Healthcare reform changes for 2015

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The law helps you by bringing down health care costs and making sure your health care dollars are spent wisely. Insurance companies will now be accountable to their customers for how they are spending premium dollars, and how much they are raising rates.

Plus, the law will help lower costs through tax credits and marketplaces where insurers will have to compete for your business. Strengthening Review of Rate Increases: In every state, insurance companies are required to publicly justify their actions if they want to raise rates by 10 percent or more.

Improving Affordability: Since the Affordable Care Act was enacted, health care prices have risen at the slowest rate in nearly 50 years. The health care law builds on what works in our health care system. Free Prevention Benefits: Insurers are now required to cover a number of recommended preventive services, such as cancer, diabetes and blood pressure screenings, without additional cost sharing such as copays or deductibles.

The Health Insurance Marketplace: The Health Insurance Marketplace is a one-stop shop where consumers can choose a private health insurance plan that fits their health needs. Most people who shop in the Marketplace qualify for financial assistance that lowers their monthly premiums and makes coverage affordable.

Nearly 50 million older Americans and Americans with disabilities rely on Medicare each year, and the health care law makes Medicare stronger by adding benefits, fighting fraud, and improving care for patients. The projected life of the Medicare Trust Fund has been extended by 13 years to as a result of reducing waste, fraud, and abuse, and slowing cost growth in Medicare. To help these seniors, the law provides relief for people in the donut hole — the ones with the highest prescription drug costs.

Since , more than 9. Seniors will continue to see additional savings on covered brand-name and generic drugs while in the coverage gap until the gap is closed in Free Preventive Services: Under the law, seniors can receive recommended preventive services such as flu shots, diabetes screenings, as well as an Annual Wellness Visit, free of charge. So far, more than 39 million seniors have already received one or more free preventive services, including the Annual Wellness Visit.

Fighting Fraud: The health care law helps stop fraud with tougher screening procedures, stronger penalties, and technology. Improving Care Coordination and Quality: The Affordable Care Act made major investments in improving the quality and safety of patient care, including for people with Medicare.

Fewer Americans are losing their lives or falling ill due to hospital-acquired conditions, like pressure ulcers, central line associated infections, and falls and traumas — which are down 17 percent since Preliminary data show that between and , there was a decrease in these conditions by more than 1. Fewer Unnecessary Hospital Readmissions: Reforms to improve the quality of hospital care have helped avoid an estimated , hospital readmissions between and They are why we got this done.

They are why I signed this bill into law. Skip to main content Skip to footer site map. GetCovered HealthCare. The Health. Health Care. Health Care that Works for Americans On March 23, , President Obama signed the Affordable Care Act into law, putting in place comprehensive reforms that improve access to affordable health coverage for everyone and protect consumers from abusive insurance company practices.

Stronger Consumer Rights and Protections million Americans no longer have lifetime dollar limits on their coverage. Dashed lines reflect the result of an ordinary least squares regression relating the change in the uninsured rate from to to the level of the uninsured rate in , run separately for each group of states.

The 29 states in which expanded coverage took effect before the end of were categorized as Medicaid expansion states, and the remaining 21 states were categorized as Medicaid nonexpansion states. Data are derived from the National Health Expenditure Accounts. Data for the series labeled Claxton et al were derived from the analyses of the Trueven Marketscan claims database reported by Claxton et al The plotted series reflects a month moving average of the hospital readmission rates reported for discharges occurring in each month.

Obama B. Importance The Affordable Care Act is the most important health care legislation enacted in the United States since the creation of Medicare and Medicaid in The law implemented comprehensive reforms designed to improve the accessibility, affordability, and quality of health care.

Objectives To review the factors influencing the decision to pursue health reform, summarize evidence on the effects of the law to date, recommend actions that could improve the health care system, and identify general lessons for public policy from the Affordable Care Act. Evidence Analysis of publicly available data, data obtained from government agencies, and published research findings. The period examined extends from to early Findings The Affordable Care Act has made significant progress toward solving long-standing challenges facing the US health care system related to access, affordability, and quality of care.

