A discussion on the significance and effects of the affordable healthcare act

Image Signs encouraging patient enrollment in a clinic in Jersey City.

how did the affordable care act impact managed care

Such delayed effects could be attributable to several factors, such as the gradual nature of the coverage expansions, increasing enrollee familiarity with their new insurance coverage, or an extended amount of medical treatment being necessary to make progress on certain chronic conditions.

By combining these two sets of estimates, we can estimate how access to care changed for those who themselves gained coverage through the expansions.

Affordable care act impact on insurance companies

Others have similarly found positive but nonsignificant improvements in ease of obtaining primary and specialty care appointments and ability to afford care among the poor in Medicaid expansion states compared with nonexpansion states 83 , 84 , To the extent that coverage expansions have improved the social and economic wellbeing of families, have they also affected the long-run outcomes of the children? The percentage was somewhat higher among those in the income range that is eligible for marketplace subsidies and much higher among those with incomes in the Medicaid-eligible range Exhibit 1. To what exent do work-tests affect enrollment especially of child-less adults who were not eligible for Medicaid before the ACA and the social and economic wellbeing of those who are Medicaid eligible? They get shifted onto taxpayers and taxpayers then pay the costs of those subsidies. Future research can help policymakers better understand how these policy shifts affect state experiences with Medicaid expansion. The difference between these 2 sets of results, representing the effect of the Medicaid expansion alone, is reported in the middle 3 rows of the bottom panel of Table 2. These studies support future strategies that target awareness about Medicaid eligibility and tax credits, outreach to and usability among non-English speakers and older adults, simplification of the enrollment process, and education about affordable plan selection. A better strategy is not cost-shifting. When there is more competition in the market, there is actually a greater downward shift in medical costs. The paper ends with a discussion of the projected impact of the ACA and offers some observations on those estimates. States with expanded Medicaid are spending much more on medications that treat opioid addiction than they used to. To address this, we use a method called two-stage least squares 2SLS instrumental—variable regressions. Results were somewhat smaller in states that refused the Medicaid expansion 6.

These inconsistencies for inpatient outcomes across evaluations of pre-ACA reforms may be driven by several factors including different methodological approaches, data sources, and follow-up time examined; state policies targeting poor populations prior to the expansion; regional variation patterns in care delivery; and unique features and implementation of individual state Medicaid programs.

The health law took effect just as the opioid epidemic was spreading to all corners of the country, and health officials in many states say that one of its biggest benefits has been providing access to addiction treatment.

how has the affordable care act changed healthcare in the us since implementation

Accountable care organizations are being adopted to achieve these goals. A detailed comparison of the two datasets can be found in Appendix Table A.

Impact of affordable care act on health care organizations

We measured access to medical care in the past year and access to a personal doctor or usual place of care. State Medicaid expansion decisions and their timing were taken from an online Kaiser table see Appendix Table B. However, payers have created narrow provider networks to account for elevated spending, which are causing issues regarding referrals among physicians. Finally, implementation of Medicaid expansion and the ACA more broadly is not homogenous across states, which could impact eligibility for coverage as well as access, utilization, and health outcomes. Among other findings, new studies in these areas show that expansion is associated with increases in cancer diagnosis rates especially early-stage diagnosis rates and access to and utilization of certain types of cancer surgery; increases in access to and Medicaid coverage of treatment including medication assisted treatment for opioid use disorder and opioid overdose; a reduction in the US poverty rate; and improvements in employment and the labor market. In summary, early evidence following ACA implementation has demonstrated significant progress toward its goal of expanding coverage for millions of low-income individuals who would have otherwise remained uninsured. What does this mean for the goals of immigrant integration? Where work or work-related activities are required, what happens when recipients search for work, but cannot find an employer who will hire them?

Second, although some of these studies methodologically took advantage of some states choosing to expand Medicaid while others did not i.

They are just as likely as those who have always been covered to report that they now have a usual place of care.

Impact of affordable care act on health care organizations 2018

Given the national marketplace enrollment in , this translates into a 1. Similarly, one year after early expansion, Medicaid coverage increased significantly in Connecticut 4. Second, when using both instruments, we test to see whether they are both exogenous assuming the Medicaid expansion is. Studies assessing longer follow-up times, however, underscore how the effects of the law may evolve over time 83 , The Appendix at the end of the brief provides a list of citations for each of the included studies, grouped by the three categories of findings. N Engl J Med. Although not exactly a natural experiment, these comparisons illustrate the disturbing trends occurring in nonexpansion states at the expense of low-income individuals and families. First, most assessed limited follow-up time, with some relying on only 6 to 12 months of post-ACA data. Report Private Health Insurance Premiums and Federal Policy February 11, Premiums for private health insurance, which are high and rising, are affected by various federal subsidies and regulations. Researchers have hypothesized that lack of immediate improvements in perceived health status could be explained by increased awareness of newly diagnosed conditions, though these perceptions may improve over time as conditions are treated 47 , 94 ,

For individuals seeking care in the Marketplace, inadequate access to in-network specialty care and incurrence of high OOP costs also remain a concern States could still regulate insurance, but consumers would see more variation from state to state.

Thus, early findings suggest that, similar to pre-ACA reforms, the ACA has encouraged the use of outpatient services and preventive care among low-income individuals.

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The Social, Economic, and Political Effects of the Affordable Care Act