The Patient Protection and Affordable Care Act also known as the Obama Care was enacted on march 23, 2010 under the auspice of President Barack Obama (Smith,2014).The legislation was established so as to enhance the access to quality and affordable health care in the United States. The PPACA is anchored on the philosophy of the public private participation in the provision of the health care. The US government has put in place a number of initiatives like the expansion of the Medicaid mandate and the provision of medication to uninsured citizens (Smith, 2014).The strategy has seen the reduction in the government spending on the health sector.
The state Medicaid expansion under the PPCA has caused a significant change in the payment of the health care in the US. However, many medical pundits and policy makers have been questioning the viability and the suitability of the change. Each state in the United States is currently making independent decisions on how to best implement the change despite the mix opinions about the new medical plan.
The Medicaid expansion at the state level started in January 2014.The states that participated in the state Medicaid expansion developed initiatives that ensured that more adults get covered than before. The Obama care has provisions that states that only adults who are between 19 and 65 years get access to the medical cover (McCue, 2015). Also, individuals whose incomes are 138% or less of that of the Federal Poverty Level are eligible for the Medicaid cover (Shahpurwala et al., 2015). Furthermore, the new legislation is clear about people who do not qualify for the Medicaid at the state level.Pulcini (2013) notes that people who are not citizens of the United States, prisoners and those American citizens who are already receiving the Medicaid are not part of the expansion.
Despite the fact that many states in the US like Georgia, Florida and Texas initially opted out of the Medicaid expansion, majority of the states have welcomed the new expansion by stating that the law is meant to enhance the health needs of the poor (Pulsini, 2013).Besides, the participating states have benefitted from both a health and a financial perspective. Furthermore, the states that are not participating in the Medicaid expansion continue to receive the Medicaid funding. However, the opting out of some states means that the state will not be under any obligation to spend the funds on the poor citizens. Therefore, the money can be used to fund other development projects a fact that leaves the poor residents without adequate medical care. The expansion of the Medicaid was meant to reduce the discrimination in the provision and access to quality health care In the US.
Advantages of the Act
The Patient protection and Affordable Care Act has immense benefits to the citize4ns of America. To begin with, the legislation has ensured that thousands of the US citizens who were uninsured can have access to affordable and quality health care through the expansion of the Medicaid. Besides, the PPCA has enhanced the provision of low cost health care insurance (Shahpurwala, 2015).
According to Pulcini (2013), the law has a provision that allows the youths to be included in the parents’ insurance plan until they reach the age of 26 years. Pratt and Belloit (2014) reiterates that this initiative was meant to ensure that over 25% of uninsured teenagers can have access to quality health care. Also the expansion of the Medicaid mandate has been critical in enhancing the conditions of the elderly since the legislation is significant in cutting down on the medication cost and wasteful spending.
Other than the promotion of the free market in the health industry, the PPAC offers tax exemptions for people who are operating small busineses.Besides; the legislation has provisions that give tax exemptions of about 50% to organizations that have employed less than 25 employees on a full-time basis. However, those institutions with over 50 employees on a full time engagement are compelled by the legislation to provided insurance cover so as to enhance the access to affordable health care (Shahpurwala, 2015).
A study by Green-Weir and Stevenson (2014) indicates that the expansion of the Medicaid has established strategies that have seen the reduction in the government’s spending on the health care. This intervention has seen the reduction in the inflation rate in the health for the past 50 years. Furthermore, the expansion of the Medicaid mandate has seen about 15 million uninsured US citizens have access to quality care. Majority of the people who could not afford medication included women, children, the elderly and persons with physical disabilities. The Obama care has been of great significance in the reduction of the discrimination in the health care. Most of the Americans who were alienated from accessing quality and affordable medication due to high cost are now guaranteed of good health courtesy of the PPCA (Pratt & Belloit, 2014).
Disadvantages of the Act
The Obama Care is too costly. According to the Chung (2014) US government has been forced to set aside a lot of money to take care of the health care needs of people who were initially alienated from accessing medical services. The American government has been forced to raise taxes a fact that has seen an increase in the cost of life. Besides, health pundits argue that the PPCA is overburdening employees (Boehner, 2011).