Research has documented accompanying improvements in access to care for example, an estimated reduction in the share of nonelderly adults unable to afford care of 5. These and related reforms have contributed to a sustained period of slow growth in per-enrollee health care spending and improvements in health care quality. Despite this progress, major opportunities to improve the health care system remain.

Conclusions and Relevance Policy makers should build on progress made by the Affordable Care Act by continuing to implement the Health Insurance Marketplaces and delivery system reform, increasing federal financial assistance for Marketplace enrollees, introducing a public plan option in areas lacking individual market competition, and taking actions to reduce prescription drug costs.

Health insurance enables children to excel at school, adults to work more productively, and Americans of all ages to live longer, healthier lives. When I took office, health care costs had risen rapidly for decades, and tens of millions of Americans were uninsured. Regardless of the political difficulties, I concluded comprehensive reform was necessary.

The result of that effort, the Affordable Care Act ACA , has made substantial progress in addressing these challenges.

Americans can now count on access to health coverage throughout their lives, and the federal government has an array of tools to bring the rise of health care costs under control. However, the work toward a high-quality, affordable, accessible health care system is not over. In this Special Communication, I assess the progress the ACA has made toward improving the US health care system and discuss how policy makers can build on that progress in the years ahead.

In my first days in office, I confronted an array of immediate challenges associated with the Great Recession. Moreover, the US system left more than 1 in 7 Americans without health insurance coverage in These included people like Natoma Canfield, who had overcome cancer once but had to discontinue her coverage due to rapidly escalating premiums and found herself facing a new cancer diagnosis uninsured. In the summer of , I signed the Tobacco Control Act, which has contributed to a rapid decline in the rate of smoking among teens, from Beyond these initial actions, I decided to prioritize comprehensive health reform not only because of the gravity of these challenges but also because of the possibility for progress.

Massachusetts had recently implemented bipartisan legislation to expand health insurance coverage to all its residents. Leaders in Congress had recognized that expanding coverage, reducing the level and growth of health care costs, and improving quality was an urgent national priority. At the same time, a broad array of health care organizations and professionals, business leaders, consumer groups, and others agreed that the time had come to press ahead with reform.

The evidence underlying this assessment was obtained from several sources. To assess trends in insurance coverage, this analysis relies on publicly available government and private survey data, as well as previously published analyses of survey and administrative data.

The dates of the data used in this assessment range from to early The ACA has succeeded in sharply increasing insurance coverage. Quiz Ref ID The number of uninsured individuals in the United States has declined from 49 million in to 29 million in This is by far the largest decline in the uninsured rate since the creation of Medicare and Medicaid 5 decades ago.

Recent analyses have concluded these gains are primarily because of the ACA, rather than other factors such as the ongoing economic recovery. States that decided to expand their Medicaid programs saw larger reductions in their uninsured rates from to , especially when those states had large uninsured populations to start with Figure 2 Early evidence indicates that expanded coverage is improving access to treatment, financial security, and health for the newly insured.

Quiz Ref ID Following the expansion through early , nonelderly adults experienced substantial improvements in the share of individuals who have a personal physician increase of 3. The law has also greatly improved health insurance coverage for people who already had it. Quiz Ref ID Coverage offered on the individual market or to small businesses must now include a core set of health care services, including maternity care and treatment for mental health and substance use disorders, services that were sometimes not covered at all previously.

Lifetime limits on coverage are now illegal and annual limits typically are as well. The law is also phasing out the Medicare Part D coverage gap. The ACA has changed the health care payment system in several important ways. The law modified rates paid to many that provide Medicare services and Medicare Advantage plans to better align them with the actual costs of providing care. Research on how past changes in Medicare payment rates have affected private payment rates implies that these changes in Medicare payment policy are helping decrease prices in the private sector as well.

In parallel with these efforts, my administration has worked to foster a more competitive market by increasing transparency around the prices charged and the quality of care delivered. Trends in health care costs and quality under the ACA have been promising Figure 4 1 , From through , mean annual growth in real per-enrollee Medicare spending has actually been negative , down from a mean of 4.

