America's Healthy Future Act of 2009 versus the PPACA and Their Effect on Health Plans, Employers and Individuals
The increasing cost of healthcare plans has been a major issue of concern to the American public. The creation of America’s Healthcare Future Act of 2009 and the Patient Protection and Affordable Care Act (PPACA) are some of the major attempts to reform healthcare in the U.S. These two legislations were instituted in a bid to improve the healthcare status in the U.S and therefore have several notable similarities. There are also differences between them as regards some of the provisions contained in each of them. In this paper, some of these similarities and differences are explored and the effect that the two legislations have on health plans, employers and individuals.
Both the America’s Healthy Future Act of 2009 and the PPACA have implicit plans to improve affordability of healthcare plans to Americans. According to Govtrack.us (2009), the America’s Healthy Future Act establishes the Medicare Commission that will independently endeavor to reduce the rate at which per capita spending on Medicare has been growing. Competition with private institutions of cooperative originations stipulated in this legislation and various price monitoring mechanisms are expected to lower prices. Similarly, Rand.org (2010) observed that the provisions under PPACCA will lower premiums paid by individuals by 2% from the prevailing level. Lower costs in this sector will attract more individuals to purchase insurance plans. However, GAO (2012) observed that the reduction in costs may not be favor of employers as well due to the tough requirements that the plans offered should meet.
A second similarity is that both Acts require all Americans to obtain healthcare plans, a responsibility that may be fulfilled partly by both the individual and the employer. PPACCA aims at reducing the number of Americans without Medicare insurance plans through individual mandate and employer mandate to obtain health insurance plans (National Conference of State Legislatures, 2012). One way through which this is affected is the above requirement. A failure to meet this requirement will see an individual face penalty charges under both laws. Therefore individuals face two alternatives: to obtain a healthcare insurance plan with at least the essential health benefits or to default, in which case they are penalized (National Conference of State Legislatures, 2012). Employers, on the hand, are obligated to offer group healthcare insurance plans that meet specified requirements. Similarly, employers who fail to meet these requirements also face a penalty charge. While the two laws provide incentives for employers to offer health plans to employees, GAO (2012) noted that more costs associated with provision of such benefits by employers will derail this incentive. The healthcare plans market is therefore likely to record higher levels of individually obtained plans.
Under both enactments, the health insurance plans offered in the individual and small group market are required to be qualified health benefits plans (QHBPS). According to the Committee on Finance (2009), one of the requirements of America’s Healthy Future Act include the above. This aspect of quality is also largely stressed in the PPACA act, which among others, stipulates that part of the packages aim at reforming the healthcare delivery system to improve the quality and efficiency of healthcare (Tribe & Pilon, 2011). A focus on quality will ensure that Americans are provided with the best healthcare solutions in the market and thus ensure that they receive a service that is worthwhile. Healthcare plans that meet specified qualifications as per the qualified healthcare benefits plans may be offered to individuals and relevant small groups or businesses in the appropriate insurance exchange system.
Another significant common feature between PPACA and America’s Healthy Future Act is the establishment of a web-based exchange system for healthcare plans. This initiative is aimed at enhancing accessibility of healthcare plans. According to Carrigan (2012), PPACA requires that states establish web-based portals that will enable individuals to have access to a one shop stop for all their medical insurance needs. Such an online exchange system will definitely improve transparency in insurance healthcare plans besides enhancing efficiency. Another implication for individual consumers of these healthcare plans is that there will be elaborate information to screen possible alternatives and be able to access the most lucrative offers on the market. Easing the process of securing healthcare insurance through Web-based system programs will in turn ease and encourage compliance with requirements of the two Acts that all individuals should obtain a plan. Related penalties will thus be lower than they would have been in the absence of exchange systems considering the difficulties that would otherwise be encountered in securing the plans. The health plans system will be more efficient and transparent as individuals and employers will be able to access more current information.
