Start reviewing and responding to the postings of your classmates as early in the unit as possible. Respond to at least two of your classmates' initial postings. Participate in the discussion by asking a question, providing a statement of clarification, providing a point of view with a rationale, challenging an aspect of the discussion, or indicating a relationship between two or more lines of reasoning in the discussion. You can ask technical questions or respond generally to the overall experience. Be objective, clear, and concise. Always use constructive language, even in criticism, to work toward the goal of positive progress. Cite sources in your responses to other classmates.
Review your lectures. Then:
- Identify, how many Americans remain uninsured despite the PPACA (Patient Protection and Affordable Care Act), using the most current scholarly resource available.
- Identify how many Americans are currently signed up for and have paid premium for the PPACA.
- Discuss the current cost to Americans in subsidies, which are financially supporting the PPACA. What is the current fine charged by the IRS to those without insurance and how much will it increase in 2016? Will this fine increase have a negative or positive impact? Explain why.
Review the following articles
Lurie, I. Z., & McCubbin, J. (2016). What can tax data tell us about the uninsured? evidence from 2014. National Tax Journal, 69(4), 883-904. doi:http://dx.doi.org.southuniversity.libproxy.edmc.edu/10.17310/ntj.2016.4.08
Impact of obamacare on coverage: Reduction in the number of uninsured. (2016). Congressional Digest, 95(3), 7.
Jost, T. S., & Pollack, H. A. (2016). Making health care truly affordable after health care reform. The Journal of Law, Medicine & Ethics, 44(4), 546-554. doi:10.1177/1073110516684785
To support your work, use your course and textbook readings a As in all assignments, cite your sources in your work and provide references for the citations in APA format.
Your initial posting should be addressed at 300-500 words.
Discussion 2
Rose Cates posted May 1, 2023 4:51 AM
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The genesis of uninsured people in American society has progressively changed over the years. Since 2010 health coverage in U.S history has experienced the largest health coverage expansions. Further, the trend for uninsured people in the country has been changing over time since 2010 to current rates. At this time, about 16% of all Americans were uninsured, but as of 2016, the uninsured rate was as low as 9%. Translating to 16 million people (Congressional Digest, 2016). However, the current population that is uninsured as of 2021 is 10%, representing about 27.5 million people in the country.
Over the past years since the inception of the Affordable Act in 2010, there have been significant changes in individuals who have been signing up for health coverage. The number of people who have signed up and paid premiums for PPACA has not passed the cross mark of ten million. The current number of people who have enrolled and paid for premium insurance has made a historical mark of 13.6 million people as of 2022. Further, these total sign-ups have been done across different platforms of health coverage, such as state-based marketplaces, the American rescue plan and through the healthcare government (Congressional Digest, 2016). Besides, this has expressed a primary positive notion to encourage people to keep signing and paying for premium services where they receive tax credits for the 2020 coverage.
The establishment of the affordable care Act is essential in providing subsidized health insurance through healthcare. Gov and the state-run marketplace. However, since then, few people have been able to subscribe for the premium help, with millions being uninsured despite the eligibility to buy on various marketplaces (Jost & Pollack, 2016). In some cases, uninsured people are priced out of the market due to their incomes which would not qualify them for the service. On the other hand, other uninsured individuals are eligible for the subsidize but may not be aware of the financial assistance that is available for them (Jost & Pollack, 2016). The extension of the eligibility plan through an Act which was passed in 2022 for covid-19 relief legislation under the American rescue plan act has enabled more people to sign up. The costs involved for Americans in subsidies is about $70 monthly for current market purchases for a person. It also ranges from an average saving of about 4213 every month for individuals between $ 400% to 600% in poverty, making t to an average saving of $33 monthly (Lurie & McCubbin, 2016). Individuals with incomes under 150% of the poverty get zero dollars on the post-subsidy premiums.
The current fine the IRS charges to individuals without insurance depends on various factors. However, the standard fine for everyone not qualifying for health coverage is $95 for adults and 447 for children under 18 years. Besides, the IRS can also determine the fine from individual taxable income of 1% yearly income above the tax return filing threshold (Lurie & McCubbin, 2016). By 2016 it would increase to 2.5% or the equivalent of 695% of individual income, which is described as whichever case is higher.
