Health Law: Pre-Existing Conditions Protection Act

Introduction

The bill H.R. 1121 was introduced in the House of Representatives in February 2017. The issue that needs to be resolved by the given bill contributes to improving the Public Health Service Act (PHSA) to provide medical services to American citizens because sometimes their expenses are not covered by insurance companies. Therefore, the law’s policy implies the improvement of certain rules listed in the Patient Protection and Affordable Care Act (PPACA). The case for the policy change described in this paper will be the following. The master’s prepared nurse will represent the president of a professional nursing organization. The company is called the National Federation of Licensed Practical Nurses (NFLPN). The problem that needs to be addressed is that some NFLPN members have particular patients in their hospitals who cannot afford their medicaments anymore. Moreover, these patients are not completely healthy yet. The purpose of the bill was influenced by multiple cases of unguaranteed coverage of clients’ medical costs by their insurance. The following paper will discuss the Pre-Existing Condition Protection Act and all possible issues that it might address regarding the USA residents who cannot afford medical procedures and drugs.

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Key Policy Events

American Health Care Act addresses the issue of citizens’ inabilities to cover their health care expenses by obligating everyone to buy insurance that is intended to make medical treatment affordable for regular American citizens. However, there are some factors in the bill H.R. 1121 contributing to reimbursement and financial help. For instance, the program presented by the discussed act implies the refund of various wellness expenses to people with low wages (“H.R.1121 – Pre-existing conditions protection act of 2017,” 2017). In particular, it covers the membership costs of individuals who attend and work out in fitness centers. Moreover, it will provide financial support to Americans who try to give up smoking as this strategy might be beneficial not only for their health but the environment in general.

Financial Data

Although there is not much information about the H.R. 1121 bill available for regular citizens, it would be proper to mention that the project requires the help of sixty-three cosponsors. Moreover, it is estimated to be Greg Walden’s most expensive health project. However, the bill mentioned above provides approximately one hundred and thirty-eight billion dollars to the states that have the highest rates of vulnerable populations to address and solve the residents’ needs (“H.R.1121 – Pre-existing conditions protection act of 2017,” 2017). Moreover, eight billion dollars are intended to reduce the medical costs of people with certain pre-existing health conditions before their treatments (“H.R.1121 – Pre-existing conditions protection act of 2017,” 2017). This financial operation is also aimed at establishing new security policies of this law.

Key/Major Stakeholders

As it was mentioned above, the H.R. 1121 bill was supported by sixty-three people who were interested in its approval by the government. All cosponsors represent the Republican Party in the USA as the project is initiated by its member. The list of the bill’s contributors includes such people as Robert Latta, Tim Walberg, Mimi Walters, Mike Bishop, Stephen Knight, and others. The implications of the stakeholders’ views contribute to governmental regulations of various insurance businesses’ activities. Moreover, the members of the U.S. Republican Party are interested in providing financial support to American residents for their health needs. Moreover, they agree that organizations that establish group health plans in the territory of the USA should stop collecting their clients’ genetic information.

Social, Economic, Ethical, Legal, and Political Factors

One of the most essential social issues addressed by the bill H.R. 1121 refers to Americans’ inability to pay for their medical treatment or drugs in critical situations. Many insurance companies might refuse to provide financial support to some of their clients. It would be proper to mention that the prices of medicaments are not regulated by national law or the government in the United States of America (Daemmrich & Mohanty, 2014). It is estimated that approximately forty percent of the American population can cover their medical expenses from their own budgets (Jaffe, 2015). The factor mentioned above impacts various stakeholders of the bill and their decisions related to the population’s issues as every sponsor has a desire to reduce the country’s citizens’ medication costs.

Economic factors of the USA are also influenced by all the issues mentioned above as the country’s residents tend to pay for their medical treatment with the national currency outside of the Commonwealth. Although this factor might not be very disadvantageous for the U.S. economic system, it also influences illegal immigration to the southern states because people from Mexico provide cheap services to Americans (Daemmrich & Mohanty, 2014). The strategy described above allows illegal immigrants to earn more money than it is possible in their countries’ territories.

Ethical factors contributed to the bill H.R. 1121 influenced stakeholders’ decisions as they are related to the issue of unregulated prices of medical services and drugs. All the sponsors think that it is wrong to make people pay enormous amounts of money to heal themselves from certain diseases. This is a primary need of a person that has to be addressed by the government to increase the U.S average longevity rate and health statistics among the country’s residents.

