Health Education Careers in a Post–Health Reform Era

2017 ◽  
Vol 18 (5) ◽  
pp. 629-635 ◽  
Author(s):  
M. Elaine Auld
Keyword(s):  
Health Education ◽  
Affordable Care Act ◽  
Preventive Health Services ◽  
Public Understanding ◽  
Business Practices ◽  
Nonprofit Hospitals ◽  
Reform Era ◽  
Needs Assessments ◽  
Patient Protection ◽  
The Individual

Since enactment of the Patient Protection and Affordable Care Act in 2010, health education specialists (HES) have made important contributions in implementing the law’s provisions at the individual, family, and population levels. Using their health education competencies and subcompetencies, HES are improving public understanding of health insurance literacy and enrollment options, conducting community health needs assessments required of nonprofit hospitals, modifying policies or systems to improve access to health screenings and preventive health services, strengthening clinical and community linkages, and working with employee benefit plans. In addition to educating stakeholders about their complementary training and roles with respect to clinical providers, HES must keep abreast of rapid changes catalyzed by the Affordable Care Act in terms of health standards, payment models, government regulations, statistics, and business practices. For continued career growth, HES must continually acquire new knowledge and skills, access and analyze data, and develop interprofessional partnerships that meet the evolving needs of employers as the nation pursues health for all.

The PPACA in Wonderland

2012 ◽  
Vol 38 (2-3) ◽  
pp. 269-287
Author(s):  
Gary Lawson ◽  
David B. Kopel
Keyword(s):  
Supreme Court ◽  
Affordable Care Act ◽  
General Public ◽  
Supreme Court Decision ◽  
Court Decision ◽  
Public Understanding ◽  
Patient Protection ◽  
Speaker Of The House ◽  
Roe V Wade ◽  
Federal Judges

On August 22, 2009, when then-Speaker of the House Nancy Pelosi was asked by a reporter whether the Patient Protection and Affordable Care Act (PPACA) was constitutional, she answered: “Are you serious? Are you serious?” Two years later, many federal judges, more than half of the States, and a flood of distinguished constitutional scholars have examined the PPACA and found at least part of it to be unconstitutional. The question was indeed serious.It remains serious today, as a Supreme Court decision on the constitutionality of the PPACA is expected in June 2012. Because the legality of the PPACA has emerged as perhaps the most publicly visible constitutional question since Roe v. Wade, clarity is vital not only for the PPACA itself, but also for general public understanding of the Constitution. Accordingly, our goals in this Article are to provide an opinionated but hopefully fair-minded guide to the constitutional issues of the PPACA and to clarify some misunderstandings that plague both popular and professional discussions of the issues.

The Individual Mandate: Implications for Public Health Law

2011 ◽  
Vol 39 (3) ◽  
pp. 401-413 ◽  
Author(s):  
Wendy E. Parmet
Keyword(s):  
Health Insurance ◽  
Affordable Care Act ◽  
Universal Coverage ◽  
Health Law ◽  
Healthy Individuals ◽  
Sick People ◽  
Patient Protection ◽  
Death Spiral ◽  
Individual Mandate ◽  
The Individual

No provision of the Patient Protection and Affordable Care Act (PPACA) has proven to be more contentious than the so-called “individual mandate.” Starting in 2014, the mandate will impose a penalty on non-exempt individuals who lack health insurance. According to Congress, the mandate is essential to ensuring near universal coverage. Without it, PPACA’s insurance reforms will lead healthy individuals to delay purchasing health insurance until they require medical care, resulting in risk pools with a disproportionate share of high-risk people. The price of insurance will then climb, causing more and more not-so-sick people to forego health insurance. The resulting “death spiral” will make insurance unaffordable to many more Americans.

The Role of Community Health Needs Assessments in Medicalizing Poverty

2018 ◽  
Vol 46 (3) ◽  
pp. 615-621 ◽  
Author(s):  
Arden Caffrey ◽  
Carolyn Pointer ◽  
David Steward ◽  
Sameer Vohra
Keyword(s):  
Affordable Care Act ◽  
Social Inequalities ◽  
Risk Exposure ◽  
Community Benefit ◽  
Non Profit ◽  
Needs Assessments ◽  
Patient Protection ◽  
History Of ◽  
The 1960S

The Patient Protection and Affordable Care Act (ACA), passed in 2010, is considered by many to be the most significant healthcare overhaul since the 1960s, but part of its promise — improvement of population health through requirements for non-profit hospitals to provide “community benefit” — has not been met. This paper examines the history of community benefit legislation, how community benefit dollars are allocated, and innovative practices by a few hospitals and communities that are addressing primarily non-medical factors that influence health such as social disadvantage, attitudes, beliefs, risk exposure, and social inequalities.

scholarly journals What is the Meaning of Health? Constitutional Implications of Defining “Medical Necessity” and “Essential Health Benefits” under the Affordable Care Act

2012 ◽  
Vol 38 (2-3) ◽  
pp. 445-470 ◽  
Author(s):  
B. Jessie Hill
Keyword(s):  
Affordable Care Act ◽  
Human Services ◽  
Health Benefits ◽  
Medical Necessity ◽  
Health And Human Services ◽  
Patient Protection ◽  
The Affordable Care Act ◽  
The Government ◽  
The Individual ◽  
Essential Health Benefits

