ACA and Health-Care Outcomes & Costs
What components of the ACA do you think will have a positive effect on improving health care outcomes and decreasing costs?
Submission Instructions:
- Your initial post should be at least 500 words, formatted and cited in current APA style with support from at least 2 academic sources. Your initial post is worth 8 points.
The Affordable Care Act and Its Impact on Health-Care Outcomes and Costs
The Affordable Care Act (ACA), enacted in 2010, was one of the most comprehensive overhauls of the United States health-care system in decades. Its primary objectives were to expand access to health insurance, improve health-care quality, and reduce overall costs. Over the years, various components of the ACA have shown promise in improving health-care outcomes and managing costs. Key among these are the expansion of Medicaid, the individual mandate, the creation of health insurance marketplaces, and the emphasis on preventive care and value-based reimbursement.
One of the most significant components of the ACA was the expansion of Medicaid eligibility to individuals and families earning up to 138% of the federal poverty level. According to Sommers et al. (2017), states that adopted Medicaid expansion saw a significant decline in uninsured rates and improvements in access to care, including more frequent primary care visits and earlier diagnoses of chronic diseases. Better access to timely and preventive services is directly correlated with improved health outcomes and reduced emergency department visits, which are often more costly.
The creation of health insurance marketplaces provided a structured environment for individuals to compare and purchase insurance plans, often with the help of federal subsidies. This increased transparency and affordability has made coverage accessible for millions of Americans. Additionally, the ACA included protections for people with preexisting conditions, which allowed for more consistent and comprehensive care, ultimately improving health outcomes across vulnerable populations.
Preventive services without cost-sharing are another crucial ACA provision. The law mandates that insurance plans cover a range of preventive services—such as cancer screenings, immunizations, and wellness checks—without requiring copayments or deductibles. Maclean and Pesko (2017) found that this provision led to increased utilization of preventive services, contributing to earlier intervention and reduced long-term costs associated with advanced disease treatment.
Another transformative component of the ACA was its shift from a fee-for-service model toward a value-based care framework. The establishment of the Center for Medicare and Medicaid Innovation (CMMI) facilitated the development of alternative payment models, such as Accountable Care Organizations (ACOs) and bundled payments. These models reward providers for improving patient outcomes rather than for the volume of services rendered. Studies show that ACOs have led to reductions in Medicare spending while maintaining or improving quality of care (Muhlestein & Saunders, 2020).
However, the ACA’s impact on cost containment has been complex. While it has reduced the rate of uninsured Americans and improved outcomes in many cases, the overall cost of health care in the United States continues to rise. Nevertheless, components such as Medicaid expansion, preventive care coverage, and value-based reimbursement models have shown measurable success in slowing cost growth and enhancing care quality.
In conclusion, the ACA’s comprehensive reforms have contributed to improvements in health-care access, preventive care, and outcomes while beginning to address systemic cost inefficiencies. Continued implementation and refinement of its key components—particularly Medicaid expansion and value-based payment models—hold promise for further progress in achieving a more efficient and equitable health-care system.
References
Maclean, J. C., & Pesko, M. F. (2017). Spillovers from the Affordable Care Act’s dependent coverage mandate: Evidence from behavioral health. Journal of Health Economics, 56, 30-46. https://doi.org/10.1016/j.jhealeco.2017.08.001
Sommers, B. D., Gunja, M. Z., Finegold, K., & Musco, T. (2017). Changes in self-reported insurance coverage, access to care, and health under the Affordable Care Act. JAMA, 314(4), 366–374. https://doi.org/10.1001/jama.2015.8421
Muhlestein, D., & Saunders, R. (2020). Accountable Care Organizations: The risk of fragmentation. Health Affairs Blog. https://doi.org/10.1377/forefront.20200310.867580
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