Some of the most influential laws passed in our country have had to be revisited and fine-tuned to remain relevant to people’s lives. It has been adjusted many times over the years to reflect changes and increased lifespans. The same applies to Medicare and Medicaid. Both have been amended and modernized many times over the years to meet expanding health needs, including the addition of prescription drug benefits for the elderly.
The Affordable Care Act, considered by many to be perhaps the most important health care legislation since Medicare and Medicaid were enacted in 1965, celebrated its 13th anniversary yesterday.
Historic legislation has provided insurance to more than 30 million Americans and has made significant contributions to promoting the health of the nation. The national uninsured rate dropped from his 15.5% to 8.6%, and Medicaid expanded in 39 states and Washington, DC. Just this week, North Carolina became the latest state to expand Medicaid, and she’s also expected to cover 600,000 residents. Public opinion is almost set in favor of her ACA. These days, it is supported by the majority of Americans.
But 13 years later, after one pandemic, things have changed, and the laws and regulations that shape the US healthcare system must reflect that reality.
Paul Keckley, consultant and editor-in-chief of The Keckley Report, wrote in a recent column that the laws governing health care need to be “modernized based on trends and issues related to health care beyond 2030.” I write that most people are aware of this.
In recent years, we have seen a dramatic expansion in the use of artificial intelligence-based technology, shifting consumer expectations around transparency, a greater awareness of the social drivers of health and the science of holistic well-being, and more. rice field. But some.
There have been other significant changes since 2010 when the ACA was signed into law. Pandemics did not exist. Telemedicine and alternative medicine were not yet widespread, and there was no private equity in the provision or financing of care.
What other types of trends and issues should a strengthened and modernized legislative and regulatory framework address? Here is a partial list:
- that public payers cover the full cost of care; With an aging population bearing complex and chronic conditions, the consequences of Medicare and Medicaid paying less to hospitals than the cost of patient care will only grow, reducing the cost of care to the most medically complex. of access barriers and hinder our ability to respond to emergencies such as COVID 19. The Medicare Payments Advisory Committee’s recommendations to Congress are wholly inadequate and far from reality given the rising costs of hospital care, especially in terms of labor costs. For many hospitals and healthcare systems that are stuck and struggling to keep their doors open, it simply isn’t good enough.
- Level the playing field for non-traditional entrants into health care. Some partners could be responsible partners, but they are well-financed predators who reject complex cases or Medicaid cases or people who don’t have insurance, without regulatory requirements or accountability. We do not want participants to put their own financial interests ahead of their patients, including disrupting continuity of care and threatening the privacy and security of sensitive health information.
- End wasteful and dangerous administrative roadblocks, including the overuse of preapprovals by commercial insurance plans, hindering the care patients need and burdening clinicians. While hospitals and health systems are focused on providing care, some insurers appear to be delaying or denying care.
The AHA strongly supported the ACA as it began efforts to transform the healthcare delivery system to expand coverage for millions of Americans, improve care and add value.
Today, we believe that the public/private coverage framework and spirit of innovation at the heart of ACA continue to provide a solid foundation for advancing health in America.
But, as Keckley insightfully concludes in his column, “Trends and problems are new and complex and require urgent forward thinking.” Action is also needed to maintain future access to quality health care services.