Affordable Care Act (ACA) vs Current adminstration question for class

Flatline, BSN, RN · Oct 23, 2017

Homework?

ialejo4321 · Oct 23, 2017

The questions themselves i came up with but to be honest its part of my NURR 208 class , precepting rotation, they ask us to post 2 questions whatever topic we choose on a Professional Forum. This is a topic that interests me and I genuinely care about as i have friends and family who have pre-existing conditions which under other proposed health care bills they would either be charged more or dropped.

My experience:

Before ACA (unable to afford health insurance): at the age of 18, went to Emergency Department due to abdominal pain never experienced before,10/10 pain, full lab work up and MRI resulted in a bill of 9 thousand dollars and a diagnosis of acute abdominal pain and was discharged several hours later. Applied for assistance with the hospital and total bill was waived but of course, someone paid the bill because nothing is free.

With ACA: age 24, due to several episodes of tonsillitis over 2-3 years and being recurrently treated with antibiotics and one episode of scarlet fever. I was able to have a tonsillectomy at a cost of $600, which I paid off myself, thanks to my health insurance I have.

Editorial Team / Admin · Oct 23, 2017

I don't know what the right direction to go is. However, the system is unsustainable. The US spends the most per capita on health care. You would then expect that we'd be one of the top countries for results, right? Nope, the report I've looked at most frequently (and there may be newer data) places the US at #37. Something has to be done, the question is what. It may quite simply take a lot of trial and error.

kbrn2002, ADN, RN · Oct 30, 2017

The affordable care act has not been so affordable for a lot of people. Sadly the extent of savings varies wildly from state to state. In Wisconsin the premiums are about double what they are in Minnesota for what is essentially the exact same policy. Not so affordable for Wisconsin residents that have no other insurance options outside the ACA.

The number of people that need or get insurance through the ACA is a fairly low percentage of insured individuals yet those that get insurance through their employer are also affected. I am insured through my employer and since the ACA went into affect my premiums have greatly increased while what the policy actually pays for has greatly decreased. I have a lot higher out of pocket health care expenses than I used to. Just my personal experience, but I am not a fan of the ACA.

I don't expect healthcare to be free, but I also don't expect to have a $300.00 + bill for an office visit and a couple of labs that thanks to my deductible I am 100% responsible for. Unless, God forbid, I have some sort of health crisis I will see very little benefit from all the money I am shovelling into the insurance I pay for. So no, I am not a fan.

There has to be a better way to provide truly affordable health care though I have to admit I don't have a clue how to accomplish that. My first choice to begin reining in skyrocketing healthcare costs is to begin putting the brakes on big pharma. Some of the medication costs are obscene. If the pharma companies were spending more money on research and production and a less on prime time TV ads that'd be a nice start.

cyc0sys · Nov 5, 2017

ACA is just another scam to make the middle class pay for the health care of the rich and poor. The average cost to average American family is now $20k per year. Prior to ACA, cost averaged $6k per year. Subsidies for obtaining coverage to 'off set the costs' do not benefit people earning over $47k or couples making over $64k. It other words, they must pay the full premium for these inflated programs. Many middle class families lost not only their insurance coverage, but jobs when the mandate forced employer programs to cover the '10 Essentials'.

While some of the concepts of the ACA are good e.g. coverage of prior conditions, 10 Essentials, universal coverage... it's basically a shell game. Those below the poverty limit have always been covered by Medicaid in most states. The rich can afford to self-insure or repeat the benefit of the tax cuts written into ACA. The middle class once again pays for everyone else.

elkpark · Nov 5, 2017

Those below the poverty limit have always been covered by Medicaid in most states.

This is a common misconception about Medicaid. It was original intended as "insurance for the poor," which is what a lot of people still think it is. However, over the years, because of ballooning healthcare costs and the high costs of paying for nursing home care, most states cut back dramatically on Medicaid coverage. In most states, if you were not under 18, over 65, pregnant, or permanently disabled -- in other words, if you were just an ordinary adult who was poor and needed healthcare -- you simply didn't qualify for Medicaid, period. The ACA was intended to remedy this through the "Medicaid expansion" that was built into the law. The expansion was mandatory, with the Federal government picking up almost the entire cost, as the law was written, but a number of Republican governors went to court to object and the Supreme Court ruled that the Federal government could not require states to expand Medicaid, that had to be optional. Many red states chose not to expand Medicaid, which left their poor citizens no better off than they had been prior to the ACA.

cyc0sys · Nov 5, 2017

This is a common misconception about Medicaid. It was original intended as "insurance for the poor," which is what a lot of people still think it is. However, over the years, because of ballooning healthcare costs and the high costs of paying for nursing home care, most states cut back dramatically on Medicaid coverage. In most states, if you were not under 18, over 65, pregnant, or permanently disabled -- in other words, if you were just an ordinary adult who was poor -- you simply didn't qualify for Medicaid, period. The ACA was intended to remedy this through the "Medicaid expansion" that was built into the law. The expansion was mandatory, with the Federal government picking up almost the entire cost, as the law was written, but a number of Republican governors went to court to object and the Supreme Court ruled that the Federal government could not require states to expand Medicaid, that had to be optional. Many red states chose not to expand Medicaid, which left their poor citizens no better off than they had been prior to the ACA.

You're correct. When I speak of those at the poverty level who are covered, I think of those who qualify for Medicaid as you've outlined in your post. I should've excluded the working poor who have no coverage. Sorry, too many years working in medical billing.