACA plan to increase coverage with each of the 3 mechanisms.
  2. You have seen that insurance coverage may not be equivalent to medical access. Are there potential problems/issues related to access in each of the 3 ACA coverage mechanisms? What is the difference between “coverage” and “access”?
  3. Why might the ACA exchanges be failing to live up to their expectations? Discuss how young, healthy individuals and the chronically ill with pre-existing conditions might behave differently with respect to the exchanges and how this would affect the risk pool.
  4. What positive and negative effects could the employer mandate have on businesses that must comply?
  5. As you know, the ACA provision to expand Medicaid was struck down by the United States Supreme Court. Who did this leave without insurance coverage that the ACA envisioned would have it? Why do you think that some 20 states have refused to adopt Medicaid expansion?

Submit a scholarly essay of approximately 1000–1200 words addressing each of the 5 topics above. Explain your responses fully with well-reasoned explanations and analysis, demonstrating a thorough understanding of the topics as discussed in the course and incorporating your own research. This assignment must cite a minimum of three scholarly sources using in text Bluebook citation format.  Acceptable sources include the textbook, the Bible, and scholarly articles published within the last five years.

Note: Your assignment will be checked for originality via the Turitin plagiarism tool.

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