The Patient Protection and Affordable Care Act (ACA) was designed to increase health insurance quality and affordability, lower the uninsured rate by expanding insurance coverage, and reduce the costs of healthcare overall. Along with sweeping change came sweeping criticisms and issues. This book explores the pros and cons of the Affordable Care Act, and explains who benefits from the ACA. Readers will learn how the economy is affected by the ACA, and the impact of the ACA rollout.
The Social Security Administration (SSA) administers two programs that provide benefits based on disability: the Social Security Disability Insurance (SSDI) program and the Supplemental Security Income (SSI) program. This report analyzes health care utilizations as they relate to impairment severity and SSA's definition of disability. Health Care Utilization as a Proxy in Disability Determination identifies types of utilizations that might be good proxies for "listing-level" severity; that is, what represents an impairment, or combination of impairments, that are severe enough to prevent a person from doing any gainful activity, regardless of age, education, or work experience.
The landmark 2010 Patient Protection and Affordable Care Act (ACA), or “Obamacare,” is a topic of great debate in mainstream, academic, and scientific media that generated strong opinions across the political spectrum and our nation. Soon after the enactment of the ACA and the fierce debate that ensued, The Affordable Care Act as a National Experiment was published by Springer in 2014. Now five years later, just finishing an election year in which the ACA was a hotly debated issue, the second edition of this title examines the history, lessons, and impact of this ground-breaking legislation. Now a decade since implementation nationally, the ACA is the largest healthcare policy innovation in the United States in at least 50 years and one of our nation’s largest healthcare experiments ever. The history of public health and medicine shows us that to develop better solutions for important health problems, we must innovate. And when we try a new strategy, we are reminded that to innovate is to experiment. This is the basis of all medical research, public health interventions, and health policy innovations. Moreover, in recent years, there is an increasing emphasis on “translational science,” research that always has an ultimate focus on having real impact on medical care and the public’s health – whether in translating from bench research to the bedside, or from limited clinical use into widespread practice, public health interventions or policy. As with the previous edition, the book opens with a chapter that gives a basic overview of The Affordable Care Act. The second chapter, which previously discussed the objectives of the ACA, now takes a look at the successes, unfinished work and impact of the ACA in the past ten years. The third chapter now ponders the question of whether the ACA has protected patients since its implementation while its previous counterpart gave predictions for the future. The chapters that follow highlight things such as Medicaid expansion and insurance reform under the ACA, the Supreme Court Review of the ACA, social determinants of health, stories of the uninsured and stabilization of the ACA, among others. The book rounds out with a summary of what’s next and the push for universal healthcare followed by an epilogue. Due to the timely nature of the subject matter, some chapters from the previous edition have been dropped and seven new chapters have been added in their place. The remaining seven chapters from the previous edition have also been fully revised and updated. Written by nationally known healthcare policy leaders who were involved directly in the creation and implementation of the ACA, the second edition of The Affordable Care Act as a National Experiment again will examine the history and impact of this ground-breaking legislation as well as recommend priorities, objectives, and next steps for translational research. It is an essential resource for all healthcare providers as well as policy makers and academics.
Not five minutes after the Affordable Care Act (ACA) was signed into law, in March 2010, Virginia’s attorney general was suing to stop it. And yet, the ACA rolled out, in infamously bumpy fashion, and rolled on, fought and defended at every turn—despite President Obama’s claim, in 2014, that its proponents and opponents could finally “stop fighting old political battles that keep us gridlocked.” But not only would the battles not stop, as Obamacare Wars makes acutely clear, they spread from Washington, DC, to a variety of new arenas. The first thorough account of the implementation of the ACA, this book reveals the fissures the act exposed in the American federal system. Obamacare Wars shows how the law’s intergovernmental structure, which entails the participation of both the federal government and the states, has deeply shaped the politics of implementation. Focusing on the creation of insurance exchanges, the expansion of Medicaid, and execution of regulatory reforms, Daniel Béland, Philip Rocco, and Alex Waddan examine how opponents of the ACA fought back against its implementation. They also explain why opponents of the law were successful in some efforts and not in others—and not necessarily in a seemingly predictable red vs. blue pattern. Their work identifies the role of policy legacies, institutional fragmentation, and public sentiments in each instance as states grappled with new institutions, as in the case of the exchanges, or existing structures, in Medicaid and regulatory reform. Looking broadly at national trends and specifically at the experience of individual states, Obamacare Wars brings much-needed clarity to highly controversial but little-understood aspects of the Affordable Care Act’s odyssey, with implications for how we understand the future trajectory of health reform, as well as the multiple forms of federalism in American politics.
