The patient protection and affordable care act: Opportunities for prevention and public health

The Lancet

Volumn 384, Issue 9937, 2014, Pages 75-82

  Shaw, Frederic E ^a   Asomugha, Chisara N ^b   Conway, Patrick H ^b   Rein, Andrew S ^a  

^a CENTERS FOR DISEASE CONTROL AND PREVENTION   (United States)

^b CENTERS FOR MEDICARE AND MEDICAID SERVICES   (United States)

Author keywords

[No Author keywords available]

Indexed keywords

ARTICLE; HEALTH CARE COST; HEALTH CARE POLICY; HEALTH CARE QUALITY; HEALTH CARE SYSTEM; HEALTH PROGRAM; HUMAN; INSURANCE; LAW; PRIORITY JOURNAL; PUBLIC HEALTH; UNITED STATES; ACCOUNTABLE CARE ORGANIZATION; CLINICAL EFFECTIVENESS; COMMUNITY ASSESSMENT; EVIDENCE BASED PRACTICE; GENERAL PRACTITIONER; GROSS NATIONAL PRODUCT; HEALTH CARE DELIVERY; HEALTH PROMOTION; HEALTH STATUS; MEDICAID; MEDICAL EDUCATION; MEDICARE; PATIENT CARE; PREVENTIVE HEALTH SERVICE; PRIMARY MEDICAL CARE; PUBLIC HEALTH SERVICE; SOCIAL WELFARE; TOTAL QUALITY MANAGEMENT;

ACCOUNTABLE CARE ORGANIZATIONS; ENVIRONMENT; HEALTH CARE COSTS; HEALTH CARE REFORM; HEALTH SERVICES ACCESSIBILITY; HUMANS; INSURANCE COVERAGE; INSURANCE, HEALTH; MEDICARE; PATIENT PROTECTION AND AFFORDABLE CARE ACT; PRIMARY PREVENTION; PUBLIC HEALTH; RESIDENCE CHARACTERISTICS; UNITED STATES;

EID: 84903768175     PISSN: 01406736     EISSN: 1474547X     Source Type: Journal    
DOI: 10.1016/S0140-6736(14)60259-2     Document Type: Review

References (74)

