Understanding the affordable care act Essay Example for Free

Understanding the affordable c be act EssayUnderstanding the Patient Protection and Affordable Care Act(PPACA or ACA) can be elusive further it is not as confusing as it may seem. This paper depart highlight some of the provisions that have already been implemented and go out discuss how it affects me, wellnesscare workers, and the citizens of Arkansas. There are two provisions I testament discuss that went into effect on January 1, 2011. One is known as the Medical-Loss Ratio(MLR) and the other is a policy focused on Bringing down healthcare premiums. The MLR policy will put an end to insurance companies being able to bawl out rates without explaining their actions, or justifying the reason for their high premiums.The policy aims to bring transparency to the healthcare rate changes by requiring that all insurers seeking rate increases of 10% or more in the individual or small group market publicly disclose the proposed increases and the justification for them. (Insuranc e Rate Increases, Posted December 21, 2010, para. 4) These proposed increases will be analyzed further by the affected state before approval to determine if they are in fact reasonable. The ACA provides funding to states in order to gird or create rate review processes and consumers will be provided with detailed information on proposed increases from their insurance provider. The other significant policy made hard-hitting at the same time is one that will bring down the cost of insurance premiums. Under this provision, insurers must spend 80% (for individual or small group insurers) or 85% (for large group insurers) of premium dollars on health costs and claims, leaving only 20% or 15% respectively for administrative costs and profits. If an insurer fails to meet this requirement, there is no penalty, but a rebate must be issued to the policy holder. (Key Features of the ACA, n.d.) This affects me by protect me from unreasonable rate increases. As I get older, I make more frequen t visits to a healthcare provider for both acute and continuing illness.The costs add up quickly and with a limited source of income, anything that I can save helps greatly. A common feeling among insurance holders is that we are paying for something that we never use so the idea of a rebate for overpayment of premiums will be welcomed by all. There is one provision that became effective on September 23, 2010 that was a relief to my family in a time of despair. My mother underwent many procedures and s pulseries in thelast few years of her life and we were concerned intimately limits on annual or life history coverage placed on her by the insurance company. Under the law, insurance companies are prohibited from imposing lifetime dollar limits on essential benefits, and their use of annual dollar limits on the amount of insurance coverage a patient may receive will be restricted. Her medical bills were significant, but we never had to worry about her coverage expiring. The America n Nurses Association has fighting for health care reform for many years.By doing so, the ANA is promoting our core value of patient advocacy. We have been taught that we should represent our patients best interests in regards to healthcare at all times. So supporting measures that will allow for more affordable healthcare, is what nurses should do. The ANA has been working to ensure that RNs are fully included as leaders and eligible health care providers in new, patient-centered, team-based models of care, and accountable care organizations. ANA continues to urge federal agencies to include advanced practice registered nurses as first-string care providers, and for nurse-managed clinics to qualify as essential community providers. (Still The Law, August 2012, para. 7) Arkansas has put a lot effort into forming our Health Insurance Benefits Exchange, called the Arkansas Health Connector. It is a course through which our more than 500,000 uninsured Arkansas can fail for affordabl e health insurance. The plans are required to offer 10 essential services. Some of which include prescription drugs, emergency and hospital care, doctor visits, maternity and mental health services, renewal and lab services.The Arkansas insurance Department(AID) has been awarded a one year, $1 million planning grant from the United States Department of Health and Human Services (DHHS) refer for Consumer Information and Insurance Oversight CCIIO) to assist with studying options for development of the best possible Insurance Exchange for Arkansans. (Planning for HBE, n.d., para. 2) This Arkansas Health Connector makes it easier for uninsured individuals to shop for comparable and affordable health plans. The requirements placed on these plans are also greatly needed in order to provide complete healthcare and retard emerging healthcare related costs. The only cons that I will mention are that not enough people know about the availability of this program and that if people do not al ready know, they will found out rather abruptly when they are assessed a $95 penalty on their filed income tax return. The ACAoutlines plans to reduce episodic based care and increase population(community) based care. The idea is to provide a higher value of healthcare instead of volume, while decrease readmissions for nosocomial infections, preventable diseases, or complications from chronic conditions and illnesses.By implementing community based programs to promote healthcare, we can reduce healthcare costs and help patients live healthier lives with reducing the risks of significant and recurring medical problems as well as their associated costs. Regardless of arguments against the ACA, the most important aspect is that it helps Americans to become and remain healthier people. It teaches our bordering generation to value healthcare, and to take an active role in being healthier adults. The ACA will affect me professionally as well as personally. some other provision of the ACA provides for the increase of payments for rural healthcare providers. The majority of communities who are most in need of higher quality and more affordable healthcare, are dictated in the rural areas of our country. These communities often have trouble attracting and retaining medical professionals. My wife is also a nursing student, and we live in a rural area, so we plan to take advantage of these incentives to provide a higher standard of healthcare to those in need.A similar provision worth mentioning calls for the rebuilding of the primary care workforce. In order to strengthen the availability and quality of healthcare, there has been increased funding for scholarships and loan repayments for primary care physicians and nurses working in underserved areas, as well as tax free student loan payments for these health professionals. (Key Features of the ACA, n.d.) Again this affects my wife and I directly through scholarship opportunities and reduced monetary burden after we graduate. Also affecting me is the increase in the number of patients seeking healthcare due to more people have health insurance. This will increase the demand for both registered and advanced practice nurses in episodic based care as well as in the community. Our role as an educator will be more important than ever when teaching patients who have never had affordable health care. There are many arguments against this legislation, but as an aspiring nurse, I have yet to find one that suggests ACA is not the best option we have for making a healthier future for America. ReferencesAffordable care act is still the law. (August 2012). Retrieved from http//www.theamericannurse.org/index.php/2012/08/06/affordable-care-act-is-still-the-law/ Key features of the affordable care act by year. (n.d.). Retrieved from http//www.hhs.gov/healthcare/facts/timeline/timeline-text.html2010 Planning for the arkansas health benefits exchange. (n.d.). Retrieved from http//hbe.arkansas.gov/Planning.pdf Shining a light on health insurance rate increases. (Posted December 21, 2010). Retrieved from https//www.cms.gov/CCIIO/Resources/Fact-Sheets-and-FAQs/ratereview.html