scholarly journals A FEW FOR-PROFIT BUSINESSES’ BATTLE OVER THE AFFORDABLE CARE ACT’S PREVENTATIVE SERVICES MANDATE

2014 ◽  
Vol 32 (2) ◽  
pp. 381-400
Author(s):  
Leigh Argentieri Coogan
Keyword(s):  
Affordable Care Act ◽  
Cost Sharing ◽  
Religious Organizations ◽  
District Court ◽  
Health Plans ◽  
For Profit ◽  
Patient Protection ◽  
The Supreme Court ◽  
Regulation Changes ◽  
Preventative Services

Under the Patient Protection and Affordable Care Act (ACA), employers are required to provide employees with health plans, which must include FDA, approved contraceptives with no cost sharing. While Health and Humans Services (HHS) revised the regulation to allow for a compromise among religious organizations and non-profits run by religious organizations, private for profit businesses must comply with the ACA even if the business asserts to be founded on religious principles. Several for profit business have sued in district court for an injunction against the requirements. However, a circuit split exists among courts granting preliminary injunctions against the ACA pending a granting of appeal. This note will focus on whether the federal government can compel secular, for profit organizations to provide employee health plans that include contraceptives, the morning after pill and sterilization under the Religious Freedom Restoration Act. Unless the statute or regulation changes, the Supreme Court will likely need to grant certiorari to resolve the issue.

scholarly journals Trends in Birth Rates After Elimination of Cost Sharing for Contraception by the Patient Protection and Affordable Care Act

2020 ◽  
Vol 3 (11) ◽  
pp. e2024398
Author(s):  
Vanessa K. Dalton ◽  
Michelle H. Moniz ◽  
Martha J. Bailey ◽  
Lindsay K. Admon ◽  
Giselle E. Kolenic ◽  
...  
Keyword(s):  
Affordable Care Act ◽  
Cost Sharing ◽  
Birth Rates ◽  
Patient Protection

Outcomes and Quality: Key Characteristics of a Successful SLP Value Journey

2015 ◽  
Vol 25 (3) ◽  
pp. 94-106 ◽  
Author(s):  
Paul R. Rao
Keyword(s):  
Affordable Care Act ◽  
Healthcare Reform ◽  
The United States ◽  
Levels Of Care ◽  
National Healthcare ◽  
Patient Protection ◽  
Key Characteristics ◽  
The Supreme Court ◽  
Insurance Rates ◽  
Roll Back

We are living in a challenging era of healthcare reform marked by dramatic change and unprecedented political and legal turmoil surrounding this reform. Healthcare reform in the name of the Patient Protection and Affordable Care Act (PPACA, 2010) is becoming “hardwired” over the five years since its inception, yet as recently as March of 2015, the Supreme Court of the United States heard arguments to roll back subsidies for the Federal Health Exchanges which if approved could increase insurance rates by nearly 75% on over 8 million subscribers. The national healthcare landscape including reforms, changes, wins, and losses to date will be described. The “secret sauce” for meeting these challenges is to embrace value in healthcare which can be defined as outcomes over cost. In the context of our current levels of care, an inexorable movement away from volume to value will be described focusing on outcomes. The challenges we face especially in reporting outcomes and shifting from volume to value are described. Finally, arguments and illustrations are provided for how speech-language pathologists (SLPs) can continue to espouse value in becoming critical players in the value-based healthcare economy.

Effect of the Patient Protection and Affordable Care Act on for-profit hospitals in the USA

2020 ◽  
Vol 14 (2) ◽  
pp. 201-215
Author(s):  
Paul Sergius Koku
Keyword(s):  
Affordable Care Act ◽  
Stock Prices ◽  
Abnormal Returns ◽  
Content Type ◽  
Significance Level ◽  
For Profit ◽  
Patient Protection ◽  
Negative Effect ◽  
The Usa ◽  
Study Methodology