1. The Patient Protection and Affordable Care Act of 2010 (P.L. 111-148), as amended by the Health Care and Education Reconciliation Act of 2010 (P.L. 111-152), together referred to as the Affordable Care Act.
2. Stolberg SG, Pear R. Obama signs health care overhaul bill, with a flourish. http://www.nytimes.com/2010/03/24/health/policy/24health.html?-r=0 (accessed May 26, 2014).
3. Hamel L, Firth J, Brodie M. Kaiser health tracking poll: April 2014. http://kff.org/health-reform/poll-finding/kaiser-health-tracking-poll-april- 2014/ (accessed May 26, 2014).
4. Berwick DM. The toxic politics of health care. JAMA 2013; 310: 1921-22.
5. Jost TS. Beyond repeal-a Republican proposal for health care reform. N Engl J Med 2014; 370: 894-96.
6. Fronstin P. Sources of health insurance and characteristics of the uninsured: analysis of the March 2012 current population survey. Employee Benefit Research Institute Issue Brief 2012, No. 376. http://www.ebri.org/pdf/ briefspdf/EBRI-IB-09-2012-No376-Sources.pdf (accessed May 25, 2014).
7. Centers for Medicare & Medicaid Services. CMS fast facts. http://www.cms.gov/Research-Statistics-Data-and-Systems/Statistics-Trends-and- Reports/CMS-Fast-Facts/index.html (accessed May 25, 2014).
8. De Lew N. Medicare: 35 years of service. Health Care Financ Rev 2000; 22: 75-103.
9. The Henry J Kaiser Family Foundation. The uninsured: a primer-key facts about health insurance on the eve of coverage expansions. http://kff.org/ uninsured/report/the-uninsured-a-primer-key-facts-about-health-insurance-on-the- eve-of-coverage-expansions/ (accessed May 26, 2014).
10. Driscoll AK, Bernstein AB Health and access to care among employed and unemployed adults: United States, 2009-2010. http://www.cdc.gov/nchs/data/ databriefs/db83.pdf (accessed April 28, 2013).
11. Hadley J, Holahan J, Coughlin T., Miller D. Covering the uninsured in 2008: current costs, sources of payment, and incremental costs. Health Aff (Millwood) 2008; 27: w399-415.
12. Baicker K, Taubman SL, Allen H.L., et al, and the Oregon Health Study Group. The Oregon experiment-effects of Medicaid on clinical outcomes. N Engl J Med 2013; 368: 1713-22.
13. Institute of Medicine. Care without coverage: too little, too late. Washington, DC: National Academy Press, 2002.
14. Levy H, Meltzer D. The impact of health insurance on health. Annu Rev Public Health 2008; 29: 399-409.
15. Congressional Budget Office. CBO's April 2014 estimate of the effects of the Affordable Care Act on health insurance coverage. http://cbo.gov/sites/ default/files/cbofiles/attachments/43900-2014-04-ACAtables.pdf (accessed June 23, 2014).
16. Office of the Assistant Secretary for Planning and Evaluation. Report shows Affordable Care Act has expanded insurance coverage among young adults of all races and ethnicities. http://aspe.hhs.gov/health/reports/2012/ YoungAdultsbyGroup/ib.shtml (accessed May 26, 2014).
17. The Henry J Kaiser Family Foundation. Health insurance market reform: rate restrictions. http://kaiserfamilyfoundation.files.wordpress.com/2013/01/ 8328.pdf (accessed May 26, 2014).
18. US Department of Health and Human Services. How do I qualify for an exemption from the fee for not having health coverage? https://www.healthcare. gov/exemptions/ (accessed May 26, 2014).
19. US Centers for Medicare & Medicaid Services. http://www.healthcare. gov/marketplace (accessed May 26, 2014).
20. Center for Consumer Information & Insurance Oversight. CMS. Essential health benefits standards: ensuring quality, affordable coverage. http://www.cms.gov/CCIIO/Resources/Fact-Sheets-and-FAQs/ehb-2-20-2013.html (accessed May 26, 2014).
21. Health Insurance Tax Credit. 77 Fed. Reg. 30,377, 30,400 (May 23, 2012) (to be codified at 26 C.F.R. Part 1 and 26 C.F.R. Part 602). Available at: http://www.gpo.gov/fdsys/pkg/FR-2012-05-23/pdf/2012-12421.pdf (accessed May 26, 2014).
22. Federal Register. Annual updated of the HHS poverty guidelines. https://www.federalregister.gov/articles/2013/01/24/2013-01422/ annual-update-of-the-hhs-poverty-guidelines(accessed May 26, 2014).
23. The Henry J Kaiser Family Foundation. Issue brief: state-by-state estimates of the number of people eligible for premium tax credits under the Affordable care Act. http://kff.org/health-reform/issue-brief/state-by-state- estimates-of-the-number-of-people-eligible-for-premium-tax-credits-under-the- affordable-care-act/ (accessed May 26, 2014).
24. President Barack Obama. Transcript of news conference on the Affordable Care Act. November 14, 2013. http://www.washingtonpost.com/politics/transcript- president-obamas-nov-14-statement-on-health-care/2013/11/14/6233e352-4d48-11e3- ac54-aa84301ced81-story.html (accessed May 26, 2014).
25. Levitt L, Claxton G, Damico A. The numbers behind "young invincibles" and the Affordable Care Act. http://kff.org/health-reform/ perspective/the-numbers-behind-young-invincibles-and-the-affordable-care-act/ (accessed May 26, 2014).
26. US Department of Health and Human Services. Health insurance marketplace: March enrollment report. http://aspe.hhs.gov/health/reports/2014/ MarketPlaceEnrollment/Mar2014/ib-2014mar-enrollment.pdf (accessed May 25, 2014).
