and policy makers can take advantage of. Such as prevention and health center funding.
Prevention centers are vital to local communities and needed they would have to demonstrate
how useful they would be the same as nonprofit hospitals.
The Implication for the Appeal of the Affordable Care Act
The ACA had many provisions that would affect how Medicaid and the many elderly
people who relied on Medicaid for health insurance coverage. The ACA really helped to
compensate hospitals for providing care to lower income families. Repealing the ACA's
sustained reductions in provider payments would be expected to increase Part A and Part B
spending (Cubanski, Neuman, Jacobson, & Boccuti, 2016). Repealing the provisions would
increase payments to providers and some hospitals. It would also help with deductible and
copayment which is paid by the beneficiary. Prior to the ACA federal payments to Medicare
Advantage plans per enrollee were 14 percent higher than the cost of covering similar
beneficiaries under the traditional Medicare program, according the Medicare Payment Advisory
Commission [MedPAC] (Cubanski et al, 2016). Repealing this would also increase the total
Medicare spending and improve the out of pocket cost for each beneficiary that is enrolled in the
Medicare Advantage plans. The ACA helped to improve preventive benefits for screenings such
as breast, diabetes, and cardiovascular to name a few. By having the preventative services
physicians could determine early signs and start treatment early or prevent it. The ACA gives the
individual permission to file an appeal if they feel they were wrongly denied. The insurance
company must notify the patient in writing the reason why the claim was denied, and that the
individual has the right to file an appeal and request an external review (Harrington, 2016, p.

Running head: AFFORDABLE CARE ACT
5
106). The appeal helps patients to get a second opinion on their case. A lot of times patients rely
on the help to cover medical expenses.
Financial Theories in the Healthcare Industry
Understanding and overcoming barriers is crucial to implementing effective
improvements. The government itself now is finding themselves faced with constraints on
healthcare spending capacity while the demands and expectations are increasing. Across health
care systems there are powerful pressures on local decisions makers to improve outcomes whilst
reducing expenditures (Willias, Brown, & Healy, 2018). The health care industry has a huge
impact in the United States economy. Health care spending is at an all-time high for the overall
economy. The ACA has made insurance more affordable for low income families but at the same
time those who are high earners, employers, and health care providers affects them by paying
more taxes. Many individuals have gain access to affordable insurance since the ACA and many
incentives were given. Some may argue that the ACA has introduced more insured patients into
the health market and has created a system overload for a shortage of healthcare professionals.


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- Spring '18