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Legal factors that have an impact on the H.R. 1121 bill sponsors lay in the constitutional rule that says that every resident has a legal right to use health care services provided by the government medical institutions. As the majority of people cannot afford their treatment, the statement mentioned above does not have any sense. Therefore, it is essential to reduce citizens’ medical and drug expenses in the territory of the United States of America.

Political factors also have a significant impact on stakeholders’ decisions as to the Pre-Existing Conditions Protection Act. Politicians are always obliged to deal with people’s complaints about the gigantic prices of medical services in the country. However, they cannot influence various pharmaceutical strategies and other related markets (Daemmrich & Mohanty, 2014). Therefore, they try to develop and implement all possible measures to help people cover their medical expenses.

Policy Intervention Options

Such an option as regulation and control of drugs and medical treatment prices is relevant to the main issue of the bill H.R. 1121. Leading countries in Europe had established health care services’ pricing policies laws that make medicine more affordable for their populations. There is another legislative proposal that is intended to address people’s abilities to cover their medical expenses. The Affordable Care Act (ACA) proposed by the Democratic Party is supported by the majority of American residents today (Sommers, Gunja, Finegold, & Musco, 2015). The ACA and the bill H.R. 1121 relate to each other as these policies are both aimed at improving insurance rules to make American citizens pay less for their medical services. However, it would be advantageous to establish a certain law that could contain all the prices of medicaments in the USA to make regular citizens’ payments lower and pharmacists’ profits appropriate (Jaffe, 2015). This regulation will reduce the number of American residents who buy drugs and receive medical treatment outside of the country, which will improve its economic and healthcare systems.

Proposed Recommendation

Basing on the research and analysis conducted above, the recommendation will be the following. It would be proper to impose limitations on the prices of services in private hospitals and pharmacies according to the average wage rate in a certain region (city, state, and so on) (Dave, Kesselheim, Fox, Qiu, & Hartzema, 2017). This will help people afford their health care treatments without taking loans from banks or other financial institutions.

Nursing Implications

The main implications for nursing related to patient safety and quality include such factors as timeliness, effectiveness, efficiency, and productivity of medical personnel’s work. Pricing is the issue that has to be addressed by various governmental organizations. As it is mentioned above, European populations do not have any problems with covering their medical expenses as prices of healthcare services and medicaments are regulated by law (Daemmrich & Mohanty, 2014). Perhaps, this strategy might not be successful in the USA because it may influence the national pharmaceutical market and will cause additional economic problems.

Conclusion

The bill H.R. 1121 initiated and presented by Greg Walden (Republican) in the House of Representatives is intended to reduce American citizens’ medical expenses. The first method implies improving the quality and appropriateness of insurance rules that have to cover people’s hospital bills. Another method is the establishment of the law that will regulate all the prices on the pharmaceutical market of the country. These actions will reduce the rate of residents who buy medicaments and use health services outside of the USA. The NFLPN organization is likely to benefit from the law described above as it might have more finances for supporting its nurses and patients. The given situation (with NFLPN’s patients who run out of money) will also be resolved as the clients’ families might afford their relatives’ treatment processes in the national hospitals.

References

Daemmrich, A., & Mohanty, A. (2014). Healthcare reform in the United States and China: Pharmaceutical market implications. Journal of Pharmaceutical Policy and Practice, 7(1), 7-9. Web.

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Dave, C. V., Kesselheim, A. S., Fox, E. R., Qiu, P., & Hartzema, A. (2017). High generic drug prices and market competition. Annals of Internal Medicine, 167(3), 145-151. Web.

H.R.1121 – Pre-existing conditions protection act of 2017. (2017). Web.

Jaffe, S. (2015). USA grapples with high drug costs. The Lancet, 386(10009), 2127-2128. Web.

Sommers, B. D., Gunja, M. Z., Finegold, K., & Musco, T. (2015). Changes in self-reported insurance coverage, access to care, and health under the Affordable Care Act. JAMA, 314(4), 366-374. Web.

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StudyCorgi. (2021, January 17). Health Law: Pre-Existing Conditions Protection Act. Retrieved from https://studycorgi.com/health-law-pre-existing-conditions-protection-act/

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