The state of American health care: November 2016 to November 2020, a look forward

2017 ◽  
Vol 13 (1) ◽  
pp. 1-9
Author(s):  
Theodore Marmor ◽  
Michael K. Gusmano
Keyword(s):  
Health Care ◽  
Health Insurance ◽  
House Of Representatives ◽  
The United States ◽  
Social Scientists ◽  
Patient Protection ◽  
The Future ◽  
American Health Care ◽  
Election Results ◽  
Child Health Insurance

AbstractThe election of Donald Trump, coupled with the retention of Republican majorities in the US House of Representatives and Senate, raises questions about future of the Patient Protection and Affordable Care Act, the structure and funding of the country’s public health insurance programs – Medicare, Medicaid and the Child Health Insurance Program – and the direction of health policy in the United States, more generally. Political scientists are not renowned for their capacity to predict the future and many of those who forecast election results have received criticism in recent weeks for failing to predict the Trump victory. While the future is uncertain, it is possible for social scientists to offer a ‘conditional causal analysis’ about the future. This essay is an effort to think about the likely shape of American health care between now and the next US presidential election.

Rhetorical Federalism: The Role of State Resistance in Health Care Decision-Making

2011 ◽  
Vol 39 (S1) ◽  
pp. 73-76
Author(s):  
Elizabeth Weeks Leonard
Keyword(s):  
Health Care ◽  
Health Insurance ◽  
The United States ◽  
Administrative Capacity ◽  
Limited Government ◽  
Local Diversity ◽  
Patient Protection ◽  
Health Care Regulation ◽  
State Resistance

The Patient Protection and Affordable Care Act (ACA) represents the most significant reform of the United States health care system in decades. ACA also substantially amplifies the federal role in health care regulation. Among other provisions, ACA expands government health care programs, imposes detailed federal standards for commercial health insurance policies, creates national requirements on employers and individuals, and enlists state administrative capacity to implement various federal reforms. In response, a persistent voice in the protracted, contentious debate surrounding ACA was, and continues to be, resistance from states. The rhetoric of federalism — states’ rights, reserved powers, state sovereignty, limited government, and local diversity — resonates deeply even around provisions of ACA that do not specifically implicate state interests. For example, the loudest and most persistent state objections target the new mandate that individuals maintain health insurance, a requirement imposed by ACA and enforced through federal tax penalties.

Health

Getting By ◽  
2019 ◽  
pp. 329-428
Author(s):  
Helen Hershkoff ◽  
Stephen Loffredo
Keyword(s):  
United States ◽  
Health Care ◽  
Health Insurance ◽  
Low Income ◽  
The United States ◽  
Health Coverage ◽  
Eligibility Criteria ◽  
Insurance Program ◽  
Health Insurance Program ◽  
Child Health Insurance

This chapter addresses the issue of health care for low-income people. The United States, virtually alone among developed nations, does not offer universal access to health care, leaving many millions of individuals without health insurance or other means of obtaining necessary medical services. In 2010, Congress enacted the landmark Patient Protection and Affordable Care Act (ACA)—popularly known as “Obamacare”—marking an important but incomplete response to the nation’s health care crisis. This chapter examines the ACA in detail, including its impact on Medicaid and Medicare, the major government health programs in the United States, its creation of Health Insurance Exchanges and tax credits to help low-income households obtain private health coverage, and the reform of private health insurance markets through a patient’s bill of rights, which, among other measures, prohibits insurance companies from refusing coverage for preexisting medical conditions. Perhaps the most critical aspect of the ACA was its expansion of Medicaid to cover virtually all low-income citizens (and certain immigrants) who do not qualify for other health coverage. Although several states opted out of the ACA’s Medicaid expansion, the Medicaid program nevertheless remains the largest single provider of health coverage in the United States. This chapter also provides a detailed description of Medicaid, its eligibility criteria and scope of coverage; the Child Health Insurance Program (CHIP), a government-funded health insurance program for children in households with too much income to qualify for Medicaid; and Medicare, the federal health insurance program for aged, blind, and disabled individuals.

Better Than Nothing: Participant Experiences in Using a County Health Plan

2012 ◽  
Vol 34 (4) ◽  
pp. 13-18 ◽  
Author(s):  
Kimberly Rovin ◽  
Rebecca Stone ◽  
Linda Gordon ◽  
Emilia Boffi ◽  
Linda Hunt
Keyword(s):  
United States ◽  
Health Care ◽  
Health Insurance ◽  
Affordable Care Act ◽  
The United States ◽  
United States Government ◽  
Patient Protection ◽  
Access To Health ◽  
History Of ◽  
Better Than

The United States health care system has reached a crisis point, with 49.9 million Americans now living without health insurance (DeNavas-Walt, Proctor, and Smith 2011). The United States government has responded to this crisis in a variety of ways, perhaps the most visible being the enactment of the Patient Protection and Affordable Care Act (ACA) in March 2010. With a goal of expanding access to health insurance to 32 million Americans by 2019, the ACA marks an important moment in the history of United States health care reform with the potential to drastically change the United States health insurance landscape (Connors and Gostin 2010). The law delineates only general categories of required benefits and leaves it to each state to decide the specific benefits that will be provided by the insurers in their state (Pear 2011).