When the government decides to assume a major role in providing and paying for healthcare, the government also has to decide exactly what constitutes appropriate, reasonable, or essential healthcare under its program. Congress, of course, recognized this necessity when it passed the Patient Protection and Affordable Care Act (ACA), and the statute itself provides authority to the Secretary of Health and Human Services (HHS) to determine the “essential health benefits” that must be covered under the ACA beginning in 2014, both by insurers offering plans within governmentally sponsored exchanges and on the individual and smallemployer markets outside the exchanges. In a decision that was hailed as both “politically astute” and problematic for the goals that the ACA itself was supposed to accomplish, HHS shunted off the task of defining the term “essential health benefits” to the individual states.

scholarly journals Hospital costs and profitability related to the Patient Protection and Affordable Care Act

2014 ◽  
Vol 3 (3) ◽  
pp. 100
Author(s):  
William Robert Pratt ◽  
Jerry D. Belloit
Keyword(s):  
Health Care ◽  
Health Care Delivery ◽  
Affordable Care Act ◽  
Care Delivery ◽  
Hospital Costs ◽  
Supreme Court Decision ◽  
The United States ◽  
Cost Shifting ◽  
Patient Protection ◽  
The Individual

On March 23, 2010, President Barack Obama signed into law the Patient Protection and Affordable Care Act (PPACA). This law was one of the most controversial and transforming pieces of legislation impacting health care delivery in recent history. The legislation was created in response to rising health care costs and the belief that, in part, cost shifting of indigent uninsured care to paying patients would reduce the overall costs of health care. The recent Supreme Court decision upholding the individual mandate portion of the law is expected to significantly reduce the number of uninsured. Using operational data from 212 hospitals in California, this study examines the anticipated impact on hospital costs, profitability, and some patient outcome benchmarks from the restructuring of health care delivery in the United States by the PPACA.

scholarly journals Constitutional Ratemaking and the Affordable Care Act: A New Source of Vulnerability

2012 ◽  
Vol 38 (2-3) ◽  
pp. 243-268
Author(s):  
Richard A. Epstein ◽  
Paula M. Stannard
Keyword(s):  
Affordable Care Act ◽  
Medicaid Expansion ◽  
Federal Poverty Level ◽  
Poverty Level ◽  
Patient Protection ◽  
Commerce Clause ◽  
Different Types ◽  
Individual Mandate ◽  
The Government ◽  
The Individual

As this Article is being written, the Patient Protection and Affordable Care Act (ACA) is being besieged with two different types of challenges. The first is a Commerce Clause challenge to the individual mandate on the ground that, although the Commerce Clause allows the government to “regulate” the transactions into which people choose to enter, it does not allow the state to force people to enter into disadvantageous transactions against their own will. The second of these challenges deals with the imposition of the Medicaid expansion provisions requiring a state to forego all of its additional Medicaid support unless it is prepared to extend Medicaid coverage, partially at its own expense, to individuals whose income levels put them at 100% to 133% of the federal poverty level.

Collaboration Across the Safety Net in the Era of Health Reform: Opportunities or Obstacles?

2016 ◽  
Vol 74 (3) ◽  
pp. 286-310 ◽  
Author(s):  
Katherine H. Mead ◽  
Erin Brantley ◽  
Julia Zur ◽  
Debora Goetz Goldberg
Keyword(s):  
Affordable Care Act ◽  
Health Reform ◽  
Safety Net ◽  
Community Action ◽  
System Transformation ◽  
Reform Era ◽  
Patient Protection ◽  
Common Goals ◽  
Safety Net Providers ◽  
Insurance Exchanges

While implementation of the Patient Protection and Affordable Care Act brings significant opportunities for safety net providers (SNP), local systems vary in how well they adapt to the rapidly evolving environment. Collaboration may enhance SNP capacity to leverage opportunities in the health reform era. Our study examines key opportunities and challenges SNPs face under health reform and how providers use collaboration as a strategy to adapt to the new environment. A qualitative study of 78 executives at safety net organizations identified six priorities that pose both opportunities and challenges for SNP, and around which collaboration is used as a strategy to achieve common goals: Medicaid expansion, outreach and enrollment, capacity and access, health system transformation, health insurance exchanges, and reductions in government funding. Three types of collaborations emerged: policy and advocacy, community action, and practice-based. Types of collaborations and stakeholders involved appeared to vary by priority.

State-Run Insurance Exchanges in Federal Healthcare Reform: A Case Study in Dysfunctional Federalism

2012 ◽  
Vol 38 (2-3) ◽  
pp. 548-569
Author(s):  
Kyle Thomson
Keyword(s):  
Health Insurance ◽  
Small Business ◽  
Affordable Care Act ◽  
Bargaining Power ◽  
Healthcare Reform ◽  
Patient Protection ◽  
Individual Mandate ◽  
The Individual ◽  
Insurance Exchanges

On March 23, 2010, President Barack Obama signed the Patient Protection and Affordable Care Act (ACA) into law, resulting in the most sweeping reform of the healthcare marketplace and one of the largest expansions in access to healthcare in American history. A key component to both restructuring the healthcare marketplace and improving access are the health insurance exchanges contained in the ACA. Today, individual and small group purchasers have difficulty finding affordable health insurance in the marketplace because they lack the tools to gather information about plans and because they lack the bargaining power to negotiate for affordable rates the way large purchasers can. In conjunction with the individual mandate, the health insurance exchanges aim to solve inefficiencies in the current marketplace by creating a centralized venue to connect insurers with individual and small business purchasers. Thus it both creates a place for insurers to readily find customers, who are now guaranteed to be there because of the individual mandate, and provides a place for customers to shop for insurance.

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