Health Sector Policy and Governance

Health Sector Policy and Governance
For many years Americans who are mid- income earners struggled with maintaining individual health insurance for themselves and their family. Under former President Obama the Affordable Care Act (ACA) of 2010, allowed for an insurances system that made health insurance more accessible to those who could not previously afford it, even if consumers had pre-existing conditions. However, the cost of insurance is still a struggle for many to afford and maintain the payments since the act was instituted. “The Affordable Care Act (ACA) has accomplished much that its drafters intended. There is considerable evidence of increased access to health care and reduced medical debt.” (Jost, 2018).

Since the enactment of the ACA the impact that both federal and state health care policies have on the consumer is still a major concern. The cost of individual insurance is rising and one main concerns of mid income and the working age consumers whose annual household income is, 400% of the US poverty level are finding it difficult to access health insurance coverage because they do not receive any federal assistance. “This is virtually the only group of Americans who, when insured, do not receive some form of direct federal financial assistance or tax subsidies for health care coverage.” (Jost, 2018).


Positive and Negative effects of the state and federal health care policies.

The state and federal health care policies will either benefit some consumers as well as leave some displeased with the options and cost they will have in the coming months. This is due to the changes that have been made under the current administration. A negative action that is already in effect and will continue in the coming months is statewide premium increases. According to an analysis by Covered California, it found there will be statewide federal policy actions. “Premium increases for every state could range from 12 to 32 percent in 2019, with cumulative increases from 2019-2021 potentially ranging from 35 to 90 percent.” (Covered California, 2018).

However, some positive changes are in the works for consumers. There are both federal and state policies that are expected to affect premiums and promote stability as the individual market is still active. The policy makers will seek how they can make the cost of coverage more affordable to consumers. Some of the strategies are: helping to make coverage more affordable for the consumers, balancing of insurance risk pools, and, supporting markets with an unequal combination of negative risks. Last October the centers of Medicare and Medicaid services (CMS), reported a 4% reduction in the silver plan for 2020 through healthcare.gov. the report also stated there will be an additional 20 insurers participating in the ACA for 2020. “The average enrollee will have between three and four health plans to choose from in 2020, CMS reports. Twelve percent of enrollees will still be limited to one option next year.” (Nania, 2019).






References

Covered California, (2018), individual markets nationally face high premium increases in coming years absent federal or state action, with wide variation among states. Retrieved from https://hbex.coveredca.com/data-research/library/CoveredCA_High_Premium_Increases_3-8-18.pdf

Jost, T. S. (2018), how will state and federal actions affect individual health insurance coverage for middle-income Americans? Retrieved from Impact of actions on health coverage for middle-income Americans

Nania, R., (2019), lower premiums for some with 2020 ACA Health Plans. Retrieved from Affordable Care Act Costs, Plans for 2020 Announced