Impact of the Patient Protection and Affordable Care Act

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Signed on March 23, 2010, the Patients Protection and Affordable Act (ACA) is arguably the most significant social legislation of this century that impacts America’s healthcare system. One of the elements of the ACA that will positively impact health care is the ability for children and young adults to remain in the medical insurance of their parents up to age 26. It is estimated that over 1.2 million young adults would benefit from this new provision Kipp & Caputo, 2010). For young adults, this element not only expand their options for health insurance, but it also makes health care more affordable.   Several provisions in this act will stem the rapidly growing tide of uninsured young adults who make up the largest uninsured portion of America’s population. Just to mention, of the  14.8 million young adults who are uninsured, almost 12.1 million might get subsidized insurance cover, 7.2 million might be covered under Medicaid, and at least 4.9 million might receive subsidized private coverage once all the provisions of this law are effected by 2014 (Collins & Nicholson, 2010).

By 2009, the number of uninsured young adults aged between 19 and 29 years had increased to 14.8 million (Jacobs & Skocpol, 2010). This was an increase of more that 1 million uninsured young adults over the previous year. This cohort of uninsured Americans represents the largest portions of America’s population without insurance. These high un-insurance rates among young adults are attributed to a decline in health insurance at two vital transition periods; graduation from high school or 19th birthday, and graduation from college. Many young adults who had been covered on their parent’s insurance policies often lose this eligibility when they reach 19 years, especially if they fail to join college (Manchikanti et al., 2011).

As highlighted above, this element of the ACA is important because it allows children and young adults to remain in their parents’ health insurance plans up to 26 years of age (Feldman, 2011).  Although the full impact of the ACA will be felt in 2014 and later years, beginning September 2010 young adults and their families began to feel some transitional relief that resulted from the enactment of several legislations of this law. This can be attributed to the fact that all insurance plans that offer dependent coverage had to provide the same level of coverage and at the same price to all enrollees’ children up to their 26th birthday (Collins & Nicholson, 2010). This law is applicable to all children and young adults, irrespective of their extent of financial independence, living situation, student or marital status. This means that adult children cannot be charged higher premiums or offered fewer benefits by health plans than younger children. Additionally, the employer’s contribution is tax-exempt, regardless of the child’s dependent status or age. Jacobs & Skocpol (2010) asserts that this law is applicable to all kinds of health insurance plans, including self insured employees and full insured employees. It also applies to all insurances that parents buy on the individual insurance market. In addition to the above, the law is applicable to grandfathered health plans (those in existence at the time of signing of the ACA) and new health plans.

Of course, every silver cloud has a gray lining; therefore there are several challenges in the implementation of this law. For example, employers, just like any one else are not eager to spend more money on insurance coverage. Many employers consider this legislation as being unfair because it compels them to cover young adults who may also be employed somewhere else (Manchikanti et al., 2011). Moreover, many businesses and employees will not be comfortable with this legislation because they will have to dig dipper into their pockets due to this expansion of health coverage to young adults.  Opponents of this legislation in its entirety also pose a major challenge to its enactment. Collins & Nicholson (2010) posits that the opponents of this legislation are of the opinion that the enactment of this legislation means that Americans will have to pay more taxes; there will be extreme regulatory burden, insurers and regulators will be empowered and that there will be some deficiencies on cost control. This means that they will be a stumbling block to the enactment of this legislation.

Although most young adults are generally healthy, living without health insurance can have detrimental financial and health consequences in the long run. For example, the Commonwealth Fund Survey of Young Adults of 2009 established that 79 percent of uninsured young adults could not get the needed care due to the costs (Collins & Nicholson, 2010). This is twice (37 percent) when compared with the number of insured young adults. Moreover, almost 11.3 million insured and uninsured young adult revealed that they were paying off some sort of medical debt. However, the Affordable Care Act will change all this. As the discourse above highlights, an additional 32 million people, of whom 30 percent are young adult, will receive insurance cover (Jacobs & Skocpol, 2010). By providing several insurance options to young adults during key transition points of their lives, in particular after graduating from high school and college, this legislation will significantly address both the short- and long-term problems in health care that have historically affected members of this cohort at all income levels (Oberlander, 2009). It is asserted that all young adults will undergo a new rite of passage after the ACA is fully implemented. This means that young adults of all income levels will be able to establish necessary ties with America’s healthcare system, without fear of accruing medical debts, as they pursue their career and educational goals.

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