27. Office of the Assistant Secretary for Planning and Evaluation. Profiles of Affordable Care Act coverage expansion enrollment for Medicaid/CHIP and the Health Insurance Marketplace, May 1, 2014. http://aspe.hhs.gov/health/reports/ 2014/MarketPlaceEnrollment/Apr2014/Marketplace-StateSum.cfm (accessed May 25, 2014).
28. Centers for Medicare & Medicaid Services. Questions and answers on options available for consumers with cancelled policies, January 3, 2014. http://www.cms.gov/CCIIO/Resources/Regulations-and-Guidance/Downloads/ cancellation-consumer-options-faq-01-03-2014.pdf (accessed May 26, 2014).
29. National Federation of Independent Business, et al. v Kathleen Sebelius, et al. 11-393, 11-398, 11-400 (US Supreme Court, June 28, 2012).
30. Kenney GM, Zuckerman S, Dubay L., et al Opting in to the Medicaid expansion under the ACA: who are the uninsured adults who could gain health insurance coverage? Timely Analysis of Immediate Health Policy Issues, August 2012. http://www.urban.org/UploadedPDF/412630-opting-in-medicaid.pdf (accessed May 26, 2014).
31. Nardin R, Zallman L, McCormick D., Woolhandler S, Himmelstein D. The uninsured after implementation of the Affordable Care Act: a demographic and geographic analysis. http://healthaffairs.org/blog/2013/06/06/the-uninsured- after-implementation-of-the-affordable-care-act-a-demographic-and-geographic- analysis/ (accessed May 26, 2014).
32. Andrews M. Despite health law's protections, many consumers may be "underinsured". http://www.kaiserhealthnews.org/stories/2013/december/ 31/michelle-andews-health-law-protections-consumers.aspx (accessed May 26, 2014).
33. Topol EJ. Topol asks Sebelius 5 ACA questions. http://wwwmedscape.com/ viewarticle/806990 (accessed May 26, 2014).
34. Abrams M, Nuzum R, Mika S., Lawlor G. Realizing health reform's potential: how the Affordable Care Act will strengthen primary care and benefit patients, providers, and payers. The Commonwealth Fund (report), January 2011. http://www.commonwealthfund.org/~/media/Files/Publications/Issue%20Brief/2011/ Jan/1466-Abrams-how-ACA-will-strengthen-primary-care-reform-brief-v3.pdf (accessed May 26, 2014).
35. Office for the Assistant Secretary for Planning and Evaluation. Long-term growth of medical expenditures-public and private. http://aspe.hhs.gov/health/ MedicalExpenditures/ (accessed May 26, 2014).
36. Martin AB, Hartman M, Whittle L., Catlin A, the National Health Expenditures Accounts Team. Rate of health spending in 2012: rate of health spending growth remained low for the fourth consecutive year. Health Aff (Millwood) 2014; 33: 67-77.
37. National Commission on Fiscal Responsibility and Reform. The moment of truth: report of the National Commission on Fiscal Responsibility and Reform, December 2010. http://wwwfiscalcommission.gov/sites/fiscalcommission.gov/files/ documents/TheMomentofTruth12-1-2010.pdf (accessed May 26, 2014).
38. Centers for Medicare and Medicaid Services (CMS). National health expenditures 2012 highlights. http://www.cms.gov/Research-Statistics-Data-and- Systems/Statistics-Trends-and-Reports/NationalHealthExpendData/Downloads/ highlights.pdf (accessed May 26, 2014).
39. Ryu AJ, Gibson TB, McKellar M.R., Chernew ME The slowdown in health care spending in 2009-11 reflected factors other than the weak economy and thus may persist. Health Aff (Millwood) 2013; 32: 835-40.
40. Cutler DM, Sahni NR If slow rate of health care spending growth persists, projections may be offby $770 billion. Health Aff (Millwood) 2013; 32: 841-50.
41. Kronick R, Po R. Growth in Medicare spending per beneficiary continues to hit historic lows. http://aspe.hhs.gov/health/reports/2013/ medicarespendinggrowth/ib.pdf (accessed May 26, 2014).
42. Centers for Medicare & Medicaid Services. Pioneer Accountable Care Organizations succeed in improving care, lowering costs. http://www.cms.gov/ Newsroom/MediaReleaseDatabase/Press-Releases/2013-Press-Releases-Items/ 2013-07-16.html (accessed May 26, 2014).
43. The White House. Deficit-reducing health care reform. http://wwwwhitehouse.gov/economy/reform/deficit-reducing-health-care-reform (accessed May 26, 2014).
44. Lallemand NC. Reducing waste in health care: health policy brief http://www.healthaffairs.org/healthpolicybriefs/briefphp?brief-id=82 (accessed May 26, 2014).
45. US Department of Health and Human Services. 2011 Report to Congress: National Strategy for Quality Improvement in Health Care. http://www.ahrq.gov/ workingforquality/nqs/nqs2011annlrpt.htm (accessed May 26, 2014).
46. US Department of Health and Human Services. 2012 Annual Progress Report to Congress: National Strategy for Quality Improvement in Health Care. http://www.ahrq.gov/workingforquality/nqs/nqs2012annlrpt.htm (accessed May 26, 2014).
47. Centers for Medicare & Medicaid Services. Quality improvement organizations. http://www.cms.gov/Medicare/Quality-Initiatives-Patient- Assessment-Instruments/QualityImprovementOrgs/index.html?redirect=/ qualityimprovementorgs/ (accessed May 26, 2014).
48. Centers for Medicare & Medicaid Services. Community-based Care Transitions Program. http://innovation.cms.gov/initiatives/CCTP/?itemID= CMS1239313 (accessed May 26, 2014).
