PPACA Annotated Bibliography

The Patient Protection and Affordable Care Act( PPACA) commonly called as Affordable Care Act ( ACA) is a United States federal statute signed into law by President Barack Obama on March23, 2010.It was enacted with the goals of increasing the quality and affordability of health insurance by introducing a number of mechanisms—including mandates, subsidies, and insurance exchanges. This has an overall increase in utilization of health care services in all the sectors.
• Primary care, specialty care, and hospital emergency departments are expected to be overburdened with an influx of newly-insured patients. Patients might use expensive services under the insurance plan, even for less severe conditions like common cold, cough. They tend to use all the sectors like acute care, outpatient care even when it is not necessary causing a moral hazard.
• Even In-patient services would be affordable with the ACA mandates increasing its utilization.
•

The need for providing uncompensated care by hospitals is expected to decrease.
• To participate in Medicare, new or existing hospitals had to be certified by December 31, 2010.

• Restrictions on expansion of existing hospitals and is viewed as an assault on the American entrepreneurial system. In response, these hospitals are expanding hours and services, and rejecting Medicare patients.
• The ACA assumes that cost control responsibilities will be shared between MCOs and Accountable Care Organizations. Medicare is authorized to develop payment methods for ACOs. Payment must include a shared savings program – pay additional moneys to ACOs that achieve targeted cost savings while meeting quality standards. This cost control method with quality management increasing the utilization of the managed care.
• Components of the ACA that affect community health centers involve maintaining adequate funding and developing teaching health centers. Health centers located in states that do not expand Medicaid could face fiscal shortfalls. This might result in provision of adequate services to the community increasing

utilization.
• Medicaid eligibility expanded to include individuals and families with incomes up to 133% of the federal poverty level, including adults without disabilities and without dependent children. This provides more access to the health care services, which might include increased use of services by the older patients who need a transition between long-term care services and the other services. Hence, there would be more utilization of long-term care, primary care and other specialties.
• Children under the age of 26 can remain on their parent’s insurance plan with no deductibles or copayments for preventive services and immunization. Because of the law, health plans must now cover preventive services like depression screening for adults and behavioral assessments for children at no cost. As a result, there would be an increase in utilization of personal medical and preventive services sector, population-based community health services sector and also health-related support services sector.
• The Affordable Care Act will provide one of the largest expansions of mental health and substance use disorder coverage in a generation, by requiring that health insurance plans on the Health Insurance plans cover mental health and substance use disorder services. These new protections will build on the Mental Health Parity and Addiction Equity to expand mental health and substance use disorder benefits and federal parity protections for behavioral health to 62 million Americans. And starting in 2014, most plans won’t be able to deny us coverage or charge us more due to pre-existing health conditions, including mental illnesses (Mentalhealth.gov).