The Affordable Care Act that became law in 2010 was aimed at expanding the number of individuals with health insurance coverage, reducing health care costs, and increasing the quality of care provided. Although much progress has been made since that year, certain difficulties continue to be unresolved, with a main one being a portion of the U.S. population still lacking adequate coverage.
During the 2016 Presidential campaign, Senator Bernard Sanders (I-VT) ignited great enthusiasm among his followers for his pledge to see to it that a Medicare For All bill would be enacted if he were elected. That notion is as relevant today as it was back then as evidenced by several prominent Democrats who have entered the race for the next presidential election and gone on record in support of his approach.
He introduced an updated version of his proposed legislation (S. 1129) on April 10, 2019. It would replace nearly all forms of private health insurance with a government-managed, single payer version of Medicare that guarantees coverage to all Americans. The universal health care program would include coverage of primary care, hospital stays, mental health treatment, and prescription drugs. This latest iteration also includes coverage for dental, vision, hearing, and home and community-based long- term care services, which resembles the House version of H.R. 1384 that was introduced by Rep. Pramila Jayapal (D-WA) on February 27. Under provisions of the Sanders bill, states would be allowed to provide additional benefits from their own budgets, and the Indian Health Service (IHS) and Veterans Health Administration (VHA) would remain in place. The legislation does not specify how it will be financed.
Provision Of Non-Medical Services For Social Needs That Affect Health
The Trump Administration at the beginning of April 2019 released guidance indicating that beginning in 2020, Medicare Advantage plans, private health plans that contract with Medicare, will be allowed, but not required, to offer chronically ill enrollees non-medical services for social needs that affect health. Plans will be able to select which non-medical services they offer, as long as there is a “reasonable expectation that the services will help people with chronic conditions improve or maintain their health or overall function.” Examples of services include: home-delivered meals, transportation for non-medical needs, pest control, indoor air quality equipment (e.g., an air conditioner for a patient with asthma), and minor home modifications (e.g., permanent ramps, widening of hallways or doorways to accommodate wheelchairs). The new coverage flexibility was made possible by the Creating High Quality Results and Outcomes Necessary to Improve Chronic (CHRONIC) Care Act (S. 870), which was a component of the Bipartisan Budget Act of 2018 (P.L. 115-123) that the President signed into law in February 2018.
House Reaction To A Lawsuit To Invalidate The Affordable Care Act
In February 2018, attorneys general in 20 states filed a lawsuit claiming that the 2017 Tax Cut law and the Jobs Act’s reduction of the individual responsibility tax penalty to zero, in effect made the Affordable Care Act’s individual mandate unconstitutional. The following December, a federal court judge in Texas entered a judgment that if the suit is upheld, the entire ACA would become invalidated. Democratic attorneys general in 17 states subsequently intervened to defend the entirety of the health reform law. The U.S. House of Representatives in April 2019 joined the fray by passing a measure (H.Res. 271) by a vote of 240-186, condemning the Trump Administration’s support for the lawsuit that would invalidate the ACA. Eight Republicans joined their Democratic colleagues in supporting the resolution, essentially agreeing that a replacement plan must be installed before the law is repealed.
Despite being rebuffed in their efforts in 2017 when Republicans controlled both chambers in Congress, a desire by that party to repeal and replace the ACA has not vanished totally. Its members recognize that a comprehensive replacement plan will have to be designed prior to attempting to launch any repeal effort in the future.
More Articles from TRENDS April 2019
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