Effective September 23, 2010 health reforms under the Affordable Care Act in the United States will provide Americans with greater rights and benefits in healthcare coverage. Many new laws are being set to control the ongoing battle of insurance fraud. More children will have health coverage, preventative services will now be covered, and many limitations will be eliminated. The reform will be a gradual process over the next few years that will continue to grow and add additional health benefits. The question remains will this $940 billion reform benefit the majority of Americans? Electronic Healthcare Network Accreditation Commission Essay

There are many advantages to the Affordable Care Act. The health reform will use $350 million over the ten year plan to prevent, detect, and fight insurance fraud in Medicare, Medicaid, and the Children’s’ Health Insurance program to convict abusers and help those that actually need the assistance. Prior to the healthcare reform, Medicare patients experience a coverage gap known as the “donut hole,” upon which they experience a coverage gap after they have reached a max where they must afford the full cost of medications.

With the modifications of the reform in 2011, these patients will receive a 50% discount on covered brand-name prescription medications once in the donut hole until an out-of-pocket max is reached; thereafter Medicare would fund most of the cost for the medications (Healthcare). There are also expansions for Medicaid coverage to include 133 percent of federal poverty level, currently defined as income of $29,327 for a family of four. Other requirements state Medicaid must cover childless adults in effect 2014. Electronic Healthcare Network Accreditation Commission Essay

Also, Federal Government will pay 100% for eligible individuals through 2016. Additional assistance provided by the health reform helps children in need. Six months after the bill is passed insurance companies must provide coverage to children with a preexisting condition. This helps the family of a child with a heart problem, for example, that must have several surgeries a year not previously covered due to insurance labeling “pre-existing. ” In 2014, insurance providers cannot deny coverage to not only children but anyone with a preexisting condition.

Thousands of adults have been denied coverage as well due to conditions they have no control over resulting in denial of surgeries/procedures they desperately need. Further benefits to children are the extension of coverage on their parent’s policy until age 26. This greatly benefits many families that have children in college that were too old to be previously covered, or that lives at home and do not attend school but still need medical coverage. Also, some young adults starting entry-level jobs may not be offered medical benefits right away, thus this will allow the parent to help them with coverage until they can get their own policy.

The Affordable Care Act will push for more affordable coverage, preventative service coverage, and less discrimination. More individuals will be offered insurance through their employer due to new requirements. Employers with more than 50 employees must provide health coverage to their workers or pay a fine of $2000 per worker annually. The uninsured/ self-employed Americans falling between the 133-400% poverty level will be allowed to purchase health plans through the state and given certain subsidies to help pay for the policy (Jackson). Electronic Healthcare Network Accreditation Commission Essay

Smaller businesses with fewer than 50 employees, as well as individuals 100-400% poverty level that do not qualify for other federal assistance can be eligible for subsidies to purchase individual health plans. Moreover, the health reform will cover physician recommended preventative services. Examples include; regular check-ups, cancer screenings, and immunizations at no additional cost (Healthcare). Many people avoid going to the doctor for years because they cannot afford to go. These individuals miss important yearly physical exams that keep our bodies healthy.

Early detection is key, whether it is breast cancer, high cholesterol, diabetes, etc. we have to be aware of the illness to cure it. The only way to stay on top of our health is to receive routine maintenance through preventative care just like we show maintenance to our vehicles. The new health laws also call for coordinated care that will invest in community health teams to manage chronic disease in areas of high minority/ lower income groups. Funding for community health centers will be increased for facilities to be able to double the patient capacity and people will not be turned away based on ability to pay (Healthcare). Electronic Healthcare Network Accreditation Commission Essay

The 32 million Americans that are currently uninsured will have expanded coverage with the Affordable Care Act (Jackson). However, despite this benefit there are costs involved that must be weighed with every plan. For those individuals who are young and make healthy choices, will now have to pay for other people that are unhealthy due to bad habits such as smoking or excessive drinking. This effect is due to the fact that health insurance companies will no longer be able to base coverage on a person’s health status. If people decide to opt out of health insurance they must pay $750 annually.

Many healthy people that do not go to the doctor often may not spend that much even paying out of pocket self -pay prices (New Health). Also, Individuals that wish to receive cosmetic surgery will now have to pay an additional 5% tax on the total cost. Additionally, as the Health Care reform bill will benefit millions of poor Americans, the wealthy will be affected by a 0. 9% increase in Medicare payroll taxes for individuals making $200,000 annually, or $250,000 for couples. Many lower class individuals may feel that the rich deserve to share the wealth, as the rich always seem to get richer while the poor get poorer. Electronic Healthcare Network Accreditation Commission Essay

However, consider the doctor that went to school for eight+ years to achieve his salary, now has to provide services for more people, thus doubling the workload, for less money, and pay more taxes to pay for the services he is providing to his patients. We have to consider is that fair? Moreover, the new reform forces Americans to buy a policy that covers “ambulatory patient services, emergency services, hospitalization, maternity and newborn care, mental health and substance use disorder services,” among other requirements.

If an individual is single without children, they must still pay for pediatric coverage, or if a woman cannot conceive a child she must still have maternity services (New Health). Americans will no longer have the privilege of choosing a health policy for a particular type of coverage for a cheaper premium. There are both pros and cons to the new health care reform. Personally, as an employee of CaroMont Health, I feel the healthcare system may become “watered” down. For example, if a restaurant put a sign out front that said free food, service would decrease.

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I do feel that it will provide people of my profession with greater job security, and for that I am thankful. I will be glad to know more people will be convicted of insurance fraud and allow for those who really need the assistance to benefit. Many Americans will get the health attention they need, such as my grandparents, or my father who had a “pre-existing” back condition. Personally, I have good insurance working in a healthcare facility, and do not feel affected by this reform, except for possible tax increases. Will the good outweigh the bad for the new health care reforms? Only time will tell. Electronic Healthcare Network Accreditation Commission Essay