Obamacare: What the affordable care act means for patients and physicians

BMJ (Online)

Volumn 349, Issue , 2014, Pages

  Hall, Mark A ^a   Lord, Richard ^a  

^a WAKE FOREST UNIVERSITY   (United States)

Author keywords

[No Author keywords available]

Indexed keywords

ARTICLE; BUDGET; COST CONTROL; DOCTOR PATIENT RELATION; GOVERNMENT REGULATION; HEALTH CARE ACCESS; HEALTH CARE POLICY; HEALTH INSURANCE; HEALTH INSURANCE ELIGIBILITY; HEALTH PROGRAM; HEALTH STATUS; HUMAN; MANDATORY PROGRAM; MEDICAID; MEDICAL PRACTICE; NATIONAL HEALTH SERVICE; OBAMACARE; POVERTY; SOCIAL INSURANCE; COST; ECONOMICS; FORECASTING; GOVERNMENT; HEALTH CARE COST; HEALTH CARE DELIVERY; INSURANCE; LEGISLATION AND JURISPRUDENCE; MEDICARE; ORGANIZATION AND MANAGEMENT; POLITICS; SOCIAL SECURITY; UNITED STATES;

BUDGETS; COST CONTROL; COST SHARING; FORECASTING; GOVERNMENT PROGRAMS; HEALTH EXPENDITURES; HEALTH INSURANCE EXCHANGES; HEALTH POLICY; HEALTH SERVICES ACCESSIBILITY; HUMANS; MEDICAID; MEDICARE; PATIENT PROTECTION AND AFFORDABLE CARE ACT; POLITICS; PRIVATE SECTOR; SOCIAL SECURITY; STATE MEDICINE; UNITED STATES; UNIVERSAL COVERAGE;

EID: 84908425483     PISSN: 09598146     EISSN: 17561833     Source Type: Journal    
DOI: 10.1136/bmj.g5376     Document Type: Article

References (79)

