Healthcare News & Insights

Health Care Bill

Image_Health_care_Bill_HealthExecNewsThe state of health care in America is one topic that is always up for debate. The mix of private and public offerings have created a lot of turmoil throughout the government and the citizens of the U.S., and legislative changes in the health care system continue to impact the lives of thousands of Americans. The newest health care bill, known formally as The Affordable Care Act and informally as “Obama’s health care plan”, was designed to keep the private insurance system structure while making care more affordable and providing coverage to more Americans.

Changes Implemented by the Health Care Bill

Under the new health care law, it is estimated that about 32 million Americans will have access to coverage once denied to them over the next decade. That means that national coverage will increase from pre-health care bill levels of 83% to 94% around 2020 (US News). And while there is no “public option” as once discussed in the preliminary draft of the Obama health care plan, this increase in coverage edges America closer to universal coverage.

The guidelines of the health care law allow for all of its changes and strategies for improvement to be rolled out within a 4-year plan, completing the health care reform overhaul in 2014. Some of the biggest improvements that President Obama’s health care plan has instated are new provisions for health care insurance companies that prevent them from using improper, profit-driven practices. These immediate changes include:

  • Extending the age limit for young adults to remain on parents’ coverage. The new age limit is now 26, unless these young adults can receive coverage through an employer.
  • Banning a drop in coverage due to sudden illness or a mistake on applications for coverage.
  • Restricting the placement of annual limits for coverage on care provided.
  • Banning the practice of “lifetime limits” for coverage given by health insurance companies.
  • Banning the denial of health insurance coverage for children with illnesses or pre-existing medical conditions.


Health Care Bill and the Focus on Quality of Care

Much of the news surrounding the health care law has been about expanding coverage and reducing costs, two very important attributes to improving the health care system in America. Other big improvements will be made in the quality of care given by physicians, specialists, and others in the health care industry.

By rewarding professionals in the health care industry with incentives based on the quality of their care instead of the previously practiced quantity scale, both the patients as well as the care providers can benefit.

Prior to the installment of the health care bill, physicians would be paid based on a “fee-for-service” scale, in which each consult, test, appointment, or other procedure administered gave them a boost in earnings. While most of the services rendered were legitimately necessary, the profit structure allowed for doctors to take advantage of the situation by ordering more, sometimes unnecessary, and even duplicate tests and procedures, with their personal profits in mind.

The new health care law allows for a different structure to take precedence and reward doctors and specialists for working together to improve the quality of the care they administer to their patients. Starting with Medicare and Medicaid programs, doctors will have incentives to work together to focus on high-quality, preventative care. In addition to changing the profit structure for physicians, the health care bill will, in effect, help patients save money and possibly extend their lives through earlier detection and preventative actions.