In contrast, several differences are also notable between America’s Healthy Future Act of 2009 and the PPACA. Whereas the PPACA stresses more on improvement of governmental public health infrastructure, America’s Healthy Future Act provides for formation of public-centered institutions that will require less Federal budget commitment. According to the Library of Congress (2009), the programs under this reform will have a minimal strain on the Federal budget. PPACA includes provisions that focus on prevention, wellness and public health. Unlike America’s Healthy Future Act, PPACA draws a relatively significant amount from the Federal budget to effect the provisions in the Act. In the long-term, this reform is also expected to consume more resources. Individuals will be able to secure low-cost healthcare under these organizations as a result of increased competition thanks to the non-profit organizations.
A major aspect of healthcare that is stressed by PPACA besides affordability is prevention. In the case of America’s Healthy Future Act of 2009, accessibility of healthcare plans is another major focus. Under PPACA, disease prevention is given significant attention than in America’s Healthy Future Act of 2009, with the creation of the National Prevention, Health Promotion and Public Health Council and the prevention and Public Health Fund (Majette, p. 380). Although America’s Healthy Futures Act also contains provisions that focus on prevention, they are less profound compared to similar provisions under PPACA (Committee on Finance, 2009). A more proactive approach to healthcare solutions is thus anticipated in this sector as much effort is directed to prevention and protection initiatives.
Notably, there are major similarities and differences between the PPACA and America’s Healthy Future Act of 2009. Similarities include the creation of a Web-based health plans exchange system, a common goal of improving affordability of these plans, a requirement on all individuals to obtain health plans and that such plans be qualified health benefits plans. Differences include the focus on public-centered institutions in the case of America’s Healthy Future Act of 2009 against PPACA’s focus on improvement of government healthcare infrastructure. The implications of the above for individuals include affordable plans, compulsory healthcare plans and ease of access to information on these plans. Employers are compelled to offer health plans to employees as well and may do so at higher costs. Overall, health plans will be more affordable to individuals, easily accessible and highly competitive.
References
Carrigan, D. M. (2012). The Patient Protection and Affordable Care Act of 2010: Constitutional?
American Journal of Health Science, 3(1): 75-82. Retrieved from:
Committee on Finance. (2009). America’s Healthy Future Act of 2009. United States Senate. Retrieved from: http://www.gpo.gov/fdsys/pkg/CRPT-111srpt89/html/CRPT-111srpt89.htm
GAO (2012) Patient Protection and Affordable Care Act: Estimates of the Effect on the
Prevalence of Employer-Sponsored Health Coverage. GAO-12-768. Retrieved from: http://www.gao.gov/assets/600/592411.pd
Library of Congress (2009). America’s Healthy Future Act of 2009. Bill Summary & Status 111th
Congress 2009-2010. Retrieved from: http://thomas.loc.gov/cgi-bin/bdquery/z?d111:S1796:
Majette, R. G. (2011). PPACA and Public Health: Creating a Framework to Focus on Prevention
and improve the Public’s Health. Journal of Law, Medicine & Ethics. Retrieved from: http://www2.law.csuohio.edu/newsevents/images/39JLME366.pdf
National Conference of State Legislatures (2012) State Health Insurance and the PPACA
Essential Benefits Provisions. Retrieved from: http://www.ncsl.org/issues-research/health/state-ins-mandates-and-aca-essential-benefits.aspx
Rand.org (2010) Analysis of the Patient Protection and Affordable Care Act (H.R. 3590). Policy
Brief. Retrieved from: http://www.rand.org/content/dam/rand/pubs/research_briefs/2010/RAND_RB9514.pdf
Tribe, H. T. & Pilon, R. (2011). Is the patient Protection and Affordable Care Act Constitutional.
The California Journal of Politics& Policy, 3(4): 1-18. Retrieved from: http://www.cato.org/pubs/articles/ObamaCare-Tribe-debate.pdf
