The Affordable Care Act in 2019

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Yes, students must include information beyond what is provided in the above link and note “Wikipedia” is not a reliable source (but is a good starting point to gather general information). The grader will be looking for additional references beyond the course textbook and the provided link.
Overlay the topic with a concept from the course textbook
The second portion of the paper should discuss how the selected issue specifically relates to a concept in the textbook. In this section, the details provided must make sense. A good way students can expedite this response is by selecting a concept from the textbook that will help fix the issue mentioned.
The Affordable Care Act in 2019: Still alive
Two years into the Trump administration, the Affordable Care Act remains law, but Republican lawmakers and the administration have reshaped parts of it through legislative, regulatory, budgetary and legal actions, the report noted. In 2019, these actions will create new winners and losers.
“Healthy individuals and small businesses seeking cheaper premiums will benefit in 2019, as will payers selling short-term, limited duration insurance and supporting association health plans,” PwC said. “New entrants specializing in underinsured and uninsured consumers may find new markets thanks to Republican actions to expand access to these plans.”
Financial services companies, makers of non-retail medical devices and employers offering high-cost insurance plans all will enjoy modest gains, too, the report added.
“On the losing end of these policies and decisions are middle-class consumers seeking comprehensive coverage on the ACA exchanges, and providers and payers dependent on patients covered by Medicaid or ACA plans living in conservative-leaning states that are more skeptical of the law,” PwC said. “Some ACA revenue-raising provisions have been delayed or eliminated, exacerbating their situation.”
The administration’s efforts to chip away at the ACA can be seen around the law’s edges through softening individual and employer mandates, expanding access to health insurance plans that don’t conform to ACA rules, reducing operational and financial support for individual exchanges, dialing back on Medicaid spending and expanding the use of health savings accounts, the report said.
“President Donald Trump, his administration and the Republican party campaigned in 2016 on repealing and replacing the ACA but failed to do it in a single piece of legislation in 2017,” PwC noted. “‘Repeal and replace’ as a political rallying cry fell away in this fall’s midterm elections, but in 2019, reshaping the law will remain a goal for the president, his administration and Republican lawmakers.”
PwC identified three implications of the still active Affordable Care Act. First, care delivery must move beyond the office and to a broader team.
“Anticipating less robust coverage on individual and non-group markets due to the greater availability of insurance plans that don’t conform to ACA regulations, providers and payers should develop plans for triaging patients and members to lower-cost care options, including telehealth or in-home nurse visits,” PwC said. “Providers also should pair patients with the most appropriate clinician to address patients’ immediate health issues. This could mean scheduling them with a nurse, dietitian, mental health specialist or social worker instead of a higher cost physician.”
The Health Research Institute found that a well-designed primary care team could result in savings of $1.2 million per 10,000 patients served annually, the report said.
Second, attention to drug prices will increase despite a slowdown in rule-making for manufacturers.
“An ACA provision that would implement monetary penalties on manufacturers that knowingly charge more than the ceiling price for a covered outpatient drug under the 340B purchasing program is scheduled to go into effect July 1,” PwC said. “The Trump administration had previously delayed the provision. Lawmakers in 2019 will be increasingly interested in how 340B entities are using the benefit and whether or not savings generated by the program are making it to consumers or padding companies’ pockets.”
Government scrutiny of drug prices is expected to continue, the report predicted. Seventy-three percent of Americans surveyed by Health Research Institute said they want the government to do more to control the cost of prescription drugs.
And third, insurance regulations are falling to states, creating a patchwork.
“States will be taking more direct action to secure their insurance markets in 2019, even as the methods for doing so become more variate, creating challenges for regulatory compliance,” PwC said. “In all states, payers will be able to sell more products in the individual and group markets, but regulations of those products will differ. States that don’t ban new products outright could still place greater restrictions on their use than federal regulations allow for.”
At the same time, states will seek ways to stabilize marketplaces through federal assistance, particularly through reinsurance programs designed to reimburse payers with high-cost beneficiaries and slow individual plans’ premium increases, the report said.
“When making decisions in 2019, payers seeking to get the most out of new opportunities should avoid thinking of states as red or blue when they approach marketplaces and should instead closely follow state regulatory decisions,” PwC said.
[UPDATE: For a look back at this story from year’s end, click here for a follow-up article from December 16, 2019.]

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