Many Americans believe that people who lack health insurance somehow get the care they really need. Care Without Coverage examines the real consequences for adults who lack health insurance. The study presents findings in the areas of prevention and screening, cancer, chronic illness, hospital-based care, and general health status. The committee looked at the consequences of being uninsured for people suffering from cancer, diabetes, HIV infection and AIDS, heart and kidney disease, mental illness, traumatic injuries, and heart attacks. It focused on the roughly 30 million-one in seven-working-age Americans without health insurance. This group does not include the population over 65 that is covered by Medicare or the nearly 10 million children who are uninsured in this country. The main findings of the report are that working-age Americans without health insurance are more likely to receive too little medical care and receive it too late; be sicker and die sooner; and receive poorer care when they are in the hospital, even for acute situations like a motor vehicle crash.
Many of the elements of the Affordable Care Act (ACA) went into effect in 2014, and with the establishment of many new rules and regulations, there will continue to be significant changes to the United States health care system. It is not clear what impact these changes will have on medical and public health preparedness programs around the country. Although there has been tremendous progress since 2005 and Hurricane Katrina, there is still a long way to go to ensure the health security of the Country. There is a commonly held notion that preparedness is separate and distinct from everyday operations, and that it only affects emergency departments. But time and time again, catastrophic events challenge the entire health care system, from acute care and emergency medical services down to the public health and community clinic level, and the lack of preparedness of one part of the system places preventable stress on other components. The implementation of the ACA provides the opportunity to consider how to incorporate preparedness into all aspects of the health care system. The Impacts of the Affordable Care Act on Preparedness Resources and Programs is the summary of a workshop convened by the Institute of Medicine's Forum on Medical and Public Health Preparedness for Catastrophic Events in November 2013 to discuss how changes to the health system as a result of the ACA might impact medical and public health preparedness programs across the nation. This report discusses challenges and benefits of the Affordable Care Act to disaster preparedness and response efforts around the country and considers how changes to payment and reimbursement models will present opportunities and challenges to strengthen disaster preparedness and response capacities.
The Future of Nursing explores how nurses' roles, responsibilities, and education should change significantly to meet the increased demand for care that will be created by health care reform and to advance improvements in America's increasingly complex health system. At more than 3 million in number, nurses make up the single largest segment of the health care work force. They also spend the greatest amount of time in delivering patient care as a profession. Nurses therefore have valuable insights and unique abilities to contribute as partners with other health care professionals in improving the quality and safety of care as envisioned in the Affordable Care Act (ACA) enacted this year. Nurses should be fully engaged with other health professionals and assume leadership roles in redesigning care in the United States. To ensure its members are well-prepared, the profession should institute residency training for nurses, increase the percentage of nurses who attain a bachelor's degree to 80 percent by 2020, and double the number who pursue doctorates. Furthermore, regulatory and institutional obstacles-including limits on nurses' scope of practice-should be removed so that the health system can reap the full benefit of nurses' training, skills, and knowledge in patient care. In this book, the Institute of Medicine makes recommendations for an action-oriented blueprint for the future of nursing.
This book examines the landmark 2010 Patient Protection and Affordable Care Act (ACA) from the perspective of health policy research as translational science. It delineates a new perspective about the creation and potential impact of the ACA and guides the development of health policy that is supported by best evidence that, in turn, transforms into practice, policy, and public benefit. Told by those involved in the creation and implementation of the ACA, the book reviews the history and impact of this ground-breaking legislation and recommends priorities, objectives, and next steps for translational research as the ACA is implemented. The book includes coverage of these topics: · Objectives of the ACA · Analysis of data collected from healthcare reform programs in Vermont and Massachusetts to inform national implementation of the ACA · Engaging the public in, and building support for, ACA implementation · Interplay of federal, state, and local healthcare policy decisions arising from the enforcement of the ACA Featuring contributions from nationally renowned leaders in healthcare policy, this book adds to the public conversation about the ACA and its role in shaping health policy and contributes to a more realistic, nuanced, and productive understanding of this landmark legislation by physicians, policy makers, and the public. It also provides a framework for next steps in continuing to improve U.S. health policy.
Healthcare decision makers in search of reliable information that compares health interventions increasingly turn to systematic reviews for the best summary of the evidence. Systematic reviews identify, select, assess, and synthesize the findings of similar but separate studies, and can help clarify what is known and not known about the potential benefits and harms of drugs, devices, and other healthcare services. Systematic reviews can be helpful for clinicians who want to integrate research findings into their daily practices, for patients to make well-informed choices about their own care, for professional medical societies and other organizations that develop clinical practice guidelines. Too often systematic reviews are of uncertain or poor quality. There are no universally accepted standards for developing systematic reviews leading to variability in how conflicts of interest and biases are handled, how evidence is appraised, and the overall scientific rigor of the process. In Finding What Works in Health Care the Institute of Medicine (IOM) recommends 21 standards for developing high-quality systematic reviews of comparative effectiveness research. The standards address the entire systematic review process from the initial steps of formulating the topic and building the review team to producing a detailed final report that synthesizes what the evidence shows and where knowledge gaps remain. Finding What Works in Health Care also proposes a framework for improving the quality of the science underpinning systematic reviews. This book will serve as a vital resource for both sponsors and producers of systematic reviews of comparative effectiveness research.