1. Oberlander J, Perreira K. Implementing Obamacare in a red state-dispatch from North Carolina. N Engl J Med 2013;369:2469-71.
2. Jacobs LR, Skocpol T. Health care reform and american politics: what everyone needs to know. Oxford University Press, 2012.
3. Jost TS. Implementing health reform: four years later. Health Aff (Millwood) 2014;33:7-10.
4. Cuckler GA, Sisko AM, Keehan SP, Smith SD, Madison AJ, Poisal JA, et al. National health expenditure projections, 2012: slow growth until coverage expands and economy improves. Health Aff (Millwood) 2013;32:1820-31.
5. Schoen C, Osborn R, Squires D, Doty MM. Access, affordability, and insurance complexity are often worse in the United States compared to ten other countries. Health Aff (Millwood) 2013;32:2205-15.
6. Hall MA. The geography of health insurance regulation: a guide to identifying, exploiting, and policing market boundaries. Health Aff (Millwood) 2000;19:173-84.
7. NIHCM Foundation. The concentration of health care spending. 2012. www.nihcm.org/component/content/article/326-publications-health-care-spending/679-the-concentration-of-health-care-spending.
8. Blumberg LJ. High-risk pools-merely a stopgap reform. N Engl J Med 2011;364:e39.
9. Quadagno J. Right-wing conspiracy? Socialist plot? The origins of the Patient Protection and Affordable Care Act. J Health Politic Policy Law 2014;39:35-56.
10. Blumberg LJ, Corlette S, Lucia K. The Affordable Care Act: improving incentives for entrepreneurship and self-employment. Robert Wood Johnson Foundation, 2013. www.rwjf.org/content/dam/farm/reports/issue-briefs/2013/rwjf406367
11. Helvering v Davis [1937] 301 US 619.
12. National Federation of Independent Business v Sebelius [2012] 567 US.
13. Sommers BD, Epstein AM. US governors and the Medicaid expansion-no quick resolution in sight. N Engl J Med 2013;368:496-9.
14. Holahan J, Buettgens M, Dorn S. The cost of not expanding Medicaid. Henry J Kaiser Family Foundation, 2013. http://kff.org/medicaid/report/the-cost-of-not-expanding-medicaid/.
15. Dorn S, Holahan J, Carroll C, McGrath M. Medicaid expansion under the ACA: how states analyze the fiscal and economic trade-offs. Urban Institute, 2013. www.urban.org/publications/412840.html.
16. Buettgens M, Dorn S, Caroll C. Consider savings as well as costs: state governments would spend at least $90 billion less with the ACA than without it from 2014 to 2019. Urban Insitute, 2011. www.urban.org/publications/412361.html.
17. Henry J Kaiser Family Foundation. The role of medicaid in state economies: a look at the research. 2009. http://kaiserfamilyfoundation.files.wordpress.com/2013/01/7075-02-es.pdf.
18. Koff S. Is Obamacare really to blame for cuts at the Cleveland Clinic and other hospitals? Cleveland Plain Dealer 2013. www.cleveland.com/open/index.ssf/2013/10/is-obamacare-realy-to-blame-fo.html.
19. Corlette S, Monahan C, Lucia K. Moving to high quality, adequate coverage: state implementation of new essential health benefit requirements. Georgetown University's Health Policy Institute, 2013. http://www.urban.org/publications/412882.html
20. Tanner MD. Bad medicine: a guide to the real costs and consequences of the new health care law. Cato Institute, 2011. www.cato.org/publications/white-paper/bad-medicine-guide-real-costs-consequences-new-health-care-law.
21. Neumann PJ, Weinstein MC. Legislating against use of cost-effectiveness information. N Engl J Med 2010;363:1495-7.
22. Ku L. Explaining recent changes in CBO projections of health insurance coverage and costs under the Affordable Care Act. 2013. HealthReformGPS. http://www.healthreformgps.org/resources/explaining-recent-changes-in-cbo-projections-of-health-insurance-coverage-And-costs-under-the-Affordable-care-Act/.
23. Congressional Budget Office. CBO's May 2013 estimate of the effects of the Affordable Care Act on health insurance coverage. CBO, 2013. www.cbo.gov/sites/default/files/cbofiles/attachments/43900-2013-05-ACA.pdf.
24. Spiro T, Gruber J. The Affordable Care Act's lower-than-projected premiums will save $190 billion. Center for American Progress, 2013. http://cdn.americanprogress.org/wp-content/uploads/2013/10/SpiroACASavings-brief.pdf.
25. Congress of the United States Congressional Budget Office. Updated estimates of the effects of the insurance coverage provisions of the Affordable Care Act, April 2014. 2014. www.cbo.gov/publication/45231.
26. Buchmueller T, Carey C, Levy HG. Will employers drop health insurance coverage because of the Affordable Care Act? Health Aff (Millwood) 2013;32:1522-30.
27. Blumberg LJ, Buettgens M, Feder J, Holahan J. Why employers will continue to provide health insurance: the impact of the Affordable Care Act. Inquiry 2012;49:116-26.
28. Eibner C, Hussey PS, Girosi F. The effects of the Affordable Care Act on workers' health insurance coverage. N Engl J Med 2010;363:1393-5.
