use reference db 1 alecia — H u m a n i t i e s

Read a selection of your colleagues’ postings.

Respond to at least two different colleagues’ postings in one or more of the following ways:

Expand on you colleague’s post on the ACA regarding affordability, rate of health insurance coverage, and access to health care.

Explain additional misconceptions that might be widespread. Suggest possible causes for these misconceptions.

Explain any insights you gained from your colleague’s post about the ACA.

Share any other insights you gained from the review of the posts submitted by your colleagues.

Use reference

DB 1

Alecia—

In times prior to the Affordable Care Act, applicants could get denied insurance due to pre-existing conditions (ironically considered risk).The exception would be if they were on a group plan or paid out-of-pocket.Paying out of pocket would result in considerably high premiums for those with health conditions.Many of the poorest individuals were those with chronic conditions.(Gehlert & Browne, 2019) Many in this population could not afford insurance.The Affordable Care Act of 2012’s premise was that each state provide both private and public affordable health insurance options to the public.The government mandated that each state choose 3 of the largest small group insurance, 3 of the largest state employed and federally employed insurance plans (6 total), the largest non-Medicaid HMO. (Collins, 2012)Of this collection of insurance plans, 10 health categories, were to be covered in the plans to qualify for the exchange.If plans were not selected and submitted by September 30, 2012, the government would choose for the state. Unlike previous insurance plans, conditions such as chronic illness, SUD Rehabilitation were covered.(Collins, 2012)The focus was on a more wholistic approach to address the whole-person’s illnesses and take preventative measures, providing incentives to keep patients healthy.

One misunderstanding were the rules under which programs the federal government would subsidize the programs.(Orient, 2019)This caused a lot of confusion within state governments and individuals experienced some lapses in coverage due to cancelled subsidies. (Orient, 2015)

Tanner (2015) pointed out that though it was projected that many would save on the exchange, the savings were not as projected and would probably go away with the return of inflation. The disadvantage is that each state offerings varied, so there was no consistency with the roll-out. It is the social worker’s job to become familiar with legislation, offerings, navigation of the exchanges and eligibility requirements.This information we pass on to the public.

I remember the roll-out of the Covered California.There were so many expectations of coverage for all.Coverage did increase nation-wide because of ACA.Tanner, 2015)It was straight forward for enrollment, but I do remember not quite understanding the overall conceptof the act.As the political climate changes and offerings of health benefits change, it is the healthcare social worker’s role to stay abreast of the changes and keep the public informed.

References

Collins, S.(2012).Essential health benefits & the Affordable Care Act: What social workers

need to know.

https://doi.org/10.1002/9781119420743

DB 2

Chelsea—

The Debate

In 2010 under the Obama administration, the Affordable Care Act was passed by a Democratic Congress and signed into law by Barak Obama (Dalen, et al., 2015). The overall goal was noted to increase the health of Americans by increasing the percentage of American’s that are insured. The opposition to the government’s role in health care came from the distrust of the government. There was also the idea that this was going to lead the United States further towards Universal Health Care.

Misconceptions regarding ACA

There are many misconceptions regarding the affordable health care act. One that I often encounter is that you can enroll in benefits with the ACA at any time. It is often assumed that since it is federally mandated, there is not a special enrollment period. I often have families who experience a life-altering hospitalization and because it is not open enrollment, they are not able to enroll in a health care plan. Another misconception is that everyone pays a penalty. There are instances in which a penalty is not assessed based on your income, or the penalty may be very low. The last misconception I will note is the idea that the ACA is “free insurance for all.” When the ACA first made is presentation many of my clients were disappointed to find insurance rates were higher than they expected and it wasn’t a system in which you could enroll in “free health care.”

Access to health care for young adults

Access to care increased significantly under the ACA due to the mandate of health insurance marketplaces. Under the 2010 ACA, coverage was not excluded if a patient had a pre-existing condition. This incorporation in the ACA was crucial to ensure young adults did not slip through the cracks and were unable to be covered and access to health care services and coverage. In the way of affordability, the ACA created avenues in which young adults in a lower socioeconomic category have access to lower-cost plans.

Influence on medical social work and roles

For young adults, the ACA incentivized a delivery system that integrated models of care to reduce fragmentation in the delivery of health services (NASW, 2016). This shifted the focus of the psychosocial being an essential part of discharge planning. The medical social worker’s role is to ensure families understand the misconceptions and are able to navigate the system. That system may be the Medicare or Medicaid system and it may be the health insurance marketplace. Families are often overwhelmed with what is going on medically with themselves and their loved ones and have trouble articulating a solution. It is also our responsibility to ensure we are up to date regarding policies that may be new or approaching, as well as ensuring that we have systems in place to attempt to get the uninsured enrolled when open enrollment happens each year or if there is a qualifying event.

References

Dalen, J., Waterbrook, K., Alpert, J., (2015). Why do so many Americans Oppose the Affordable Care Act? The American Journal of Medicine, 128(8), 807-810. Retrieved from https://doi.org/10.1016/j.amjmed.2015.01.032

National Association of Social Workers. (2016) Affordable Care Act Integration. Retrieved from