As a result, health care spending is likely to be far lower than expected. At the same time, the United States has seen important improvements in the quality of care. While the Great Recession and other factors played a role in recent trends, the Council of Economic Advisers has found evidence that the reforms introduced by the ACA helped both slow health care cost growth and drive improvements in the quality of care.

I am proud of the policy changes in the ACA and the progress that has been made toward a more affordable, high-quality, and accessible health care system. Despite this progress, too many Americans still strain to pay for their physician visits and prescriptions, cover their deductibles, or pay their monthly insurance bills; struggle to navigate a complex, sometimes bewildering system; and remain uninsured.

More work to reform the health care system is necessary, with some suggestions offered below. First, many of the reforms introduced in recent years are still some years from reaching their maximum effect. In addition, a critical piece of unfinished business is in Medicaid. As of July 1, , 19 states have yet to expand their Medicaid programs. I hope that all 50 states take this option and expand coverage for their citizens in the coming years, as they did in the years following the creation of Medicaid and CHIP.

In parallel, I expect continued bipartisan support for identifying the root causes and cures for diseases through the Precision Medicine and BRAIN initiatives and the Cancer Moonshot, which are likely to have profound benefits for the 21st-century US health care system and health outcomes. Second, while the ACA has greatly improved the affordability of health insurance coverage, surveys indicate that many of the remaining uninsured individuals want coverage but still report being unable to afford it.

Third, more can and should be done to enhance competition in the Marketplaces. For most Americans in most places, the Marketplaces are working.

The ACA supports competition and has encouraged the entry of hospital-based plans, Medicaid managed care plans, and other plans into new areas.

Some parts of the country have struggled with limited insurance market competition for many years, which is one reason that, in the original debate over health reform, Congress considered and I supported including a Medicare-like public plan. Public programs like Medicare often deliver care more cost-effectively by curtailing administrative overhead and securing better prices from providers.

Now, based on experience with the ACA, I think Congress should revisit a public plan to compete alongside private insurers in areas of the country where competition is limited. Adding a public plan in such areas would strengthen the Marketplace approach, giving consumers more affordable options while also creating savings for the federal government.

There is another important role for Congress: it should avoid moving backward on health reform. While I have always been interested in improving the law—and signed 19 bills that do just that—my administration has spent considerable time in the last several years opposing more than 60 attempts to repeal parts or all of the ACA, time that could have been better spent working to improve our health care system and economy.

In some instances, the repeal efforts have been bipartisan, including the effort to roll back the excise tax on high-cost employer-provided plans. Although this provision can be improved, such as through the reforms I proposed in my budget, the tax creates strong incentives for the least-efficient private-sector health plans to engage in delivery system reform efforts, with major benefits for the economy and the budget. It should be preserved. While historians will draw their own conclusions about the broader implications of the ACA, I have my own.

These lessons learned are not just for posterity: I have put them into practice in both health care policy and other areas of public policy throughout my presidency. The first lesson is that any change is difficult, but it is especially difficult in the face of hyperpartisanship.

Republicans reversed course and rejected their own ideas once they appeared in the text of a bill that I supported. For example, they supported a fully funded risk-corridor program and a public plan fallback in the Medicare drug benefit in but opposed them in the ACA. They supported the individual mandate in Massachusetts in but opposed it in the ACA.

Moreover, through inadequate funding, opposition to routine technical corrections, excessive oversight, and relentless litigation, Republicans undermined ACA implementation efforts. We could have covered more ground more quickly with cooperation rather than obstruction. It is not obvious that this strategy has paid political dividends for Republicans, but it has clearly come at a cost for the country, most notably for the estimated 4 million Americans left uninsured because they live in GOP-led states that have yet to expand Medicaid.

Quiz Ref ID The second lesson is that special interests pose a continued obstacle to change. We worked successfully with some health care organizations and groups, such as major hospital associations, to redirect excessive Medicare payments to federal subsidies for the uninsured.

Yet others, like the pharmaceutical industry, oppose any change to drug pricing, no matter how justifiable and modest, because they believe it threatens their profits. But we also need to reinforce the sense of mission in health care that brought us an affordable polio vaccine and widely available penicillin.