Purpose This study aims to examine the effect of the Patient Protection and Affordable Care Act (PPACA) on for-profit hospitals in the USA. Design/methodology/approach The study uses the event study methodology to examine the stock market’s reaction to the passage of the PPACA. Findings The results of the analysis do not show a negative effect; on the contrary, the stock prices of for-profit hospitals increased, on average, by 6%. The cumulative abnormal returns were 5.64% with a generalized z-value of 3.851 with a significance level of 0.001 (two-tailed test). This translates into an average gain of $230,537,096 for the four days (dates) that a positive step was taken in making the Affordable Care Act (ACA) a law of the country. Practical implications Because the study suggests that for-profit hospitals will be profitable under the PPACA, one could expect to see growth or, at the minimum, expansion in for-profit hospitals under the Act. Furthermore, and consistent with the principles of marketing, one would expect all the for-profit hospitals, at this nascent stage of the ACA, to pull resources together to promote the benefits of having the ACA. Originality/value To the best of the author’s knowledge, this is the first study to examine the effect of the PPACA on the operations of for-profit hospitals.

scholarly journals The Impact of the Affordable Care Act on Colorectal Cancer Incidence and Mortality: the case of Kaiser Permanente of Northern California

2020 ◽  
Author(s):  
Catherine Lee ◽  
Elizabeth H. Eldridge ◽  
Mary E. Reed ◽  
Jeffrey K. Lee ◽  
Lawrence H. Kushi ◽  
...  
Keyword(s):  
Affordable Care Act ◽  
Cost Sharing ◽  
P Value ◽  
Health Plans ◽  
Kaiser Permanente ◽  
Crc Screening ◽  
Incidence And Mortality ◽  
Race Ethnicity ◽  
The Impact ◽  
Related Mortality

AbstractBackgroundThe Patient Protection and Affordable Care Act (ACA) eliminated cost sharing for preventive services, including colorectal cancer (CRC) screening for individuals aged 50 to 75 with private health insurance. The present study is the first to examine the impact of the no-cost CRC screening due to the ACA on CRC incidence and mortality.MethodsWe modeled trends in CRC incidence and CRC-related mortality in an open cohort of 2,113,283 Kaiser Permanente Northern California (KPNC) members aged 50 years and older between 2003 and 2016 using an interrupted time series design. Individual-level data were analyzed at the month-level. Analyses were adjusted for age, race/ethnicity and sex. As a sensitivity analysis, we considered a controlled approach, with a comparison group of KPNC members covered by health plans with pre-ACA zero cost-sharing for CRC screening.ResultsA total of 178,582,512 person-months were used in the analysis of CRC incidence, of which 48% occurred in the period before the ACA was passed into law (1/1/2003-3/31/2010) and 52% after (4/1/2010-12/31/2016). In primary analyses, the model for CRC incidence indicated a drop in the trend coinciding with the passage of the ACA (change in level incidence rate ratio, IRR: 0.83, 95% CI: 0.77-0.90, p-value < 0.0001), followed by a decrease in trend (change in slope IRR: 0.97/year, 95% CI: 0.93-1.00, p-value = 0.05). Results for CRC-related mortality were similar. Our controlled results indicate that free screening due to the ACA was associated with greater improvements in CRC outcomes among members previously covered by health plans with out-of-pocket costs for screening, compared to health plans with zero cost sharing for screening before the ACA went into effect.ConclusionsWe found that free CRC screening due to the ACA was associated with a decrease in age-, race/ethnicity- and sex-adjusted CRC incidence and CRC-related mortality, after accounting for contemporaneous competing interventions. Furthermore, these findings were robust to the addition of a comparison group with zero cost sharing both pre- and post-ACA.

Implications of the Supreme Court's ACA Medicaid Decision

2013 ◽  
Vol 41 (S1) ◽  
pp. 77-79 ◽  
Author(s):  
Jane Perkins
Keyword(s):  
Affordable Care Act ◽  
Medicaid Expansion ◽  
Federal Poverty Level ◽  
Poverty Level ◽  
President Obama ◽  
Patient Protection ◽  
General Welfare ◽  
The Supreme Court ◽  
Medicaid Eligibility ◽  
Over Time

