The Affordable Care Act and assisted reproductive technology use

2015 ◽  
Vol 34 (2) ◽  
pp. 71-90 ◽  
Author(s):  
Patricia Stapleton ◽  
Daniel Skinner
Keyword(s):  
Affordable Care Act ◽  
Technology Use ◽  
Assisted Reproductive Technologies ◽  
Insurance Coverage ◽  
The United States ◽  
Reproductive Technologies ◽  
Gender And Sexuality ◽  
Insurance Markets ◽  
The Affordable Care Act ◽  
American Society

The Affordable Care Act (ACA) has prompted numerous gender and sexuality controversies. We describe and analyze those involving assisted reproductive technologies (ART). ART in the United States has been regulated in piecemeal fashion, with oversight primarily by individual states. While leaving state authority largely intact, the ACA federalized key practices by establishing essential health benefits (EHBs) that regulate insurance markets and prohibit insurance-coverage denials based on pre-existing conditions. Whatever their intentions, the ACA’s drafters thus put infertility in a subtly provocative new light clinically, financially, normatively, politically, and culturally. With particular attention to normative and political dynamics embedded in plausible regulatory trajectories, we review—and attempt topreview—the ACA’s effects on infertility-related delivery of health services, on ART utilization, and on reproductive medicine as a factor in American society.

The Impact of the Affordable Care Act Medicaid Expansions on the Sources of Health Insurance Coverage of Undergraduate Students in the United States

2021 ◽  
pp. 107755872110158
Author(s):  
Priyanka Anand ◽  
Dora Gicheva
Keyword(s):  
United States ◽  
Health Insurance ◽  
Undergraduate Students ◽  
Affordable Care Act ◽  
Insurance Coverage ◽  
Health Insurance Coverage ◽  
The United States ◽  
Percentage Points ◽  
The Affordable Care Act ◽  
Medicaid Expansions

This article examines how the Affordable Care Act Medicaid expansions affected the sources of health insurance coverage of undergraduate students in the United States. We show that the Affordable Care Act expansions increased the Medicaid coverage of undergraduate students by 5 to 7 percentage points more in expansion states than in nonexpansion states, resulting in 17% of undergraduate students in expansion states being covered by Medicaid postexpansion (up from 9% prior to the expansion). In contrast, the growth in employer and private direct coverage was 1 to 2 percentage points lower postexpansion for students in expansion states compared with nonexpansion states. Our findings demonstrate that policy efforts to expand Medicaid eligibility have been successful in increasing the Medicaid coverage rates for undergraduate students in the United States, but there is evidence of some crowd out after the expansions—that is, some students substituted their private and employer-sponsored coverage for Medicaid.

“A Take-Home Baby”

2019 ◽  
pp. 3-21
Author(s):  
Robert L. Klitzman
Keyword(s):  
United States ◽  
New Technologies ◽  
Ethical Issues ◽  
Assisted Reproductive Technologies ◽  
Insurance Coverage ◽  
The United States ◽  
Third Party ◽  
Legal Cases ◽  
Professional Experiences ◽  
American Society

This introductory chapter provides an outline of the structure and themes of the book, and describes how I became interested in this topic—through both personal and professional experiences. The chapter presents a brief overview of infertility and several assisted reproductive technologies (ARTs), including new technologies (e.g., gene editing and CRISPR) and their history; recent statistics on use of these interventions in the United States and elsewhere; several relevant current policies, guidelines, and recent legal cases in the United States, Europe, and elsewhere (e.g., from the FDA, CDC, and the American Society for Reproductive Medicine [ASRM]) pertaining to sale and purchase of so-called third-party gametes (i.e., human eggs and sperm); costs and insurance coverage; ethical issues posed by ARTs (e.g., regarding eugenics); and other aspects of these treatments. The chapter also provides an overview of the qualitative methods used in the research that forms a basis of the book.

The Impact of the Affordable Care Act on Insurance Coverage of Hearing Healthcare

2014 ◽  
Vol 15 (1) ◽  
pp. 19-26 ◽  
Author(s):  
Jessica J. Messersmith ◽  
Lindsey Jorgensen
Keyword(s):  
Affordable Care Act ◽  
Quality Care ◽  
Insurance Coverage ◽  
Health Benefit ◽  
State Level ◽  
The United States ◽  
Department Of Health ◽  
The Affordable Care Act ◽  
Definition Of ◽  
The Impact

Implementation of the Affordable Care Act (ACA) impacts the profession of audiology beyond individual audiology practice patterns in the clinic. The legislation and further required implementation of the ACA may dictate coverage of audiologic services and devices now and into the future. Audiologic (re)habilitative services and devices have not historically been covered and are unlikely included in benchmark plans. Under the current language of the ACA, states without mandated coverage of hearing healthcare prior to 2011 will face significant challenges in creating mandates. Arguments for including audiologic services and devices as an Essential Health Benefit (EHB) include quality care, improved patient outcomes, and improved consistency in coverage patterns across the United States. Due to the limited definition of EHB from the Department of Health and Human Services (HHS) and loopholes in plans required to follow ACA guidelines, it is very possible that the inconsistencies across plans and states may increase and that financial repercussions at the state level may hinder passage of state-level mandated coverage of hearing healthcare.

