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bio_man bio_man
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Posts: 33222
5 years ago
Citation: U.S. Senate. (2010). The Patient Protection and Affordable Care Act. Retrieved from http://www.dpc.senate.gov/healthreformbill/healthbill04.pdf

Overview: The following is a summary of the key content areas found in the Patient Protection and Affordable Care Act of 2010. The Patient Protection and Affordable Care Act (ACA) will ensure that all Americans have access to quality, affordable healthcare and will create the transformation within the healthcare system necessary to contain costs. The Congressional Budget Office (CBO) has determined that the ACA is fully paid for, ensures that more than 94 percent of Americans have health insurance, bends the healthcare cost curve, and reduces the deficit by $118 billion over the next 10 years and even more in the following decade.

Title I. Quality, Affordable Healthcare for All Americans
The ACA will accomplish a fundamental transformation of health insurance in the United States through shared responsibility. Systemic insurance market reform will eliminate discriminatory practices by health insurers such as preexisting condition exclusions. Achieving these reforms without increasing health insurance premiums will mean that all Americans must have coverage. Tax credits for individuals, families, and small businesses will ensure that insurance is affordable for everyone. These three elements are the essential links to achieving meaningful reform.

Title II. The Role of Public Programs
The ACA expands eligibility for Medicaid to lower-income persons and assumes federal responsibility for much of the cost of this expansion. It provides enhanced federal support for the Children’s Health Insurance Program, simplifies Medicaid and CHIP enrollment, improves Medicaid services, provides new options for long-term services and supports, improves coordination for dual-eligibles, and improves Medicaid quality for patients and providers.

Title III. Improving the Quality and Efficiency of Healthcare
The ACA will improve the quality and efficiency of U.S. medical care services for everyone, and especially for those enrolled in Medicare and Medicaid. Payment for services will be linked to better-quality outcomes, and the ACA will make substantial investments to improve the quality and delivery of care and support research to inform consumers about patient outcomes resulting from different approaches to treatment and care delivery. New patient care models will be created and disseminated, rural patients and providers will see meaningful improvements, and payment accuracy will improve. The Medicare Part D prescription drug benefit will be enhanced, and the coverage gap, or doughnut hole, will be reduced. An Independent Payment Advisory Board will develop recommendations to ensure long-term fiscal stability.

Title IV. Prevention of Chronic Disease and Improving Public Health
To better orient the nation’s healthcare system toward health promotion and disease prevention, a set of initiatives will provide the impetus and the infrastructure. A new interagency prevention council will be supported by a new Prevention and Public Health Investment Fund. Barriers to accessing clinical preventive services will be removed. Developing healthy communities will be a priority, and a 21st-century public health infrastructure will support this goal.

Title V. Healthcare Workforce
To ensure a vibrant, diverse, and competent workforce, the ACA will encourage innovations in healthcare workforce training, recruitment, and retention and will establish a new workforce commission. Provisions will help to increase the supply of healthcare workers. These workers will be supported by a new workforce training and education infrastructure.

Title VI. Transparency and Program Integrity
To ensure the integrity of federally financed and sponsored health programs, this title creates new requirements to provide information to the public on the health system and promotes a newly invigorated set of requirements to combat fraud and abuse in public and private programs.


Title VII. Improving Access to Innovative Medical Therapies
Biologics Price Competition and Innovation. The ACA establishes a process under which the FDA will license a biological product that is shown to be biosimilar or interchangeable with a licensed biological product, commonly referred to as a reference product. No approval of an application as either biosimilar or interchangeable is allowed until 12 years from the date on which the reference product is first approved. If FDA approves a biological product on the grounds that it is interchangeable to a reference product, HHS cannot make a determination that a second or subsequent biological product is interchangeable to that same reference product until one year after the first commercial marketing of the first interchangeable product.

Title VIII. Community Living Assistance Services and Supports
Establishment of a national voluntary insurance program for purchasing community living assistance services and support (CLASS program). The ACA establishes a new, voluntary, self-funded long-term care insurance program, the CLASS Independence Benefit Plan, for the purchase of community living assistance services and supports by individuals with functional limitations. The HHS secretary will develop an actuarially sound benefit plan that ensures solvency for 75 years, allows for a five-year vesting period for eligibility of benefits, creates benefit triggers that allow for the determination of functional limitation, and provides a cash benefit that is not less than an average of $50 per day. No taxpayer funds will be used to pay benefits under this provision.

Title IX. Revenue Provisions
Excise Tax on High-Cost Employer-Sponsored Health Coverage. The ACA levies a new excise tax of 40 percent on insurance companies or plan administrators for any health coverage plan with an annual premium that is above the threshold of $8,500 for single coverage and $23,000 for family coverage. The tax applies to self-insured plans and plans sold in the group market, and not to plans sold in the individual market (except for coverage eligible for the deduction for self-employed individuals). The tax applies to the amount of the premium in excess of the threshold. A transition rule increases the threshold for the 17 highest-cost states for the first three years. An additional threshold amount of $1,350 for singles and $3,000 for families is available for retired individuals age 55 and older and for plans that cover employees engaged in high-risk professions.

Title X. Strengthening Quality, Affordable Care
Title X made many improvements to the preceding nine titles, and descriptions of those changes are included above.


1.
Do you think this law has left out any critical healthcare policy issues? If so, what has been left out?


2.
Review each of the titles (topical issues found in the legislation). Select three that interest you, and examine them in more detail. How do they relate to nurses and nursing care?


3.
If you had to select which title was the most important, what would you select and why?
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Anonymous
wrote...
A year ago
In a market​ system,

 provide individuals the information they need to make decisions because they provide signals about the relative

cost
scarcity
 of a product and help an economy respond.
bio_man Author
wrote...
Educator
A year ago
In a market system, prices provide individuals the information they need to make decisions because they provide signals about the relative scarcity of a product. Because if there are high prices of goods in the economy, it means that there is a relative lack of that good. And if there are low prices in the economy, it means that there is more of that good available.
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