The increased fine charged will have a negative impact on the people affected since they will have to pay fines based on their income tax. The general deduction of a significant income tax for a household will increase, making it an issue to their spending, savings and potential lifestyle in the long run. Besides, in some cases, it is possible that paying insurance can be cheaper than the fine being charged by IRS from the household income.
References
Lurie, I. Z., & McCubbin, J. (2016). What Can Tax Data Tell Us about the Uninsured? Evidence from 2014. National Tax Journal, 69(4), 883-903. doi: http://dx.doi.org.southuniversity.libproxy.edmc.edu/10.17310/ntj.2016.4.08
Jost, T. S., & Pollack, H. A. (2016). Making health care truly affordable after health care reform. The Journal of Law, Medicine & Ethics, 44(4), 546-554. doi:10.1177/1073110516684785
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Discussion 2
Rose Cates posted May 1, 2023 4:51 AM
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The genesis of uninsured people in American society has progressively changed over the years. Since 2010 health coverage in U.S history has experienced the largest health coverage expansions. Further, the trend for uninsured people in the country has been changing over time since 2010 to current rates. At this time, about 16% of all Americans were uninsured, but as of 2016, the uninsured rate was as low as 9%. Translating to 16 million people (Congressional Digest, 2016). However, the current population that is uninsured as of 2021 is 10%, representing about 27.5 million people in the country.
Over the past years since the inception of the Affordable Act in 2010, there have been significant changes in individuals who have been signing up for health coverage. The number of people who have signed up and paid premiums for PPACA has not passed the cross mark of ten million. The current number of people who have enrolled and paid for premium insurance has made a historical mark of 13.6 million people as of 2022. Further, these total sign-ups have been done across different platforms of health coverage, such as state-based marketplaces, the American rescue plan and through the healthcare government (Congressional Digest, 2016). Besides, this has expressed a primary positive notion to encourage people to keep signing and paying for premium services where they receive tax credits for the 2020 coverage.
The establishment of the affordable care Act is essential in providing subsidized health insurance through healthcare. Gov and the state-run marketplace. However, since then, few people have been able to subscribe for the premium help, with millions being uninsured despite the eligibility to buy on various marketplaces (Jost & Pollack, 2016). In some cases, uninsured people are priced out of the market due to their incomes which would not qualify them for the service. On the other hand, other uninsured individuals are eligible for the subsidize but may not be aware of the financial assistance that is available for them (Jost & Pollack, 2016). The extension of the eligibility plan through an Act which was passed in 2022 for covid-19 relief legislation under the American rescue plan act has enabled more people to sign up. The costs involved for Americans in subsidies is about $70 monthly for current market purchases for a person. It also ranges from an average saving of about 4213 every month for individuals between $ 400% to 600% in poverty, making t to an average saving of $33 monthly (Lurie & McCubbin, 2016). Individuals with incomes under 150% of the poverty get zero dollars on the post-subsidy premiums.
The current fine the IRS charges to individuals without insurance depends on various factors. However, the standard fine for everyone not qualifying for health coverage is $95 for adults and 447 for children under 18 years. Besides, the IRS can also determine the fine from individual taxable income of 1% yearly income above the tax return filing threshold (Lurie & McCubbin, 2016). By 2016 it would increase to 2.5% or the equivalent of 695% of individual income, which is described as whichever case is higher.
The increased fine charged will have a negative impact on the people affected since they will have to pay fines based on their income tax. The general deduction of a significant income tax for a household will increase, making it an issue to their spending, savings and potential lifestyle in the long run. Besides, in some cases, it is possible that paying insurance can be cheaper than the fine being charged by IRS from the household income.