As noted by Pratt & Belloit (2014), the PPCA has provided many insurance options a fact that makes the whole process complicated. Most of the American citizens are at a high risk of losing out as a result of over-buying or under-buying of the medical cover. Besides, the Obama care tends to favor teenagers as compared to the rest of the population. This is due to the fact that the legislation has provisions that allow the youths to have access to low premiums besides enjoying the insurance cover of their parents until they reach 26 years.
A study by Fischer (2013) that the payment PPCA has limited the payment of the Medicaid to the health institutions. The bill seeks to control the payment rates thus leading to an increase in the health cost. Furthermore, the sustainability of the Obama Care is in doubt since the legislation has seen the cost of accessing medication in the US rise above that of other developed countries like Australia which provides universal health care to the citizens (Boehner, 2011). In addition, the bill has enhanced the development of a culture whereby many doctors and health institutions are concerned about the compliance with the bill so as to benefit from the Medicare payments at the expense of the clients.
How state Medicaid expansion will influence the delivery of services
A research McCue (2015) by indicated that Medicaid pays poorly compared to other insurance providers. This has made many health providers favor patients with alternative insurance covers. Also, receiving Medicaid reimbursement is too cumbersome and takes a lot of time. These shortcomings have hampered the provision the access to medical services by patients with Medicaid since some hospitals are reluctant to accept Medicaid patients due to logistical issues. However, most of the expansion of the Medicaid s has enhances the provision of services to patients who need surgical operation since mince most of the surgeons prefers the insurance plan.
Impact of the state Medicaid expansion on the role and work of Nurses
The state expansion of the Medicaid has increased the number of people that have access to quality care in the participating states. This is because many people who were initially uninsured have been catered for by the new medical plan (McCue, 2015). This development has increased the number of people who are seeking medical assistance. The increased in the patient has an effect on the workload of the individual nurse. It is important for the state to employ more health workers so as to cope up with the big number of the patients. Heavy workloads can an impediment to the provision of the quality health care .This is because overworking of nurses can lead to the occurrence of the medical errors. It is imperative for the states to implement nurse-safe-staffing strategies that will ensure that all the needs of the patients are adequately met.
Conclusion
The Patient protection and Affordable care Act has been of great significance in reducing discrimination in the US health care system. This is because the legislation seeks to provide quality care to both the rich and the poor by targeting the elderly, youths and the disabled persons who were initially alienated from accessing quality care. Also, the new law ensures that the patients are not exploited.
References
Boehner, J. (2011). Obamacare: A budget-Bursting, Job Killing Health Care law. New York: DIANE Publishing.
Chung, K. C. (2014). The Patient Protection and Affordable Care Act. Hand Clinics, 30(3), 345- 352. doi:10.1016/j.hcl.2014.05.002
Fischer, A. K. (2013). Resolving Healthcare Issues In Compliance With The Patient Protection And Affordable Care Act. Journal of Business Case Studies (JBCS), 9(6), 449. doi:10.19030/jbcs.v9i6.8190
Green-Weir, R. R., & Stevenson, T. N. (2014). Healthy Decisions and Unintended Consequences: Implications of the Protection and Affordable Care Act (ACA) for Higher Education. The Obama Administration and Educational Reform, 337-351. doi:10.1108/s1479-358x20130000010017
McCue, M. J. (2015). The Impact of Medicaid Expansion on Medicaid Focused Insurers in California. INQUIRY: The Journal of Health Care Organization, Provision, and Financing, 52(0). doi:10.1177/0046958015595960
Pratt, W. R., & Belloit, J. D. (2014). Hospital costs and profitability related to the Patient Protection and Affordable Care Act. JHA, 3(3). doi:10.5430/jha.v3n3p100
Pulcini, J. (2013). Update on the Patient Protection and Affordable Care Act. AJN, American Journal of Nursing, 113(4), 25-27. doi:10.1097/01.naj.0000428744.63675.26
Shahpurwala, Z., Ramachandran, S., Banahan, I. B., Hardwick, S., & Clark, J. (2015). Impact of Medicaid managed care expansion on access to providers in Mississippi. Value in Health, 18(3), A78. doi:10.1016/j.jval.2015.03.455
Smith, K. J. (2014). Navigating the Minefields of the Patient Protection and Affordable Care Act. Employment Relations Today, 41(2), 75-80. doi:10.1002/ert.21457