29. Gabel JR, Whitmore H, Pickreign J, Satorius JL, Stromberg S. Small employer perspectives on the Affordable Care Act's premiums, SHOP exchanges, and self-insurance. Health Aff (Millwood) 2013;32:2032-9.
30. Families USA. How does the Affordable Care Act affect people who buy health insurance in the individual market? 2013. http://familiesusa.org/product/how-does-Affordable-care-Act-Affect-people-who-buy-health-insurance-individual-market.
31. Buettgens M, Hall MA. Who will be uninsured after health insurance reform? Urban Institute, 2011. www.urban.org/UploadedPDF/1001520-Uninsured-After-Health-Insurance-Reform.pdf.
32. Buettgens M, Garrett B, Holahan J. America under the Affordable Care Act. Urban Institute, 2010. www.urban.org/publications/412267.html.
33. Blumenthal D, Collins SR. Health care coverage under the Affordable Care Act-A progress report. N Engl J Med. 2014;371:275-81.
34. Department of Health and Human Services. Health insurance marketplace: summary enrollment report for the initial annual open enrollment period for the period: October 1, 2013-March 31, 2014. www.aspe.hhs.gov/health/reports/2014/marketplaceenrollment/apr2014/ib-2014apr-enrollment.pdf
35. Blumberg LJ, Holahan J, Kenney GM, Buettgens M, Anderson N, Recht H, et al. Measuring marketplace enrollment relative to projections. Urban Institute, 2014. www.urban.org/UploadedPDF/413087-Measuring-Marketplace-Enrollment-Relative-to-Enrollment-Projections.pdf.
36. Levey NN. Obamacare has led to health coverage for millions more people. Los Angeles Times 2014. http://articles.latimes.com/2014/mar/30/nation/la-na-obamacare-uninsured-national-20140331.
37. Bhardwaj A, Coe E, Cordina J, Rayasam M. Individual market enrollment: updated view. McKinsey Center for US Health System Reform, 2014. http://healthcare.mckinsey.com/individual-market-enrollment-updated-view.
38. Henry J Kaiser Family Foundation. Medicaid enrollment: an overview of the CMS April 2014 data update. 2014. http://kff.org/medicaid/fact-sheet/medicaid-enrollment-An-overview-of-the-cms-April-2014-update/.
39. Carman KG, Eibner C. Changes in health insurance enrollment since 2013: evidence from the RAND health reform opinion study. 2014. RAND Corporation. www.rand.org/pubs/research-reports/RR656.html.
40. Hofer AN, Abraham JM, Moscovice I. Expansion of coverage under the Patient Protection and Affordable Care Act and primary care utilization. Milbank Q 2011;89:69-89.
41. Gottlieb S, Emanuel EJ. No, there won't be a doctor shortage. New York Times 2013. www.nytimes.com/2013/12/05/opinion/no-there-wont-be-A-doctor-shortage.html?-r=0.
42. Gray J. ACAView: measuring the impact of patient acuity. Athenahealth, 2014. http://www.athenahealth.com/blog/2014/05/19/acaview-measuring-impact-patient-Acuity/
43. Holahan J, Peters R, Lucia K, Monahan C. Cross-cutting issues: insurer participation and competition in health insurance exchanges: early indications from selected states. Urban Institute, 2013. www.rwjf.org/content/dam/farm/reports/issue-briefs/2013/rwjf406939.
44. Cox C, Claxton G, Levitt L, Khosla H. An early look at premiums and insurer participation in health insurance marketplaces, 2014. Henry J Kaiser Family Foundation, 2013.
45. Department of Health and Human Services ASPE Office of Health Policy. Health insurance marketplace premiums for 2014. 2013. http://aspe.hhs.gov/health/reports/2013/marketplacepremiums/ib-marketplace-premiums.cfm.
46. McKinsey Center for US Health System Reform. Emerging exchange dynamics: temporary turbulence or sustainable market disruption? 2013. http://www.mckinsey.com/~/media/mckinsey/dotcom/client-service/healthcare%20systems%20and%20services/pdfs/emerging-exchange-dynamics-september-2013-final.ashx
47. Holahan J, Peters R, Lucia K. The launch of the Affordable Care Act in selected states: insurer participation, competetion, and premiums. 2014. The Urban Institute and Georgetown University Health Policy Institute. www.urban.org/publications/413040.html.
48. McCue MJ, Hall MA. The federal medical loss ratio rule: implications for consumers in year 2. Commonwealth Fund, 2014. www.commonwealthfund.org/publications/issue-briefs/2014/may/medical-loss-ratio-rule.
49. Bernasek A. Insurers' stocks, unhurt by the dawn of the health care law. New York Times 2013.www.nytimes.com/2013/10/27/business/insurers-stocks-unhurt-by-the-dawn-of-obamacare.html.
50. Glesa K, Carlson C. My generation: age band compression under health care reform. Contingencies, 2013. www.nahu.org/meetings/capitol/2013/attendees/jumpdrive/contingencies20130102-1357146485000c7cc7dd5e1-pp.pdf.
51. Skopec L, Kronick R. Market competition works: proposed silver premiums in the 2014 individual and small group markets are nearly 20% lower than expected. Department of Health and Human Services Office of the Assistant Secretary for Planning and Evaluation, 2013. http://aspe.hhs.gov/health/reports/2013/MarketCompetitionPremiums/rb-premiums.pdf.