References
Lurie, I. Z., & McCubbin, J. (2016). What Can Tax Data Tell Us about the Uninsured? Evidence from 2014. National Tax Journal, 69(4), 883-903. doi: http://dx.doi.org.southuniversity.libproxy.edmc.edu/10.17310/ntj.2016.4.08
Jost, T. S., & Pollack, H. A. (2016). Making health care truly affordable after health care reform. The Journal of Law, Medicine & Ethics, 44(4), 546-554. doi:10.1177/1073110516684785
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Uncompensated Care.html
Uncompensated Care
When we as a society discuss the topic of uncompensated care it is very important to understand the scope of the problem. The reality is that we have no real idea how many people are facing this crisis. One of the major obstacles to an accurate estimate is the enormous influx of undocumented aliens now working and residing in the U.S. Because this number is not verifiable we do not understand the true scope of the crisis.
Additionally, a circumspect discussion of noninsured individuals should also examine the plight of the underinsured, who face similar worries in time of medical need. During the recent years of economic downturn, many previously insured Americans have either lost their jobs (and benefits) completely or have become victims of downsizing with benefit reductions. One of the most impacted benefits is typically healthcare insurance, due to its cost. As a result, many Americans have been forced to settle for a lesser form of healthcare coverage, higher deductibles, higher co-pays, and greater restrictions on access.
The healthcare insurance crisis affects families at all levels and therefore has a direct affect on children, adults, and seniors. One of the hardest hit areas of a hospital is the Emergency Department (ED). Today many people without coverage will flock to area EDs for everything from sniffles and sneezes to crisis management for chronic diseases. Higher emergency-level service fees are incurred, and some patients may require hospital admission. The end result is that billions of dollars go uncollected annually. Currently, no real answers have been devised to deal with the mounting crisis.
In the past, seniors enjoyed solid coverage through Medicare. However, in recent years the increasing cost of supplemental coverage, co-pays, pharmaceuticals, and medical supplies has added a more substantial strain to retirees on fixed incomes.
So far, we have learned about Uncompensated Care the main takeaway from this lecture We will now build upon our knowledge with our next lecture, which is about the Accountable Care Act supporting those without access to healthcare. As you continue to explore the information presented this week, reflect on how you might use new knowledge and skills in your daily work as a healthcare manager. Review the material below for more information of these topics.
Resources:
Office of the Federal Registry (n.d.) The daily journal of the federal government. Federal Register. Retrieved from: https://www.federalregister.gov
Additional Materials
media/transcripts/SU_MHC6301_W2_L2_G2.jpg
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Challenges and the PPACA.html
Challenges and the PPACA
The PPACA has faced legal challenges, with the most important Supreme Court decision recognizing the legislation as a tax. It must be acknowledged that the success of the legislation is based upon diverse enrollment of a wide spectrum of income levels and the individual mandate. The expansion of Medicaid also carries a ripple effect. While the notion of "affordable" resonates with many, to others, it's the antithesis of the commonly accepted definition of "affordable."
Most states have developed a statewide uncompensated care pool. This is a direct source of money used to pay hospitals for some portion of their uncompensated care delivery. The funding stream for the pool is usually from all hospitals within the state. Some states extract a higher percentage of money from those few hospitals that are still for profit. The individual mandate combined with the expansion of Medicaid reduces the amount of uncompensated care and isolated corporate charity care income tax reporting. The effect of the individual mandate and expanded roles of Medicaid reduces the burden of uncompensated care.
The government's role as a third-party payer continues to expand, currently providing reimbursement for over 55 percent of healthcare services. Partly to blame for high hospital costs are government regulations regarding hospital fee structure and limits. This rule stipulates that no hospital that accepts Medicare payment is permitted to charge patients more than the Medicare rate. As a direct result of this government rule, hospitals constantly inflate their Medicare rates. While a hospital inflates the Medicare rate, it does not mean the reimbursement rate is at the inflated Medicare rate value. The expansion of Medicaid and Medicare reduces the overall profit for the hospital. The PPACA contains a provision to increase reimbursement payments, maintaining financial solvency for hospitals.
In this last video you were presented with the various challenges presented with the implementation of the Patient Protection and Affordable Care Act (PPACA). Your discussions and assignments will be an application of the impact of uncompensated care and the Patient Protection and Affordable Care Act (PPACA). As you reflect on your organization, study these concepts impact and how the challenges are being attended too.
Additional Materials