UKM2 Task 2: Healthcare Policy and Economics
Healthcare Policy and Economics
College of Health Professions, Western Governors University
UKM2 Task 2: Healthcare Policy and Economics
A.1. Federal Healthcare Enacted Law
One federal public healthcare law that affects the provisions of patient care and healthcare
delivery is the Patient Protection and Affordable Care Act (ACA), which was enacted on March
23, 2010. The law has three primary goals: make affordable health insurance available to more
people, expand the Medicaid program to cover all adults with income below 138% of the FPL,
and support innovative medical care delivery methods designed to lower the costs of health care
(Assistant Secretary for Public Affairs (ASPA), 2022). It was hoped that, when fully
implemented, the ACA would result in health insurance coverage for about 94% of the American
population and an increase in Medicaid enrollment by 15 million beneficiaries.
A.2. How the ACA Works
The ACA consists of 10 legislative titles to cover the three primary goals listed above. With the
first provisions of the law, the ACA made health insurance coverage a legal obligation and
expectation for American citizens, with tax breaks for citizens who have insurance coverage and
penalizing those who don't. The ACA is a federally mandated program, but due to the 10th
Amendment of the Constitution, it is up to the states to implement federal insurance regulations.
Part of this law is setting federal standards for insurers to ban discrimination against women,
elderly, children, and people with pre-existing conditions and guaranteeing the right to internal
and external impartial appeal procedures if coverage is denied (Rosenbaum, 2011). Insurers and
employer health benefit plans are now required to cover services with an A or B rating from the
US Preventative Services Task Force, immunizations recommended by the Advisory Committee
on Immunization Practices, and other preventative health maintenance for children, adolescents,
and women (Rosenbaum, 2011). The goal to improve healthcare quality and efficiency starts by
putting changes into the Medicaid/Medicare system that provide payment or no payment based
on the quality of care provided, readmission rates, and reports based on the clinician's
performance.
A.3. Impact on Population
Populations that will benefit from the ACA are low-income families, the elderly, and individuals
who have pre-existing conditions. This law also helped the younger generation, allowing them to
remain on their parent’s insurance plan until they reached 26. The population that benefits from
the ACA is more likely to find and be approved for affordable healthcare, have the right to
appeal insurance denial, are less likely to face discrimination, and will now have preventative
care covered by insurance. The populations that are negatively affected are small businesses that
now have to provide coverage for full-time employees and middle to high-income families that
, may have higher insurance premiums than they did before; both of these populations could now
face financial strain due to the ACA being implemented. The ACA impacts health disparities and
equity by increasing access to healthcare coverage, providing quality care, and including
preventative measures in health plan coverage.
A.4. Supporting Evidence
The research found that 2.3 million more young adults reported health insurance coverage due to
remaining on their parent’s insurance policy, and Medicaid had an enrollment increase of 14.5
million people, showing that the implementation of the ACA increased insurance coverage in the
U.S. (Gruber & Sommers, 2019). The National Health Interview Survey concluded that
uninsured non-elderly individuals decreased from 16.6 percent to 10.4 percent, the lowest level
recorded in American history (Gruber &Sommers, 2019). The research was primarily non-
conclusive regarding the effects on healthcare utilization and health, showing results that differ
from state to state when looking at emergency department visits and mortality. Still, other studies
Healthcare Policy and Economics
College of Health Professions, Western Governors University
UKM2 Task 2: Healthcare Policy and Economics
A.1. Federal Healthcare Enacted Law
One federal public healthcare law that affects the provisions of patient care and healthcare
delivery is the Patient Protection and Affordable Care Act (ACA), which was enacted on March
23, 2010. The law has three primary goals: make affordable health insurance available to more
people, expand the Medicaid program to cover all adults with income below 138% of the FPL,
and support innovative medical care delivery methods designed to lower the costs of health care
(Assistant Secretary for Public Affairs (ASPA), 2022). It was hoped that, when fully
implemented, the ACA would result in health insurance coverage for about 94% of the American
population and an increase in Medicaid enrollment by 15 million beneficiaries.
A.2. How the ACA Works
The ACA consists of 10 legislative titles to cover the three primary goals listed above. With the
first provisions of the law, the ACA made health insurance coverage a legal obligation and
expectation for American citizens, with tax breaks for citizens who have insurance coverage and
penalizing those who don't. The ACA is a federally mandated program, but due to the 10th
Amendment of the Constitution, it is up to the states to implement federal insurance regulations.
Part of this law is setting federal standards for insurers to ban discrimination against women,
elderly, children, and people with pre-existing conditions and guaranteeing the right to internal
and external impartial appeal procedures if coverage is denied (Rosenbaum, 2011). Insurers and
employer health benefit plans are now required to cover services with an A or B rating from the
US Preventative Services Task Force, immunizations recommended by the Advisory Committee
on Immunization Practices, and other preventative health maintenance for children, adolescents,
and women (Rosenbaum, 2011). The goal to improve healthcare quality and efficiency starts by
putting changes into the Medicaid/Medicare system that provide payment or no payment based
on the quality of care provided, readmission rates, and reports based on the clinician's
performance.
A.3. Impact on Population
Populations that will benefit from the ACA are low-income families, the elderly, and individuals
who have pre-existing conditions. This law also helped the younger generation, allowing them to
remain on their parent’s insurance plan until they reached 26. The population that benefits from
the ACA is more likely to find and be approved for affordable healthcare, have the right to
appeal insurance denial, are less likely to face discrimination, and will now have preventative
care covered by insurance. The populations that are negatively affected are small businesses that
now have to provide coverage for full-time employees and middle to high-income families that
, may have higher insurance premiums than they did before; both of these populations could now
face financial strain due to the ACA being implemented. The ACA impacts health disparities and
equity by increasing access to healthcare coverage, providing quality care, and including
preventative measures in health plan coverage.
A.4. Supporting Evidence
The research found that 2.3 million more young adults reported health insurance coverage due to
remaining on their parent’s insurance policy, and Medicaid had an enrollment increase of 14.5
million people, showing that the implementation of the ACA increased insurance coverage in the
U.S. (Gruber & Sommers, 2019). The National Health Interview Survey concluded that
uninsured non-elderly individuals decreased from 16.6 percent to 10.4 percent, the lowest level
recorded in American history (Gruber &Sommers, 2019). The research was primarily non-
conclusive regarding the effects on healthcare utilization and health, showing results that differ
from state to state when looking at emergency department visits and mortality. Still, other studies