49. Centers for Medicare & Medicaid Services. Hospital-acquired conditions (present on admission indicator). http://www.cms.gov/Medicare/ Medicare-Fee-for-Service-Payment/HospitalAcqCond/index.html?redirect=/ hospitalacqcond (accessed May 26, 2014).
50. Brock J, Mitchell J, Irby K., et al, and the Care Transitions Project Team. Association between quality improvement for care transitions in communities and rehospitalizations among Medicare beneficiaries. JAMA 2013; 309: 381-91.
51. Centers for Medicare & Medicaid Services. Affordable Care Act update: implementing Medicare cost savings. http://www.cms.gov/apps/docs/aca-update- implementing-medicare-costs-savings.pdf (accessed May 26, 2014).
52. Centers for Medicare & Medicaid Services. Hospital value-based purchasing. http://www.cms.gov/Medicare/Quality-Initiatives-Patient-Assessment- Instruments/hospital-value-based-purchasing/index.html?redirect=/ hospital-value-based-purchasing (accessed May 26, 2014).
53. Centers for Medicare & Medicaid Services. National health expenditures tables, 2012. http://www.cms.gov/Research-Statistics-Data-and- Systems/Statistics-Trends-and-Reports/NationalHealthExpendData/Downloads/tables. pdf (accessed May 26, 2014).
54. Koh HK, Sebelius KG Promoting prevention through the Affordable Care Act. N Engl J Med 2010; 363: 1296-99.
55. National Prevention Council. National prevention strategy: America's plan for better health and wellness. http://www.surgeongeneral.gov/initiatives/ prevention/strategy/ (accessed May 26, 2014).
56. Centers for Disease Control and Prevention. CDC grand rounds: the Million Hearts initiative. MMWR Morb Mort Wkly Rep 2012; 61: 1017-21.
57. George MG, Tong X, Sonnenfeld N., Hong Y. Recommended use of aspirin and other antiplatelet medications among adults - National Ambulatory Medical Care Survey and National Hospital Ambulatory Medical Care Survey, United States, 2005-2008. MMWR Morb Mort Wkly 2012; 61 (suppl): 11-18.
58. Frieden TR. Foreword. In: Centers for Disease Control and Prevention. Use of selected clinical preventive services among adults-United States, 2007-2010. MMWR Morb Mortal Wkly Rep 2012; 61 (suppl): 1-2.
59. Institute of Medicine. Clinical preventive services for women: closing the gaps. http://iom.edu/Reports/2011/Clinical-Preventive-Services-for-Women- Closing-the-Gaps.aspx (accessed May 26, 2014).
60. Skopec L, Sommers BD Seventy-one million additional Americans are receiving preventive services coverage without cost-sharing under the Affordable Care Act. http://aspe.hhs.gov/health/reports/2013/PreventiveServices/ib- prevention.cfm (accessed May 26, 2014).
61. Cassidy A. Health policy brief: preventive services without cost sharing. http://www.healthaffairs.org/healthpolicybriefs/briefphp?brief-id=37 (accessed May 26, 2014).
62. Kathleen Sebelius, Secretary of Health and Human Services, et al. Petitioners v. Hobby Lobby Stores, Inc., et al. U.S. Supreme Court, certiorari granted, November 26, 2013.
63. Conestoga Wood Specialties Corporation, et al., Petitioners v. Kathleen Sebelius, Secretary of Health and Human Services, et al., U.S. Supreme Court, certiorari granted, November 26, 2013.
64. Denniston L. Court to rule on birth-control mandate, UPDATED. http://www.scotusblog.com/2013/ll/court-to-rule-on-birth-control-mandate/ (accessed May 26, 2014).
65. The Patient Protection and Affordable Care Act of 2010, Section 4002. 42 U.S.C. § 300u-ll(a).
66. Centers for Disease Control and Prevention. Community transformation grants. http://www.cdc.gov/nccdphp/dch/programs/communitytransformation/ (accessed May 26, 2014).
67. McAfee T, Davis KC, Alexander R.L., Pechacek TF, Bunnell R. Effect of the first federally funded US antismoking national media campaign. Lancet 2013; 382: 2003-11.
68. Scutchfield FD, Michener JL, Thacker SB Are we there yet? Seizing the moment to integrate medicine and public health. Am J Prev Med 2012; 42: S97-102.
69. Institute of Medicine. Primary care and public health: exploring integration to improve population health. Washington DC: National Academies Press, 2012.
70. Beitsch LM, Grigg M, Menachemi N., Brooks RG Roles of local public health agencies within the state public health system. J Public Health Manag Pract 2006; 12: 232-41.
71. Madamala K, Sellers K, Beitsch L.M., Pearsol J., Jarris PE Structure and functions of state public health agencies in 2007. Am J Public Health 2011; 101: 1179-86.
72. Calman N, Hauser D, Lurio J., Wu WY, Pichardo M. Strengthening public health and primary care collaboration through electronic health records. Am J Public Health 2012; 102: e13-18.
73. Smith D, Kinsley A, Leyvas C., Walker A. California's innovative immunization billing project plan. http://psbweb.co.kern.ca.us/PH-Internet/pdfs/ HotTopic/FinalCaliforniaBillingPlan.pdf (accessed May 26, 2014).
74. The Patient Protection and Affordable Care Act of 2010 (P.L. 111-148), as amended by the Health Care and Education Reconciliation Act of 2010 (P.L. 111-152, together referred to as the Affordable Care Act. Section 9007(e).