Introduction
Healthcare reform refers to significant changes in the health system and is commonly associated with innovations introduced by the Affordable Care Act (ACA). Efforts to change the health care system to increase its effectiveness and improve the availability of health services. The implications of the reforms may differ by the state since everyone can accept changes to varying degrees. Despite the achievements and positive effects of the reform, the system still needs new revisions since shortcomings, and negative aspects are affecting the population.
Discussion
The US healthcare system has been changing for some time, being at the center of the debate. Discussions covered issues of cost, affordability, service quality, and economic consequences (Warner et al., 2020). Nevertheless, several changes are key milestones, and the discussion of reform is usually associated with them. Warner et al. (2020) note that Medicare and Medicaid, adopted 50 years before ACA, and the ACA, introduced in 2010, became the most significant events. At the same time, these changes have controversial results, as there are both positive and negative effects on the population.
The reform has significantly improved the healthcare system for the population. In particular, health services have become more accessible to the people. For example, insurance companies can no longer reject citizens with health conditions diagnosed before buying insurance (Warner et al., 2020). Moreover, more tax relief has become available to the low-income population, making insurance more affordable (Crowley et al., 2019). The reform also established markets where people could purchase an insurance (Crowley et al., 2019). Following the changes, children can be included in their parents’ insurance packages until they are 26 (Crowley et al., 2019). As a result, the scope of coverage of the population by insurance has grown, making services more affordable.
The reform has also contributed to the focus shift from treating diseases to preventing them, which is an important implication. ACA law contains provisions focusing on preventive measures to improve the nation’s health (Warner et al., 2020). Actions in this direction include increased investment in prevention efforts, overcoming barriers to preventive measures, and both activities (Warner et al., 2020). Prevention improves the general health of the population and reduces the burden on the healthcare system in treating diseases.
Other benefits of healthcare reform relate to the quality of services provided. For instance, the law helped spread value-based care delivery models. This approach assumes that providers are paid based on the patient’s health rates and outcomes, not just the efforts made. As a consequence, providers are more interested in ensuring better services and working to improve patient health (Warner et al., 2020). Another critical achievement of the reforms was an investment in biomedical research (Warner et al., 2020). The findings in the studies contribute to more effective approaches to disease treatment and prevention. As a result, the reform achieved significant changes that the American healthcare system demanded.
The achievements of reform are significant, but there are specific gaps and drawbacks. In particular, the constitutionality of the ACA was disputed since it was federal law and envisaged the expansion of Medicaid, but states should take such a decision (Warner et al., 2020). Moreover, the reform did not achieve universal coverage of the population in the accessibility of medical services. For example, in 2016, out of about 27 million citizens who did not have insurance, more than 7.5 million could receive benefits, and another seven million could become part of extended Medicaid (Crowley et al., 2019). Moreover, the insurance cost is still very high and rising, representing a critical barrier to citizens who want to acquire it (Crowley et al., 2019). As a consequence, reform is an essential step toward improving the system, but there is a need for further work.
In addition to the gaps in system change, implementing the reform also has negative aspects. For example, the number of specialists that patients can consult is significantly limited, hindering people’s care delivery (Crowley et al., 2019). Moreover, the population has little understanding of the law and its possibilities since they do not know it well enough. At the same time, difficulties arise when it is necessary to check whether citizens meet the requirements in the law for obtaining benefits or insurance (Crowley et al., 2019). This situation highlights the importance of further efforts to improve health care.
The states have implemented the measures provided for by the reform to various extents, and the current situation for providing services may differ. Considering Florida’s case, the state did not expand Medicaid for the population. According to 2022 data, services are not available to a significant part of the population – 51% of residents are not sure they will be able to purchase insurance (PerryUndem, 2022). As a result, about 40% of citizens do not seek medical care or postpone visits (PerryUndem, 2022). State residents want more system improvements and health care services availability (PerryUndem, 2022). If medicine does not become more accessible, the entire population’s health may deteriorate.
Conclusion
Thus, the reform of the healthcare system is associated with the introduction of the ACA. It has increased the availability of health services to the public, allowing more people to get the care they need. Moreover, the law emphasized the importance of preventive measures and improving the quality of medical services. However, the law failed to cover all citizens needing insurance, and its cost remains high. There are also problems with understanding and implementing the law, which prevents the population from taking full advantage of it. Some states have not adopted all the innovations of ACA, for example, Florida, and at the moment, many people do not have access to medical services.
References
Crowley, R. A., Bornstein, S. S., & Health and Public Policy Committee of the American College of Physicians. (2019). Improving the Patient Protection and Affordable Care Act’s insurance coverage provisions: A position paper from the American College of Physicians. Annals of Internal Medicine, 170(9), 651-653. Web.
PerryUndem. (2022). How Floridians feel about affordability and healthcare reform. The Robert Wood Johnson Foundation. Web.
Warner, J. J., Benjamin, I. J., Churchwell, K., Firestone, G., Gardner, T. J., Johnson, J. C., Ng-Osorio, J., Rodriguez, C. J., Todman, L., Yaffe, K., Yancy, C. W. & American Heart Association Advocacy Coordinating Committee. (2020). Advancing healthcare reform: The American Heart Association’s 2020 statement of principles for adequate, accessible, and affordable health care: A presidential advisory from the American Heart Association. Circulation, 141(10), e601-e614. Web.