Proposal for New Healthcare Legislation to be Presented by Political Party to United States Citizens

Final Assessment Proposal Instructions

Write a proposal for new healthcare legislation to be presented by your political party to the citizens of the United States. It will be an hour long televised presentation of where we as a nation are, where we are heading, and how your legislation will create the perfect healthcare for the American Citizens.

You must present legislation that provides for all the following provisions:

  • Access to affordable healthcare by all Americans
  • Coverage for those living below the poverty level
  • Making existing healthcare legislation financially soluble
  • Making insurance coverage portable for all Americans
  • Making the legislation budget neutral without raising or creating new taxes
  • Controlling medical costs by defining how medical professionals provide services and how Americans receive services.

Proposed Healthcare Legislation – Sample Paper

Introduction

Healthcare is one of the most integral sectors in any given society. Recently, many countries have made attempts to make it possible for their citizens to have better access to healthcare. Significant development has been to shift the focus from curative care to preventive care (Luytem et al., 2015). This has been done through investment in primary care, which ensures that there is improved policy and legislation that focus on preventive medicine. The leading areas in the provision of quality healthcare to the entire population include healthcare insurance cover, investment in the training of highly qualified medical professionals such as doctors and nurses, expansion and empowerment of the public health sector (Douthit et al., 2015).

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The most significant move in healthcare legislation in the United States was in the enactment and implementation of the Patient Protection and Affordable Care Act of 2010. The law brought about a paradigm shift in healthcare in the country. This was in the expansion of Medicaid, as well as in the enforcement of laws that mandates all insurance providers to not discriminate against people with pre-existing conditions (French et al., 2016). Since the enactment of the legislation, a signifanct people have been enrolled in Medicaid. However, the legislation has faced a number of challenges in its objective of improving the general status of healthcare in the country. This paper elaborates on the nature of the current legislation, the challenges it has faced, as well as provides legislation proposals that can be enforced to improve healthcare in the country.  

Current Healthcare Legislation

The current healthcare legislation is known as the Patient Protection and Affordable Care Act. The legislation was enacted by the congress in 2010 and signed into law by President Obama in the same year. The legislation is also referred to as Obamacare and came into force in 2014. The legislation brought about an exponential increase in health insurance coverage. This is due to many provisions that are contained in the legislation. The first of which is the requirement that the state provides health insurance exchanges. Through this, individuals are able to compare different insurance options, make applications for financial help, as well as to purchase suitable health insurance coverage. 

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The legislation also contains many regulations on the health insurance market. On this, the law makes it illegal for providers to deny providing coverage to people with pre-existing conditions. Additionally, the legislation provides for the increase of dependent coverage to the age of 26. The legislation has a goal of expanding Medicaid to cover up to 138 percent of the national poverty level, which requires a streamlined application for Medicaid and tax credits. The hallmark of the legislation is in the requirement of individuals to purchase insurance cover, and the cover provided takes care of a standardized list of essential health benefits (Parsons et al., 2016).

Problems with the Current Legislation

The first problem with the Patient Protection and Affordable Care Act is the fact that it has high deductibles (Fletcher, 2016). This poses a serious challenge to many people who do not qualify for national subsidies provided by the federal government. This is a challenge especially faced by older adults in rural areas, who have incomes that are beyond 400 percent of the national poverty line (Fletcher, 2016). Another problem with the law is that it provides for universal coverage for some aspects that not all people would need. Such coverage is the one that provides for maternity care, which may not be applicable to everyone that seeks insurance coverage (Arthur, 2018).

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As such, the insurance coverage ends up being too expensive, unnecessarily. The legislation also has a negative influence on employment. The most relevant provision in this sector is the one on the employer mandate. The legislation requires that an employer with more than 50 employees and does not provide insurance coverage to its employees to do so (Sommers, Shepard & Hempstead, 2018). This has pushed many employers to avoid surpassing the 50 employees mark. This has also led to many employers opting to employ many people on a part-time basis. Finally, another significant problem is on the requirement that pharmaceutical companies have to pay extra in fees. This has the potential of hurting their capacity, as well as accessibility for patients.

Future of healthcare if the Current Legislation is left as is

There is expected to be an increase in the cost of healthcare nationwide. This is due to a number of factors. Firstly, the pharmaceutical companies are expected to spend over $84 billion in fees, for the period covering 2013 to 2023. Although this may not hurt the pharmaceutical companies significantly, it may lead to an increase in the cost of medicines for patients. The law also provides that, from 2022, health insurance providers will be assessed 40% tax on premiums exceeding $27,500 for families and $10,200 for individuals (Elliott, 2015).

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As these plans apply for people in high-risk groups such as those in highly hazardous jobs, the tax would be passed to their employers. This serves as a cause for significant concern as it would raise deductibles and premiums. Another major challenge going forward, if the current legislation is not altered, is that there will be the need for many companies to restructure themselves. This is due to the complex and unworkable subsidies system. The current system provides poor deals for employees that earn less in a company, while those that earn more have better deals. This puts a company in a stressful position due to the requirements of the employer mandate.