The third lesson is the importance of pragmatism in both legislation and implementation. Simpler approaches to addressing our health care problems exist at both ends of the political spectrum: the single-payer model vs government vouchers for all. Yet the nation typically reaches its greatest heights when we find common ground between the public and private good and adjust along the way. That was my approach with the ACA.

We engaged with Congress to identify the combination of proven health reform ideas that could pass and have continued to adapt them since. This includes abandoning parts that do not work, like the voluntary long-term care program included in the law. It also means shutting down and restarting a process when it fails. When HealthCare. Both the process and the website were successful, and we created a playbook we are applying to technology projects across the government.

I often think of a letter I received from Brent Brown of Wisconsin. We can help them. I will repeat what I said 4 years ago when the Supreme Court upheld the ACA: I am as confident as ever that looking back 20 years from now, the nation will be better off because of having the courage to pass this law and persevere.

As this progress with health care reform in the United States demonstrates, faith in responsibility, belief in opportunity, and ability to unite around common values are what makes this nation great. Published Online: July 11, All of the individuals who assisted with the preparation of the manuscript are employed by the Executive Office of the President.

Figure 1. View Large Download. Figure 2. Figure 3. Figure 4. Figure 5. Figure 6. Published December 3, Accessed June 14, Health spending in OECD countries: obtaining value per dollar. Health Aff Millwood. PubMed Google Scholar Crossref. The implications of regional variations in Medicare spending: part 1: the content, quality, and accessibility of care.

Ann Intern Med. The implications of regional variations in Medicare spending: part 2: health outcomes and satisfaction with care. The quality of health care delivered to adults in the United States. N Engl J Med. Commonwealth Fund. Why not the best? Published July 1, Early release of selected estimates based on data from the National Health Interview Survey, National Center for Health Statistics.

Published May 24, Health insurance coverage trends, estimates from the National Health Interview Survey. Cohen RA. Trends in health care coverage and insurance for Published November 15, Council of Economic Advisers. Methodological appendix: methods used to construct a consistent historical time series of health insurance coverage. Published December 18, The Oregon experiment: effects of Medicaid on clinical outcomes.

Mortality and access to care among adults after state Medicaid expansions. Changes in mortality after Massachusetts health care reform: a quasi-experimental study. Covering the uninsured in current costs, sources of payment, and incremental costs.

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Updated Jan. The map and state table are updates to our September analysis, which examined premium changes for the lowest-cost bronze plan and the two lowest-cost silver plans in 16 major cities. The second-lowest cost silver plan in each state is of particular interest as it acts as a benchmark that helps determine how much assistance eligible individuals can receive in the form of federal tax credits.

Although premium changes vary substantially across and within states, premium changes for in general are modest when looking at the low-cost insurers in the marketplaces, where enrollment is concentrated. Change in Benchmark Silver Premiums, — Silver and Bronze Premium Changes from to The tables below were first published in the Kaiser Family Foundation analysis of premium changes in September, As our society evolves, our healthcare requirements naturally evolve.

Healthcare reform has often been proposed but has rarely been accomplished. Speaker of the House Thaddeus Sweet vetoed the bill in committee. In , after 20 years of congressional debate, President Lyndon B. Johnson enacted legislation that introduced Medicare and Medicaid into law as part of the Great Society Legislation.

Since becoming law, additional rules and regulations have expanded upon the Patient Protection and Affordable Health Care for America Act. Choosing a healthcare plan illustrates the complexity of health insurance plans in the U. About half of Americans who have private health insurance are covered under self-insured plans, each with their own design. The one commonality among all insurance plans is how dramatically they vary.

Deductibles, co-insurance, co-payments, and maximum out-of-pocket expenses are a few of the inconsistent variables among insurance plans. Additionally, some insurance companies are for-profit and others are not-for-profit, indicating another point of confusion.

Insurance is not the only complexity within the system. The Affordable Care Act added more agencies to this list, including state insurance exchanges and the Center for Medicare and Medicaid Innovation. Each area of healthcare has its own complexities. As components of the larger healthcare system work together, the complex layers unfold.

