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Three Years of Health Care Reform

Rosenberg, Karen

AJN, American Journal of Nursing: June 2013 - Volume 113 - Issue 6 - p 19
doi: 10.1097/01.NAJ.0000431258.55461.6a
In the News

Even now, many consumers still don't understand the ACA.



Three years after passage of the Patient Protection and Affordable Care Act (ACA), considerable progress has been made in implementing some of the law's key provisions. Questions and concerns remain about other provisions, however, and a lack of understanding about the law remains widespread.

According to a February 28 bulletin from the Centers for Medicare and Medicaid Services (CMS), health care spending is slowing, patient outcomes are improving, and more providers are participating in Medicare accountable care organizations. Adoption of electronic health records is also growing, and programs that reward hospitals for the quality of care they provide have been implemented.

One notable achievement has been in the provision of preventive health services, such as colonoscopy, flu shots, Papanicolaou testing, mammography, and well-child visits. Most insurance plans must now provide coverage for these and other recommended services without cost sharing. The Department of Health and Human Services estimates that 71 million additional Americans benefitted from expanded coverage of one or more preventive services in 2011 and 2012.

Medicare recipients are benefitting from the law, too. The CMS just announced that more than 6.3 million people with Medicare saved a total of more than $6 billion on prescription drugs as a result of the ACA, which makes prescription drug coverage (Part D) more affordable by gradually closing the “doughnut hole,” the gap in coverage that requires beneficiaries to pay the full cost of their prescriptions out of pocket.

Despite these gains, in a recent survey, 67% of uninsured respondents under 65 and 57% of the overall population said they still don't understand what the law will mean for them.

Employers, particularly small businesses, are still concerned about the costs of providing health care coverage for their employees, and health insurers predict that premiums for some individuals and small businesses could increase, according to the March 22 Wall Street Journal. However, the Obama administration points out that lower-income consumers will qualify for federal subsidies and small businesses will receive tax credits to help offset the costs of insurance. The administration maintains that, overall, the law will make health care coverage more affordable and accessible.—Karen Rosenberg

© 2013 Lippincott Williams & Wilkins, Inc.