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The Affordable Care Act: Controlling Health Care Costs

Statement of Issue

The Affordable Care Act, the original purpose of which was the improvement of public health through an increase in insurance and coverage rates, is achieving unsatisfactory results. The reform has resulted in greater access to health care and improved health outcomes, but the provisions also resulted in higher healthcare costs. Furthermore, many households with middle or low incomes still struggle to afford care despite purchasing insurance due to high out-of-pocket costs.

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Health care spending is growing faster than the national GDP

Although the ACA has managed to slow the rise in health care costs down, the values are now returning to their previous high states.

Insurance providers are designing plans that bypass the ACA’s intent

Cost-sharing reductions are only available to a small section of the population that requires them, and insurers offer plans with upfront cost-sharing that is not affordable for most lower- and middle-income consumers.

Policy Options

Keep the ACA intact and searching for solutions to current issues elsewhere. The law’s provisions, such as Medicaid expansion and the requirement for employers to provide their employees with insurance options, would stay in force, although details could be altered. They are supported by the majority of the population as well as medical workers such as nurses.

  • Advantages: Guarantees continued coverage to people with lower and middle incomes and the superior health outcomes associated with the Act. It allows the use of the ACA as a practical framework for the creation of solutions and improvements.
  • Disadvantages: Does not directly address the prevalent issues surrounding health care. The concerns have not been resolved prior, and there is no guarantee that effective legislation that addresses the weaknesses of the current system will be developed in the future.

Repeal the ACA and replace it with another set of health policies that will address the current issues. Parts of the Act may be kept intact, but the overall intent and effects of the document will be considerably different. They were supported by the Republican Party, small business owners, and labor unions.

  • Advantages: Will significantly diminish or eliminate the current issues surrounding the ACA. A new set of legislation, created from the ground up, maybe more effective at addressing the current situation than the ACA, which was designed for different circumstances.
  • Disadvantages: The repeal of the Act includes the removal of the taxes collected to support it, which would increase the national budget deficit. Numerous people would lose their insurance, and people who purchase individual plans may have difficulty affording premiums if the refundable tax credits clause is removed.

Policy Recommendation

The factions that oppose the Affordable Care Act have not offered a sufficiently broad and effective option that could replace it. Furthermore, the policy has proven itself valid, despite initial protests and lack of acceptance by the majority of the population. A continuation of the ACA’s active period and a search for solutions to the current issues elsewhere will likely produce the desired results without significantly disrupting the national healthcare system.

Role of DNPs

DNPs can use their expertise to provide detailed insights into the field of healthcare. They can appeal to their representatives in Congress and explain their positions on the necessity of the ACA with the help of experience and evidence. As members of a field that is directly affected by the national healthcare legislation, they can accurately analyze the potential impacts of various policies and formulate their own proposals that they can then develop and submit.

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Cox, C., Claxton, G., & Levitt, L. (2017). How Affordable Care Act repeal and replace plans might shift health insurance tax credits. Web.

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Families USA. (2015). Non-group health insurance: Many insured Americans with high out-of-pocket costs forgo needed health care. Web.

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Wherry, L. R., & Miller, S. (2016). Early coverage, access, utilization, and health effects associated with the Affordable Care Act Medicaid expansions: a quasi-experimental study. Annals of internal medicine, 164(12), 795-803.

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