Affordable Care Act in Florida: Pros and Cons

Introduction

The Affordable Care Act (ACA), also known as Obamacare, is a federal healthcare reform legislation intended to increase healthcare coverage across the United States. Although the implementation of ACA was mandatory, each state was given a choice on how to enact its provisions – using governmental funds or on their own. ACA in Florida has brought numerous advantages for citizens in terms of healthcare availability, but there are still some severe drawbacks, which are due to the ACA provisions and the state’s approach to their implementation.

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Main body

Since the ACA provisions grant the residents greater flexibility, more patients can choose the plan that would suit their needs. Over the period between 2010 and 2016, the percentage of uninsured adults in the US dropped from 20% to 12%, which is a positive change (Gunja, Collins, Doty, & Beutel, 2017, p. 2). However, the effectiveness of the ACA is different for each area since it is up to the state to decide whether they will run their marketplace or resort to federal government services.

Florida is one of the states that decided to use federal marketplace services and not to expand eligibility for Medicaid for lower-income adult residents. The ACA in Florida allows families and individuals to choose a healthcare insurance plan that would match their particular case. It takes into account various eligibility criteria, offers subsidies for lower-income patients, provides tax credits, as well as grants access to the health insurance Marketplace. Florida residents have several options for getting insurance: a private health plan, employment coverage, Medicaid, Medicare, and the Children’s Health Insurance Program (CHIP). All individuals (provided that they are not exempt) are required to get insurance coverage. Failure to do so may lead to fines that are calculated based on a person’s income.

Florida’s approach to enacting the ACA has numerous strengths, but there are also some weaknesses. Hence, in Florida, only adults with income at 33% of the federal poverty level (and below) can benefit from Medicaid, whereas adults without children do not qualify for it at all (Gunja et al., 2017). Under the Florida ACA provisions, children of legal immigrants are eligible to qualify for Medicaid without the five-year waiting period, whereas illegal immigrants are out of the equation. Therefore, the impact of ACA in Florida remains a debatable question among policymakers, patients, medical workers, and other stakeholders.

The biggest strengths include free preventive care for eligible citizens, limitless coverage for the residents with employer plans, the possibility for young adults to stay on their parent’s insurance until age 26, and more. Similarly, ACA in Florida significantly expands Medicaid coverage for eligible Floridians and ensures a slower premium tax credit growth. Compared to healthcare policies before the ACA, the current arrangement is much better. However, this approach does not provide the degree of transparency that was expected.

Some of the most prominent weaknesses of the ACA enactment in Florida are due to the state’s decision to operate using the federal government’s funding. Carrasquillo and Mueller (2018) note that Florida is one of two states that have the highest uninsured rates across the US, and of those who do not have access to Medicaid, 54% are racial or ethnic minorities. It is also estimated that the expansion of Medicaid eligibility would provide healthcare coverage to four million more uninsured adults (Carrasquillo & Mueller, 2018). Another massive drawback of ACA enactment in Florida is that undocumented residents are entirely left out of its provisions. There is no access to healthcare for illegal immigrants. They can neither get Medicaid nor buy a private insurance plan. All in all, Florida significantly preserves budget cost by reducing healthcare spendings, but a lot of people are deprived of high-quality medical help at the moment.

The effect of Florida’s approach to ACA on its stakeholders is a debatable question. The study conducted by Barakat et al. shows controversial findings regarding the impact of Medicaid on the quality of care, hospital readmission rates, and the healthcare cost. Whereas the self-pay visits to emergency departments in Florida decreased by 5.1%, the overall percentage of patients transferred to the hospital decreased by 2.1% (Barakat et al., 2017). Although the government took over the reimbursement burden from medical facilities and patients, there were no significant changes in hospital use.

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Conclusion

To conclude, the Affordable Care Act brought massive changes to the US healthcare system. In Florida, for example, more medical services became available for larger patient groups. However, numerous limitations stand on the way to affordable healthcare in this area. Namely, lower-income citizens still do not have access to all the benefits of ACA, whereas undocumented residents cannot receive any medical help at all. At the same time, there is no notable increase in hospital use across the area, even though the federal government reimburses these costs under the ACA. Overall, Florida’s approach to healthcare has its strengths, but there is a lot to be improved.

References

Barakat, M. T., Mithal, A., Huang, R. J., Mithal, A., Sehgal, A., Banerjee, S., & Singh, G. (2017). Affordable Care Act and healthcare delivery: A comparison of California and Florida hospitals and emergency departments. PLOS ONE, 12(8), 1-12.

Carrasquillo, O., & Mueller, M. (2018). Refinement of the Affordable Care Act: A progressive perspective. Annual Review of Medicine, 69(1), 29-39.

Gunja, M. Z., Collins, S. R., Doty, M. M., & Beutel S. (2017). Insurance coverage, access to care, and medical debt since the ACA: A look at California, Florida, New York, and Texas. Issue Brief (Commonwealth Fund), 7, 1-12.

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