Congress implemented the Medicaid Act in 1965, acting pursuant to its Spending Clause authority to “provide for the…general Welfare.” Over time, the Act has been amended more than 50 times. Most recently, as part of the Patient Protection and Affordable Care Act (ACA), Congress required participating states to extend Medicaid eligibility to childless, non-disabled, and non-elderly adults with incomes below roughly 133% of the federal poverty level (referred to as childless adults).Within hours of President Obama signing the ACA into law, four lawsuits were filed challenging the con-stitutionality of the ACA, including a case in Florida that eventually made its way to the Supreme Court as National Federal of Independent Business v. Sebelius (NFIB). As part of this case, officials from 26 states argued that Congress was improperly coercing them into participating in the Medicaid expansion.

scholarly journals Personal Federal Tax Issues And The Affordable Care Act: Can Tax Penalties And Subsidized Premiums Provide Sufficient Incentives For Health Insurance Purchases

2013 ◽  
Vol 11 (7) ◽  
pp. 315
Author(s):  
Alan D. Eastman ◽  
Kevin L. Eastman
Keyword(s):  
Health Insurance ◽  
Affordable Care Act ◽  
Tax Credits ◽  
Medical Expenses ◽  
Patient Protection ◽  
Tax Cost ◽  
The Supreme Court ◽  
Gross Income ◽  
The Cost ◽  
Threshold Amount

The Patient Protection and Affordable Care Act of 2010 (ACA) includes many changes to the U.S. Federal Tax Code. The tax penalty imposed on individuals who choose to remain uninsured received extraordinary attention while the Supreme Court determined the constitutionality of the ACA. Now, the more relevant question is what impact the penalty may have on individual behavior. This paper presents information that suggests the tax penalty may provide insufficient incentive for many individuals to purchase insurance, even with premium tax credits to reduce the cost for households earning up to 400% of the federal poverty limit. The ACA also reduces the tax benefit from themedical expense deduction by increasing the threshold amount from 7.5% of adjusted gross income to 10% of adjusted gross income. This may increase the after-tax cost of purchasing health insurance, especially for healthier individuals whose medical expenses (excluding insurance premiums) are below the threshold amount, increasing the incentive to forego the purchase of health insurance and to pay the penalty instead. An approach more consistent with the aims of the ACA is to eliminate the threshold amount but limit the deduction to lower-income taxpayers.

scholarly journals Affordable Care Act Litigation: The Standing Paradox

2012 ◽  
Vol 38 (2-3) ◽  
pp. 410-444
Author(s):  
Elizabeth Weeks Leonard
Keyword(s):  
Supreme Court ◽  
Federal Government ◽  
Affordable Care Act ◽  
Judicial Review ◽  
Federal Law ◽  
Legal Challenge ◽  
Patient Protection ◽  
The Supreme Court ◽  
Minimum Requirements ◽  
Federal Laws

The Patient Protection and Affordable Care Act (ACA or the “Act”) litigation presents a standing paradox. In the current posture, it appears that states lack standing to challenge the federal law on behalf of individuals, while individuals possess standing to challenge the federal law on behalf of states. This Article contends that there is no principled reason for this asymmetry and argues that standing doctrine should apply as liberally to states as to individuals, assuming states allege the constitutional minimum requirements for standing and especially where the legal challenge turns on the allocation of power between the federal government and the states. While states may have no greater claim to judicial review of federal laws than individuals, they should not have any less.The Supreme Court will not have to reach this particular procedural conundrum to decide the merits of the Florida lawsuit on which it granted certiorari because the particular constellation of plaintiffs before the Court covers all fronts.

scholarly journals The Patient Protection And Affordable Care Act Of 2010: Constitutional?

2011 ◽  
Vol 3 (1) ◽  
pp. 75-82
Author(s):  
Martin D. Carrigan
Keyword(s):  
Health Insurance ◽  
National Health Insurance ◽  
National Health ◽  
Affordable Care Act ◽  
District Court ◽  
Appellate Court ◽  
District Courts ◽  
Obama Administration ◽  
Patient Protection

After decades of debates and policy discussions, in early 2010, the Obama Administration, with the Democrat party controlling both the House and the Senate, passed a National Health Insurance Act. The Patient Protection and Affordability Act was immediately challenged in court. One district court in Florida declared it unconstitutional. Two other district courts and an appellate court declared it constitutional. This paper looks at the Act and those issues.

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