The USA Healthcare and the Affordable Care Act Discussion

1. Discuss the attempts made in the U.S. prior to the ACA to reform health care. What programs were successful and which were unsuccessful? 400-500 words APA format

2. Write a 3-5 page paper discussing the pros and cons of the Affordable Care Act (ACA). Discuss what changes you would make to the ACA if you were in charge of developing a repeal. APA format. scholarly articles/journals as references

The ACA changed the health insurance landscape through numerous new insurance protections that improved access to coverage for people with diabetes, as well as the quality of that coverage. Since the ACA passed in 2010, ADA has made great progress in ensuring that the law is implemented in a way that will benefit people with or at risk for developing diabetes and that these individuals are aware of the numerous improvements made by the law. Some of the health insurance improvements and advocacy victories include:

• Health plans cannot deny people coverage or charge them more because they have diabetes or any other preexisting condition.

• Plans cannot have annual or lifetime dollar limits on essential health benefits.

• The amount of cost-sharing that individuals and families pay for their care each year is limited.

   ❍ In 2015, after out-of-pocket spending of $6,600 for individual coverage or $13,200 for family coverage, the plan pays 100% of the cost of covered essential health benefits.

• A Health Insurance Marketplace (Marketplace) is available in every state, through which individuals and families can shop for and buy health insurance. Marketplace plans are separated into four categories: Bronze, Silver, Gold, and Platinum. Moving from Bronze to Platinum, in general, out-of-pocket costs decrease and premiums tend to increase. People who meet income requirements qualify for assistance in paying their Marketplace plan premiums (through a tax credit) and may qualify for other assistance to lower their out-of-pocket costs when they access care.

   ❍ For example, in 2015, help in paying Marketplace premiums was available to individuals earning $11,770–$47,080 and families of four earning $24,250–$97,000. In addition, individuals earning up to $29,425 and families of four earning up to $60,625 were eligible for help paying cost-sharing expenses for certain Marketplace plans.

• Plans and issuers that offer dependent coverage are required to make the coverage available until adult children reach the age of 26.

• A minimum set of essential health benefits (EHBs) such as hospitalization, prescription drugs, chronic disease management, and preventive services must be covered in most individual and small-group plans, including all plans sold in the state Marketplaces.

   ❍ The design of a plan’s package of EHBs also cannot discriminate against individuals with a disability or chronic health care needs.

  Important information for writing discussion questions and participation

  Welcome to class

  Hello class and welcome to the class and I will be your instructor for this course. This is a -week course and requires a lot of time commitment, organization, and a high level of dedication. Please use the class syllabus to guide you through all the assignments required for the course. I have also attached the classroom policies to this announcement to know your expectations for this course. Please review this document carefully and ask me any questions if you do. You could email me at any time or send me a message via the “message” icon in halo if you need to contact me. I check my email regularly, so you should get a response within 24 hours. If you have not heard from me within 24 hours and need to contact me urgently, please send a follow up text to

  I strongly encourage that you do not wait until the very last minute to complete your assignments. Your assignments in weeks 4 and 5 require early planning as you would need to present a teaching plan and interview a community health provider. I advise you look at the requirements for these assignments at the beginning of the course and plan accordingly. I have posted the YouTube link that explains all the class assignments in detail. It is required that you watch this 32-minute video as the assignments from week 3 through 5 require that you follow the instructions to the letter to succeed. Failure to complete these assignments according to instructions might lead to a zero. After watching the video, please schedule a one-on-one with me to discuss your topic for your project by the second week of class. Use this link to schedule a 15-minute session. Please, call me at the time of your appointment on my number. Please note that I will NOT call you.

  Please, be advised I do NOT accept any assignments by email. If you are having technical issues with uploading an assignment, contact the technical department and inform me of the issue. If you have any issues that would prevent you from getting your assignments to me by the deadline, please inform me to request a possible extension. Note that working fulltime or overtime is no excuse for late assignments. There is a 5%-point deduction for every day your assignment is late. This only applies to approved extensions. Late assignments will not be accepted.

