Healthcare Reform, Research Paper Example

The most recent implementation of U.S. healthcare reform is the Patient Protection and Affordable Care Act (PPACA), signed into law in 2010 by President Obama and ruled constitutional by the Supreme Court last June. The law sets a federal mandate that all citizens and many legal residents buy health insurance or be taxed for it; creates taxpayer subsidized health-insurance markets; expands eligibility for Medicaid; and slows the projected increase of Medicare payments (Blahous, 2012). Healthcare in the U.S. will never be the same.

The most important change will be the highly significant expansion of healthcare insurance to at least 30 million more people. The financial penalty for failing to enroll in a plan has been ruled a tax for constitutional purposes, so doctors and hospitals, particularly emergency room facilities, can expect an increase in people seeking treatments they otherwise would have left untreated, or sought to have treated outside  the formal medical system. Such patients will reason that since they are now forced to pay for health insurance anyway, they might as well get their money’s worth. Moral hazard will ensure that with health insurance now paid for, risks that individuals would not have taken before will be taken now. Finally, adverse selection will ensure that individuals who before would have been rejected as applicants will have to be accepted.

Some hospital administrators will have a hugely profitable new business model to follow, as will Medicare insurers: shares of HCA Holdings, Tenet Healthcare, and Molina Healthcare went up between 7% – 10% after the Supreme Court’s June ruling. Group plan administrators must learn how the interim final rule (IFR) explains the no-rescission policy, and they should also keep tabs on the resultant conflict between that IFR and COBRA (Hamburger, 2010).

The first joint administrative challenge to meet: preparing physician and nursing staffs before the insured-patient tsunami arrives. Insurance reform alone will just lengthen queues.

References

Blahous, C. (2012). The fiscal consequences of the affordable care act. Manuscript submitted for publication, Mercatus Center, George Mason University, Arlington, VA. Retrieved from http://mercatus.org/sites/default/files/publication/The-Fiscal-Consequences-of-the-Affordable-Care-Act_1.pdf

Hamburger, P. (2010, July 15). Health care reform’s no-rescission rule and COBRA — do they conflict? Retrieved from http://www.thompson.com/public/newsbrief.jsp?cat=BENEFITS&id=2973