Affordable Care Act Remains Intact

  • Friday, March 31, 2017 1:30am
  • Opinion

The latest efforts to repeal and replace the Affordable Care Act (ACA) have proven unsuccessful. While many of us – patients, health care providers and insurers across the country – can breathe a sigh of relief, we must remain vigilant and vocal about the many benefits the ACA brings to more than 24 million people across our country.

A few key benefits to keep in mind include:

1. Coverage for preventive services. The ACA requires almost all health plans to cover the cost of preventive care services without charging patients a co-payment or co-insurance or requiring them to meet a deductible. Preventive services that are completely covered under the ACA include wellness visits for all family members, cancer screenings such as mammograms and colonoscopies, and immunization vaccines for adults and children, including annual flu shots.

2. Incentives for high-quality, well-coordinated care. The ACA contains several provisions that target longstanding problems in the health care system around cost, quality and patient satisfaction. These include initiatives that reward health care providers for higher quality care, effective care coordination and better clinical outcomes. Results so far are hard to gauge, but overall the incentives are an important step in the right direction.

3. Lower hospital rates for low-income families. The ACA requires hospitals to charge lower rates to patients who are eligible for their financial assistance programs. It also requires all nonprofit hospitals to publish a written financial assistance policy online that clearly states whether the hospital offers free or discounted care along with a clear statement of the eligibility requirements.

4. Supporting the health of the community. The ACA requires nonprofit hospitals to conduct a community health needs assessment every three years for the area the hospital serves. The process requires seeking broad community input on factors that influence the community’s health or emergency preparedness. Nonprofit hospitals also have to develop and report their strategy – updated every year – for improving the health of the surrounding community.

5. Affordable health insurance. The ACA makes health care insurance available to individuals who cannot get affordable coverage any other way. The result is that we have seen tremendous progress in expanding insurance coverage, particularly in states such as ours that chose to expand Medicaid eligibility to individuals with incomes at or below 138 percent of the official poverty level. Here in Washington, more than 600,000 people have enrolled in Apple Health as part of the Medicaid expansion. Statewide, the uninsured rate has dropped significantly, from 14 percent in 2013 to just 5.8 percent today.

The features of the ACA that I’ve mentioned above are just some of the many ways our health care system has been significantly improved by the ACA. Our national focus should now be on working together, regardless of political affiliations, to make the law even better and more effective. Access to affordable, appropriate health care is essential to the quality of life for all Americans.

-Gary S. Kaplan, M.D., Chairman and CEO, Virginia Mason Health System