The Impact of the Affordable Care Act on Substance Use Disorder Treatment for Emerging Adults

2017 ◽  
pp. 119-146
Author(s):  
Christina M. Andrews ◽  
Clifford Bersamira ◽  
Melissa Westlake
Keyword(s):  
Substance Use ◽  
Emerging Adults ◽  
Affordable Care Act ◽  
Insurance Coverage ◽  
Health Insurance Coverage ◽  
The United States ◽  
Treatment Access ◽  
The Affordable Care Act ◽  
Access And Quality ◽  
Dependent Coverage

Emerging adults have the highest prevalence of substance use disorders (SUD) of any age group, and only a fraction of those emerging adults in need of SUD treatment ever receive it. However, the Affordable Care Act (ACA) has dramatically increased the number of emerging adults with health insurance coverage for SUD in the United States. In this chapter, we examine how several provisions of the ACA, including Medicaid expansion, the dependent coverage mandate, and the establishment of healthcare marketplaces, have increased emerging adults’ access to quality SUD treatment. On the whole, the ACA has significantly increased access to SUD treatment among emerging adults. However, addressing existing barriers to effective implementation, including issues related to the capacity of our current SUD treatment system, socioeconomic barriers, public outreach and awareness, and variation in treatment access and quality, will prove vital in securing long-term success of the ACA.

Choosing Policies

2019 ◽  
pp. 252-271
Author(s):  
Robert L. Klitzman
Keyword(s):  
New Technologies ◽  
Assisted Reproductive Technologies ◽  
Insurance Coverage ◽  
Self Regulation ◽  
The United States ◽  
Professional Organizations ◽  
Control And Prevention ◽  
Donor Agencies ◽  
American Society

The United States regulates assisted reproductive technologies far less than do other Western countries, most of which have more nationalized health insurance. US states vary widely in whether they have any laws and, if so, what. Governmental agencies (e.g., Food and Drug Administration, Centers for Disease Control and Prevention) and professional organizations (e.g., American Medical Association, American Society of Reproductive Medicine) have begun addressing several areas but could potentially do more. Improved national and professional policies are needed regarding several areas, including egg and sperm donation, egg donor agencies, numbers of embryos transferred into wombs, gestational surrogacy, oversight of providers, insurance coverage, and data collection. Doctors generally perceive problems in the field but argue that industry self-regulation, rather than government policy, is adequate. Yet many providers fail to follow current guidelines and regulations. Moreover, new technologies continue to develop, including gene editing of embryos through CRISPR and mitochondrial replacement therapy (so-called three-parent babies). More data and research are crucial on current use of procedures and long-term medical and psychological follow-up of patients, egg donors, gestational surrogates, and offspring, to evaluate, for instance, the effectiveness of egg freezing and longitudinal follow-up of children born through these procedures.

The Right(s) to Procreate and Assisted Reproductive Technologies in the United States

2020 ◽  
Author(s):  
I. Glenn Cohen
Keyword(s):  
United States ◽  
Technology Use ◽  
Assisted Reproductive Technologies ◽  
Self Regulation ◽  
The United States ◽  
Reproductive Technologies ◽  
Reproductive Technology ◽  
Professional Self ◽  
The Uk ◽  
The Right

This chapter focuses on the right (or rights) to procreate in the United States, with a focus on reproductive technology use. The United States has been too often described as the “wild west” of reproductive technology use. When measured against many of its comparators—Canada, Australia, the UK, Germany, etc.—it is undoubtedly true that more forms of reproductive technology use are permitted in the United States than elsewhere. It is for this reason that the United States has been a frequent destination for “circumvention tourism” or “fertility tourism.” At the same time, it would be wrong to think that reproductive medicine is unregulated in the United States. The chapter argues that it is just that the regulation is more fragmented, both in terms of the locus of control (federal vs. state authority, governmental vs. professional self-regulation, etc.) and also of the legal sources involved (more of a focus on tort law and family law than direct regulation at the statutory or constitutional level).

scholarly journals Health Insurance Coverage before and after the Affordable Care Act in the USA

Sci ◽  
2021 ◽  
Vol 3 (2) ◽  
pp. 25
Author(s):  
Jesse Patrick ◽  
Philip Q. Yang
Keyword(s):  
Health Insurance ◽  
National Health ◽  
Affordable Care Act ◽  
The United States ◽  
Insurance Status ◽  
Health Insurance Status ◽  
Full Implementation ◽  
Before And After ◽  
The Affordable Care Act ◽  
Partial Implementation

The Affordable Care Act (ACA) is at the crossroads. It is important to evaluate the effectiveness of the ACA in order to make rational decisions about the ongoing healthcare reform, but existing research into its effect on health insurance status in the United States is insufficient and descriptive. Using data from the National Health Interview Surveys from 2009 to 2015, this study examines changes in health insurance status and its determinants before the ACA in 2009, during its partial implementation in 2010–2013, and after its full implementation in 2014 and 2015. The results of trend analysis indicate a significant increase in national health insurance rate from 82.2% in 2009 to 89.4% in 2015. Logistic regression analyses confirm the similar impact of age, gender, race, marital status, nativity, citizenship, education, and poverty on health insurance status before and after the ACA. Despite similar effects across years, controlling for other variables, youth aged 26 or below, the foreign-born, Asians, and other races had a greater probability of gaining health insurance after the ACA than before the ACA; however, the odds of obtaining health insurance for Hispanics and the impoverished rose slightly during the partial implementation of the ACA, but somewhat declined after the full implementation of the ACA starting in 2014. These findings should be taken into account by the U.S. Government in deciding the fate of the ACA.

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