  If you think you would be needing accommodations due to any reasons, please contact the appropriate department to request accommodations.

  Plagiarism is highly prohibited. Please ensure you are citing your sources correctly using APA 7th edition. All assignments including discussion posts should be formatted in APA with the appropriate spacing, font, margin, and indents. Any papers not well formatted would be returned back to you, hence, I advise you review APA formatting style. I have attached a sample paper in APA format and will also post sample discussion responses in subsequent announcements.

  Your initial discussion post should be a minimum of 200 words and response posts should be a minimum of 150 words. Be advised that I grade based on quality and not necessarily the number of words you post. A minimum of TWO references should be used for your initial post. For your response post, you do not need references as personal experiences would count as response posts. If you however cite anything from the literature for your response post, it is required that you cite your reference. You should include a minimum of THREE references for papers in this course. Please note that references should be no more than 5 years old except recommended as a resource for the class. Furthermore, for each discussion board question, you need ONE initial substantive response and TWO substantive responses to either your classmates or your instructor for a total of THREE responses. There are TWO discussion questions each week, hence, you need a total minimum of SIX discussion posts for each week. I usually post a discussion question each week. You could also respond to these as it would count towards your required SIX discussion posts for the week.

  I understand this is a lot of information to cover in 5 weeks, however, the Bible says in Philippians 4:13 that we can do all things through Christ that strengthens us. Even in times like this, we are encouraged by God’s word that we have that ability in us to succeed with His strength. I pray that each and every one of you receives strength for this course and life generally as we navigate through this pandemic that is shaking our world today. Relax and enjoy the course!

  Hi Class,

  Please read through the following information on writing a Discussion question response and participation posts.

  Contact me if you have any questions.

  Important information on Writing a Discussion Question

  • Your response needs to be a minimum of 150 words (not including your list of references)
  • There needs to be at least TWO references with ONE being a peer reviewed professional journal article.
  • Include in-text citations in your response
  • Do not include quotes—instead summarize and paraphrase the information
  • Follow APA-7th edition
  • Points will be deducted if the above is not followed

  Participation –replies to your classmates or instructor

  • A minimum of 6 responses per week, on at least 3 days of the week.
  • Each response needs at least ONE reference with citations—best if it is a peer reviewed journal article
  • Each response needs to be at least 75 words in length (does not include your list of references)
  • Responses need to be substantive by bringing information to the discussion or further enhance the discussion. Responses of “I agree” or “great post” does not count for the word count.
  • Follow APA 7th edition
  • Points will be deducted if the above is not followed
  • Remember to use and follow APA-7th edition for all weekly assignments, discussion questions, and participation points.
  • Here are some helpful links
  • The is a great resource

   

   

• All plans must provide a plain-language summary (called a Summary of Benefits and Coverage [SBC]) of its benefits to help people better understand its coverage and compare plans.

   ❍ The SBC includes a coverage snapshot of how much the plan might pay for medical care for a sample patient with type 2 diabetes. ADA advocated for this example to be included in the SBC.

• Most plans must provide coverage of numerous preventive services without a copayment if the services are obtained through an in-network provider.

   ❍ Currently, plans must cover without cost-sharing type 2 diabetes screening for adults with high blood pressure, type 2 diabetes screening for pregnant women at high risk, and gestational diabetes screening for all pregnant women. ADA is working toward expanding the requirement for type 2 diabetes screening for all adults at high risk in accordance with ADA standards, and there is currently a draft recommendation from the U.S. Preventive Services Task Force to that end.

• The Medicare “donut hole” (a coverage gap in many Medicare Part D prescription drug plans that used to make beneficiaries responsible for 100% of the cost of their drugs above an initial coverage limit but less than the amount needed to trigger “catastrophic” coverage) is gradually closing and will no longer exist in 2020.

• Medicaid eligibility was extended to all Americans earning up to 138% of the federal poverty level (FPL; $16,243 for individuals and $33,465 for families of four in 2015), although, as a result of a 2012 Supreme Court ruling, this extension is optional for states. Currently, 30 states and the District of Columbia have expanded Medicaid.