Legislative Proposals

The first significant proposal is to make changes in the rules regulating the private market. The private market should provide coverage to people with pre-existing conditions on an individual basis. This should take into account the condition of the patient, as well as their health insurance needs. However, the private insurers should provide insurance cover to people with pre-existing conditions, unconditionally. The private insurers should also extend the dependent coverage to 28 years, contrary to the current limit of 26 years. The private insurers should give space for the old and the unemployed to be covered under the dependent category in cases where their relatives wish to register them as such. In extension, pharmaceutical companies are to be given tax waivers to enable them to operate smoothly. This would reduce their need to transfer the burden of the increased cost of medicines to patients.

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On women’s health, there should be a review of the standardized essential healthcare benefit. In this regard, there should be an evaluation of an individual patient’s situation on a case to case basis. Classification of such needs as maternity care as an essential health benefit is to be removed. This is to allow women to get cover that reflects their current needs. This is essential in curbing excessive increases in the cost of insurance cover on individuals. Ensure that abortion services are adequately covered as a single item that requires prioritization. This is to prevent any attempts by some providers to leave it out from coverage in individual schemes, as the issue of coverage of abortion services has come under attack severally (Salganicoff et al., 2016).

The new legislation will focus on the lowering of tax demands to allow for large-scale employers to flourish. Large-scale employers to be expected to provide insurance cover for all their employees. The coverage, however, to be carried out in a manner that allows both the employer and the employee to agree on how each is to contribute to the coverage of the employee. Tax penalties are to be initiated on the party that fails to play their part in coming up with individualized agreements. The income threshold for the cost of health insurance covers deductions to be lowered from the current 10 percent to 5 percent.

To ensure that every citizen acquires insurance services, all the citizens need to ensure that they have a valid health insurance cover. Penalties are to be applied to citizens that fail to obtain insurance during the sign-up period. The penalties are to be standardized to cover all individuals that fail to obtain insurance. Households should be made to pay about 3 percent of household income as a fine for failure to sign-up for insurance cover. Waiting period penalties should be applied for individuals who take a break in health insurance coverage. This is to ensure that individuals who opt out of a group policy do so after their individual plans have been finalized.

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Several changes are to be made on provisions regarding premium subsidies for individuals. The Fines for erroneous claims of tax credits on premium plans to be increased to 30 percent. The income eligibility for tax credits for individuals to be calculated from 0 percent of the Federal Poverty Line (FPL) to 400 percent of the Federal Poverty Line. This would ensure that more individuals qualify for tax credits, and, therefore, serve as an added motivation to seek individual health insurance covers (Ali et al., 2016). This would also help in increasing enrolment in health insurance cover countrywide. The required personal contribution is to be reduced for younger persons and increased for older individuals at the same income levels.  This is to apply for persons at 200 percent FPL and above. This would help to harmonize insurance coverage to reflect the health needs of each individual based on their vulnerability.

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Under a program referred to as the block grant benefits, each individual state should come up with a list of covered benefits that are applicable to its religion. This is to ensure that each state caters to the unique needs of its population. This would help to ensure that patients have coverage for a number of issues as a block, and prevent the disintegration of related services into individualized components. This would also make it flexible for insurance companies to provide robust insurance services that target gender-related services, age-related services, as well as those based on the sexual orientation of individuals. In this requirement, the requirement to not prohibit coverage to persons with pre-existing conditions applies.

States are to be allowed to extend the benefits of block grant benefits to cover the needs of high-risk categories. For the purposes of this legislation, high-risk categories are the sick individuals without well and able relatives who can offset their medical bills. It also includes street families, the older adults that have been abandoned by their families, as well as underage children who are without parents. This provision would help to provide coverage to these vulnerable groups who would find it difficult to access healthcare services without an insurance cover. Each state would enter into agreements with the Federal government on how to share the costs that arise from this provision.

Summary

The current legislation, the Patient Protection and Affordable Care Act (2010), has made significant strides in elevating the status of healthcare in the country. The legislation has made it mandatory for every individual to acquire health insurance services. This is an essential provision in the healthcare sector as it has ensured that every individual takes charge of their health. This has led to increased commitment to healthy living by individuals, as well as in the uptake of health insurance solutions in the country. The act also provides for people with pre-existing conditions to receive insurance coverage from private providers without any discrimination. This has made it possible for these sets of people to have increased access to services that they could not afford before.

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The law ensures that individuals are made to sign-up to insurance cover to avoid facing the hefty penalties associated with non-adherence to these requirements. In cases of companies that employ more than 50 employees, the companies are required to provide insurance services to their employees. This provision is referred to as the employer mandate. Although the Patient Protection and Affordable Care Act (2010) is elaborate and expansive enough, it has a few problems that make it impossible to attain the intended efficiency in the provision of affordable healthcare. The employer mandate is a significant hindrance to many companies as it overstretches the resources of these companies. Many companies are forced to restructure their employee numbers, as well as their salaries. The increased cost incurred by pharmaceutical companies is expected to be transferred to patients in the future. This would significantly increase the cost of healthcare. The deductibles are also complex, as much as they are high. This makes insurance coverage to be unaffordable to many people. The proposed legislation would be able to take care of these deficiencies in the current health policy. The new policy seeks to modify the existing employer mandate and provide for employees and their employers to agree on how the employee’s insurance cover would be acquired and services. The proposed legislation also seeks to provide tax waivers to pharmaceutical companies and help to reduce the cost of medicines. The block grant benefits would allow states to have individualized health plans, which would be flexible for patients and providers. The regulation on the capping of premium subsidies for individuals, as well as on tax credits applied for premium plans ensures that there is better access for healthcare and at a more affordable price.

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