affordable care act (Obamacare)
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Introduction
signed it into law in 2010
upheld by Supreme Court in June 2012
open enrollment on October 1, 2013
enacted Jan 2014
Notes
Provisions that affect care of the elderly include:
- $10 billion for establishment of the Center for Medicare & Medicaid Innovation
- elimination of the 'doughnut hole' coverage gap, by reducing co-insurance rates from 100% to 25% for patients affected by the gap
- creation of Accountable Care Organizations, in which physicians share in the cost savings to Medicare by attaining specified quality measures
- a 10% increase in fee for service reimbursement rates for geriatricians delivering primary care services
Funding for Medicare Advantage Programs is decreased because the alleged increase overall costs[3]
health insurance exchanges & Medicaid expansion enacted in 2014
- expanding Medcaid under the Affordable Care Act reduces number of uninsured 14%[6] & improves healthcare access[8]
- Medicaid expansion associated with better coverage & access[11]
- % of patients with newly diagnosed cancer without health insurance declined by 1/3 after ACA enacted[12]
- with its incentives & financial readmission penalties the the Affordable Care Act has reduced hospital readmissions[7]
repeal of the ACA would worsen the opioid epidemic[10]
References
- ↑ Health Affairs Blog, November 7th, 2012 Election 2012: A Win For Health Reform, But Much Work Remains http://healthaffairs.org/blog/2012/11/07/election-2012-a-win-for-health-reform-but-much-work-remains/
- ↑ Washington Post. Wokblog. November 7th, 2012 Obamacare stands. Now states need to make it work. http://www.washingtonpost.com/blogs/ezra-klein/wp/2012/11/07/obamacare-stands-now-states-need-to-make-it-work/
- ↑ 3.0 3.1 Geriatric Review Syllabus, 8th edition (GRS8) Durso SC and Sullivan GN (eds) American Geriatrics Society, 2013
- ↑ Blumenthal D and Collins SR Health Care Coverage under the Affordable Care Act - A Progress Report. N Engl J Med. July 2, 2014 <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/24988300 <Internet> http://www.nejm.org/doi/full/10.1056/NEJMhpr1405667
- ↑ Orciari Herman A, Fairchild DG Affordable Care Act to Face Supreme Court Physician's First Watch, March 4, 2015 David G. Fairchild, MD, MPH, Editor-in-Chief Massachusetts Medical Society http://www.jwatch.org
- ↑ 6.0 6.1 Sommers BD, Blendon RJ, Orav EJ Both The 'Private Option' And Traditional Medicaid Expansions Improved Access To Care For Low-Income Adults. Health Affairs. 2016 Jan 35(1):96-105 <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/26733706 <Internet> http://content.healthaffairs.org/content/35/1/96.abstract
- ↑ 7.0 7.1 Zuckerman RB et al. Readmissions, observation, and the Hospital Readmissions Reduction Program. N Engl J Med 2016 Feb 24 PMID: https://www.ncbi.nlm.nih.gov/pubmed/26910198 Free Article
- ↑ 8.0 8.1 Wherry LR, Miller S Early Coverage, Access, Utilization, and Health Effects Associated With the Affordable Care Act Medicaid Expansions: A Quasi-experimental Study. Ann Intern Med. Published online 19 April 2016 PMID: https://www.ncbi.nlm.nih.gov/pubmed/27088438
Kullgren JT Injecting Facts Into the Heated Debates Over Medicaid Expansion. Ann Intern Med. Published online 19 April 2016 <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/27088778 <Internet> http://annals.org/article.aspx?articleid=2515051 - ↑ Obama B United States Health Care Reform. Progress to Date and Next Steps. JAMA. Published online July 11, 2016 <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/27400401 <Internet> http://jama.jamanetwork.com/article.aspx?articleid=2533698
- ↑ 10.0 10.1 Friedmann PD, Andrews CM, Humphreys K How ACA Repeal Would Worsen the Opioid Epidemic. N Engl J Med 2017; 376:e16. March 9, 2017 <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/28273016 <Internet> http://www.nejm.org/doi/full/10.1056/NEJMp1700834
- ↑ 11.0 11.1 11.2 The Commonwealth Fund. Insurance Coverage, Access to Care, and Medical Debt Since the ACA: A Look at California, Florida, New York, and Texas. http://www.commonwealthfund.org/publications/issue-briefs/2017/mar/coverage-access-medical-debt-aca-california-florida-new-york-texas
- ↑ 12.0 12.1 Soni A, Sabik LM, Simon K et al Changes in Insurance Coverage Among Cancer Patients Under the Affordable Care Act. JAMA Oncol. Published online October 19, 2017. PMID: https://www.ncbi.nlm.nih.gov/pubmed/29049486 https://jamanetwork.com/journals/jamaoncology/article-abstract/2657670
- ↑ Bagley N Perspective. Is Obamacare Really Unconstitutional? N Engl J Med. Jan 2, 2020 PMID: https://www.ncbi.nlm.nih.gov/pubmed/31893512 https://www.nejm.org/doi/full/10.1056/NEJMp1917063
- ↑ The Affordable Care Act. Read the Law. http://www.hhs.gov/healthcare/about-the-law/read-the-law/
- ↑ Center for Medicare & Medicaid Innovation http://innovations.cms.gov