Private Health Insurance

2014 ◽  
Author(s):  
James A. Morone
Keyword(s):  
United States ◽  
Health Care ◽  
Health Insurance ◽  
Affordable Care Act ◽  
Private Health Insurance ◽  
The United States ◽  
Present Condition ◽  
American Health Care ◽  
The Affordable Care Act ◽  
Multiple Risk

This article explores the development, the present condition, and the likely future of private health insurance in the United States. It emphasizes the three kinds of fragmentation that mark American health care: scattered oversight, multiple risk pools, and inchoate government. I pay special attention to the health-care challenges we face, the persisting patterns of inequality, and the important but limited reforms introduced by the Affordable Care Act.

scholarly journals PPACA and Public Health: Creating a Framework to Focus on Prevention and Wellness and Improve the Public's Health

2011 ◽  
Vol 39 (3) ◽  
pp. 366-379 ◽  
Author(s):  
Gwendolyn Roberts Majette
Keyword(s):  
Public Health ◽  
Health Care ◽  
Health Care Reform ◽  
House Of Representatives ◽  
Deep Understanding ◽  
The United States ◽  
Health Issues ◽  
President Obama ◽  
Reform Legislation ◽  
Patient Protection

On March 23, 2010, President Obama signed the Patient Protection and Affordable Care Act (PPACA), a major piece of health care reform legislation. This comprehensive legislation includes provisions that focus on prevention, wellness, and public health. Some, including authors in this symposium, question whether Congress considered public health, prevention, and wellness issues as mere afterthoughts in the creation of PPACA. As this article amply demonstrates, they did not.This article documents the extent of congressional consideration on public health issues based on personal experience working on the framework for health care reform — specifically, my experience as a Fellow for a member of the Health Subcommittee of the Senate Finance Committee from 2008-2009. I also include a review of congressional activity in the United States House of Representatives. Analysis of the congressional meetings and hearings reveals that Congress had a deep understanding about the critical need to reform the U.S. public health and prevention system.

A comprehensive assessment of the cost of multiple sclerosis in the United States

1998 ◽  
Vol 4 (5) ◽  
pp. 419-425 ◽  
Author(s):  
Kathryn Whetten-Goldstein ◽  
Frank A Sloan ◽  
Larry B Goldstein ◽  
Elizabeth D Kulas
Keyword(s):  
Multiple Sclerosis ◽  
Health Care ◽  
Health Insurance ◽  
Informal Care ◽  
Annual Cost ◽  
Lifetime Cost ◽  
The United States ◽  
Personal Health ◽  
Secondary Sources ◽  
The Cost

Comprehensive data on the costs of multiple sclerosis is sparse. We conducted a survey of 606 persons with MS who were members of the National Multiple Sclerosis Society to obtain data on their cost of personal health services, other services, equipment, and earnings. Compensation of such cost in the form of health insurance, income support, and other subsidies was measured. Survey data and data from several secondary sources was used to measure costs incurred by comparable persons without MS. Based on the 1994 data, the annual cost of MS was estimated at over $34 000 per person, translating into a conservative estimate of national annual cost of $6.8 billion, and a total lifetime cost per case of $2.2 million. Major components of cost were earnings loss and informal care. Virtually all persons with MS had health insurance, mostly Medicare/Medicaid. Health insurance covered 51 per cent of costs for services, excluding informal care. On average, compensation for earnings loss was 27 per cent. MS is very costly to the individual, health care system, and society. Much of the cost (57 per cent) is in the form of burdens other than personal health care, including earnings loss, equipment and alternations, and formal and informal care. These costs often are not calculated.

Health Care, Health Insurance, and the Distribution of American Incomes

2010 ◽  
Vol 13 (1) ◽  
Author(s):  
Gary Burtless ◽  
Pavel Svaton
Keyword(s):  
Health Care ◽  
Health Insurance ◽  
Panel Study ◽  
The United States ◽  
Medical Expenditure ◽  
Cash Income ◽  
Health Coverage ◽  
Money Income ◽  
Health Care Consumption ◽  
The Impact

Cash income offers an incomplete picture of the resources available to finance household consumption. Most American families are covered by an insurance plan that pays for some or all of the health care they consume. Only a comparatively small percentage of families pays for the full cost of this insurance out of their cash incomes. As health care has claimed a growing share of consumption, the percentage of care that is financed out of household incomes has declined. Because health care consumption is more important for some groups in the population than others, the growth in spending and changes in the payment system for medical care have reduced the value of standard income measures for assessing relative incomes of the rich and poor and the young and old. More than a seventh of total personal consumption now consists of health care that is purchased with government insurance and employer contributions to employee health plans. This paper combines health care spending and insurance reimbursement data in the Medical Expenditure Panel Study and money income and health coverage data in the Current Population Survey to assess the impact of health insurance on the distribution of income. Our estimates imply that gross money income significantly understates the resources available to finance household purchases. The estimates imply that a more complete measure of resources would show less inequality than the income measures that are currently used. The addition of estimates of the value of health insurance to countable incomes reduces measured inequality in the population and the income gap between young and old. If the analysis were extended over a longer period, it would show a sizeable impact of insurance on inequality trends in the United States.

Sign in / Sign up

Export Citation Format

Share Document