While change is expected in the coming years, it is likely to occur slowly. Changes in the healthcare industry usually occur at the legislative level, but once enacted these changes have a direct impact on facility operations and the use of resources. For example, the ways patients and administrators utilize resources such as Medicare and Medicaid have changed due to legislation. Technology has had a further impact on how healthcare administrators handle resources and manage medical centers.

Cultural shifts, cost of care, and policy adjustments have contributed to a more patient-empowered shift in care over the last century. Technological advancements contribute to a shift in our patient-centered healthcare system. This trend is expected to continue as new healthcare electronic technologies , such as 3D printing, wearable biometric devices, and GPS tracking, are tested and introduced for clinical use. Policies and procedures in individual facilities may restrict how and when new technologies are introduced, but cutting-edge technology is expected to play an increasingly larger role in our healthcare system within the coming years.

As legislative and demographic changes trickle down into care facilities, the use of hospital services is expected to grow significantly between and This growth is due to an anticipated increase in Medicare beneficiaries in the coming decade.

The cost of hospital care is expected to rise from 0. Since then, Congress has made Medicare and Medicaid changes to open eligibility to more people. For example, Medicare was expanded in to cover the disabled, people over 65, and others. Medicare includes more benefits today, including limitless home health visits and quality standards for Medicare-approved nursing homes.

Medicaid has also been expanded to cover a larger group than initially intended. This includes coverage for low-income families, pregnant women, people requiring long-term care, and people with disabilities. Wide variations in Medicaid programs across the nation occur because individual states have the ability to tailor Medicaid programs to serve the needs of their residents.

Potential consumers can now use the Marketplace website to determine their Medicaid eligibility. As the baby boomer generation approaches retirement, thus qualifying for Medicare, healthcare spending by federal, state, and local governments is projected to increase.

Assuming the government continues to subsidize Marketplace premiums for lower-income populations, this increased government healthcare spending will greatly affect the entire healthcare system in the U.

Although Medicaid spending growth decelerated in due to reduced enrollment, spending is expected to accelerate at an average rate of 7. Along with policy and technological changes, the people who provide healthcare are also changing. Providers are an important part of the healthcare system and any changes to their education, satisfaction or demographics are likely to affect how patients receive care. Future healthcare providers are also more likely to focus their education on business than ever before.

This growth may result in more private practices and healthcare administrators. In recent years, the demographics of the medical profession have shifted. Women currently make up the majority of healthcare providers in certain specialties, including pediatrics and obstetrics and gynecology. Nearly one-third of all practicing physicians are women. According to an Association of American Medical Colleges AAMC analysis, women comprise 46 percent of all physicians in training and nearly half of all medical students.

Based on these statistics, we can assume more women may enter the medical profession in the coming years. African-American women are more likely to become doctors than their male counterparts, according to AAMC data.

While African-Americans comprise only four percent of the physician workforce, 55 percent of the African American physician workforce is female. This shift in demographics to include more women in healthcare supports diversity in the industry and represents overall population diversity. The prevalence of malpractice lawsuits is one way to evaluate the competence of healthcare providers. The amount of malpractice claims in the U.

As the trend of declining malpractice lawsuits continues, it may indicate that provider competence and patient care will continue to improve. Job satisfaction is one area that must improve. Nurses report higher overall career satisfaction than doctors, based on results of the latest Survey of Registered Nurses conducted by AMN Healthcare and compared to the Physician Compensation Report.

Nine out of 10 nurses who participated in the survey said they were satisfied with their career choice. However, one out of every three nurses is unhappy with their current job.

It is difficult to say whether job satisfaction will increase in the coming years, but continued technological advancements designed to streamline the healthcare process offer hope to those who may be frustrated with the complexity of their jobs.

Demands on healthcare change due to various reasons, including the needs of patients. Every year, new cures and treatments help manage common diseases. Each such development affects the entire healthcare system as much as it has a positive impact on patients. As illnesses become more common, our healthcare system must adapt to treat them.