52. PwC Health Research Institute. Health insurance premiums: comparing ACA exchange rates to the employer-based market. 2014. www.pwc.com/us/en/health-industries/health-research-institute/assets/pwc-hri-health-insurance-premium.pdf.
53. Gabel JR, Lore R, McDevitt RD, Pickreign JD, Whitmore H, Slover M, et al. More than half of individual health plans offer coverage that falls short of what can be sold through exchanges as of 2014. Health Aff (Millwood) 2012;31:1339-48.
54. Levitt L, Claxton G, Damico A. Quantifying tax credits for people now buying insurance on their own. Henry J Kaiser Family Foundation, 2013. http://kff.org/health-reform/issue-brief/quantifying-tax-credits-for-people-now-buying-insurance-on-their-own/.
55. Blumberg LJ, Buettgens M. Why the ACA's limits on age-rating will not cause "rate shock": distributional implications of limited age bands in nongroup health insurance. Urban Institute, 2013. www.urban.org/publications/412757.html.
56. McCue MJ, Hall MA. Insurers' responses to regulation of medical loss ratios. Commonwealth Fund, 2012. www.commonwealthfund.org/~/media/files/publications/issue-brief/2012/dec/1634-mccue-insurers-responses-mlr-regulation-ib.pdf.
57. Hall MA, Rosenbaum S. The health care safety net in a post-reform world. Rutgers University Press, 2012.
58. Iglehart JK. Expanding the role of advanced nurse practitioners-risks and rewards. N Engl J Med 2013;368:1935-41.
59. Davis K, Abrams M, Stremikis K. How the Affordable Care Act will strengthen the nation's primary care foundation. J Gen Intern Med 2011;26:1201-3.
60. McWilliams JM, Chernew ME, Zaslavsky AM, Hamed P, Landon BE. Delivery system integration and health care spending and quality for Medicare beneficiaries. JAMA Intern Med 2013;173:1447-56.
61. Mechanic R, Altman S. Medicare's opportunity to encourage innovation in health care delivery. N Engl J Med 2010;362:772-4.
62. Rajkumar R, Conway PH, Tavenner M. CMs: engaging multiple payers in payment reform. JAMA 2014;311:1967-8.
63. Delisle DR. Big things come in bundled packages: implications of bundled payment systems in health care reimbursement reform. Am J Med Qual 2013;28:339-44.
64. Weeks WB, Rauh SS, Wadsworth EB, Weinstein JN. The unintended consequences of bundled payments. Ann Intern Med 2013;158:62-4.
65. Sood N, Huckfeldt PJ, Escarce JJ, Grabowski DC, Newhouse JP. Medicare's bundled payment pilot for acute and postacute care: analysis and recommendations on where to begin. Health Aff (Millwood) 2011;30:1708-17.
66. McWilliams JM, Chernew ME, Dalton JB, Landon BE. Outpatient care patterns and organizational accountability in medicare. JAMA Intern Med 2014;174:938-45.
67. Colla CH, Wennberg DE, Meara E, Skinner JS, Gottlieb D, Lewis VA, et al. Spending differences associated with the Medicare Physician Group Practice Demonstration. JAMA 2012;308:1015-23.
68. Kocher R, Sahni NR. Hospitals' race to employ physicians-the logic behind a money-losing proposition. N Engl J Med 2011;364:1790-3.
69. Cohn J. The perils of health care nostalgia. Milbank Q 2014;92:177-81.
70. Orszag PR, Emanuel EJ. Health care reform and cost control. N Engl J Med 2010;363:601-3.
71. Berenson RA. Implementing health care reform-why Medicare matters. N Engl J Med 2010;363:101-3.
72. McKinsey Center for US Health System Reform. Hospital networks: configurations on the exchanges and their impact on premiums. 2013. file:///C:/Private/Downloads/Hospital-Networks-Configurations-on-the-Exchanges-And-Their-Impact-on-Premiums.pdf.
73. McKinsey Center for US Health System Reform. Hospital networks: updated national view of configurations on the exchanges. 2014. http://healthcare.mckinsey.com/hospital-networks-updated-national-view-configurations-exchanges.
74. Fronstin P. Private health insurance exchanges and defined contribution health plans: is it deja vu all over again? Employee Benefit Research Institute, 2012. www.ebri.org/pdf/briefspdf/EBRI-IB-07-2012-No373-Exchgs2.pdf.
75. Pauly MV, Harrington SE. Private health insurance exchanges. Health Manag Policy Innov 2013;1:61-72.
76. Wharam JF, Ross-Degnan D, Rosenthal MB. The ACA and high-deductible insurance-strategies for sharpening a blunt instrument. N Engl J Med 2013;369:1481-4.
77. Haviland AM, Marquis MS, McDevitt RD, Sood N. Growth of consumer-directed health plans to one-half of all employer-sponsored insurance could save $57 billion annually. Health Aff (Millwood) 2012;31:1009-15.
78. Hall MA, Schneider CE. Professional obligations when patients pay out of pocket. J Fam Pract 2009;58:E1-4.
79. Ubel PA, Abernethy AP, Zafar SY. Full disclosure-out-of-pocket costs as side effects. N Engl J Med 2013;369:1484-6.