The Patient Protection and Affordable Care Act

Davis Weiss The Patient Protection and Affordable Care Act is a federal statute that was signed into law in America by President Barack Obama on March 23, 2010. It is divided into 10 titles. The bill contains provisions that will go into effect on June 21, 2010 and September 23, 2010. Also, the additional provisions will go into effect in 2014. Title I of H. R. 3590 will ensure quality affordable health care for all Americans by eliminating discriminatory practices by health insurers such as pre-existing condition exclusions. Title I also extends dependant coverage up to age 26, caps insurance companies non-medical expenses, and prevents unfair termination of insurance policies. Title II expands eligibility for Medicaid to lower income persons and assumes federal responsibility for much of the cost of this expansion. These bills provide enhanced federal support for the Children’s Health Insurance Program, simplify Medicaid and CHIP enrollment, and improve Medicaid services. Title III will strengthen the quality of healthcare by establishing The Physician Quality Reporting Initiative (PQRI) which is a value-based purchasing program for hospitals that link Medicare payments to quality performance. Title IV puts into place a new interagency council to promote healthy policies and to establish a national prevention and health promotion strategy. Title V will encourage innovations in health care workforce training, recruitment, and retention, and will establish a new workforce commission. Title VI creates new requirements to provide information to the public on the health system and promotes a newly invigorated set of requirements to combat fraud and abuse in pubic and private programs. Title VII allows certain hospitals and treatment centers to receive discounted and/or generic drugs to aid their budget. Title VIII establishes a new, voluntary, self-funded long-term care insurance program, the Community Living Assistance Services and Support (CLASS) Independence Benefit Plan, for the purchase of community living assistance services and supports by individuals with functional limitations. No taxpayer funds will be used to pay benefits under this provision. Title IX levies an excise tax of 40 percent on insurance companies and plan administrators for any health coverage plan that is above the threshold of $10,200 for individual coverage and $27,500 for family coverage. It also requires employers to disclose the value of the benefit provided by the employer for each employee’s health insurance coverage on the employee’s annual Form W-2. And lastly, Title X requires employers that offer and make a contribution towards employee coverage to provide free choice vouchers to qualified employees for the purchase of qualified health plans through Exchanges. The Patient Protection and Affordable Care Act reforms the health care system by expanding the availability of health insurance, regulating health insurance coverage, and restructuring health care delivery, including how it is paid for. The bill would reduce the number of uninsured Americans by 31 million, leaving only 6 percent of nonelderly adults uninsured. A number of different mechanisms are used to increase coverage, including expanding Medicaid, which provides insurance to low-income parents and children at very small cost; establishing state-based insurance exchanges with subsidies for low- and middle-income households; requiring individuals to obtain coverage; and mandating that most employers offer health insurance. The new act would make Medicaid available to all individuals earning less than 133 percent of the federal poverty line, or $14,500 a year ($29,500 for a family of four) while improving services for beneficiaries. The Patient Protection and Affordable Care Act also create state-based health insurance exchanges, called Health Benefit Exchanges, which are marketplaces where consumers can shop for and purchase health insurance. The Patient Protection and Affordable Care Act include numerous reforms of the health insurance market, in many cases regulating this market for the first time. The Congressional Budget Office estimates that about 8 million such persons would remain uninsured. Additionally, the bill restricts access to abortion services in the Health Benefits Exchanges and, in particular, for people receiving federal subsidies. The Patient Protection and Affordable Care Act saves money by reducing the cost of premiums that families and individuals pay to maintain their health insurance policies. It also saves money by getting rid of waste in the medical industry by establishing a center where physicians can report waste and by supporting comparison shopping for medical equipment. In addition, the act helps small businesses to save money by giving them the opportunity o offer health benefits to their employees without devastating the budget of their company. The Patient Protection and Affordable Care Act raise revenue by imposing an annual fee on the health insurance sector. Such fees would be imposed on insurance companies that sell high cost health insurance plans. The fee is designed to generate smarter, more cost-effective health coverage choices. The r econciliation bill delays this new fee until 2018 so that plans have time to implement reform and begin to save from its efficiencies. The amount of the fee is $8. 0 billion in 2014, $11. 3 billion in years 2015-2016, $13. 9 billion in 2017, and $14. 3 billion in 2018. According to the Congressional Budget Office (CBO), the legislation will reduce the deficit by $138 billion over the first decade and by $1. 2 trillion in the second decade, as compared to current legislation. The CBO has recalculated its estimates several times, first projecting a savings of $132 billion, then $118 billion, and $143 billion. It also increases the Medicare Hospital Insurance (HI) tax rate by 0. percentage points on an individual taxpayer earning over $200,000 ($250,000 for married couples filing jointly). The revenues from this tax will be credited to the HI trust fund. The taxable base of the HI tax is also broadened by including net investment income. The act would also impose a ten percent tax on amounts paid for indoor tanning services. The tax is effective for services on or after July 1, 2010. Reduces the deficit in the next ten years and beyond. The bill is fully paid for with revenue provisions that focus on paying for reform within the health care system. The Patient Protection and Affordable Care Act 1. Determine how this Federal law will affect market-driven and non-market driven decisions. This federal will affect the marketing aspect of the health care industry regardless if they are driven or not. If the companies are driven and market correctly then they will be able to attract people that are willing to pay for the services they provide. This will cause for private health insurance providers to change the way they provide services. The new marketing strategies will show how they are providing better care for those who have pre-existing conditions. This law will affect how the private health insurance sector markets the different types of services they provide. The companies will have to go back and look at how they are marketing their services to get the clients they want to attract. If they are market driven then they will market things that are more appealing to the clientele they currently serve or want to be serving, this could involve free health screening, more bang for their bucks, and the opportunity to understand all that the company offers to its insured. Some will be more ambitious to provide new marketing ideas to keep current clients and attract new ones while others might hate change and move slower towards new ideas. This will cause them to either loose current clients and not attract new ones. 2. Describe the circumstances at which you would prepare a strategic plan to include this new law in your marketing decisions, knowing this new law may or may not take effect. I would focus more on the issue of providing current policy holders that currently have pre-existing conditions with better options to health care. I would try to incorporate lower premiums or not charge them as much as competing insurance companies do. I would advertise free screening to all my customers and guarantee coverage. I would sit down with each of my potential policy holders and explain to them the ins and outs of what we offer and what would benefit them. I would want them to feel cared about and not just another policy number. They would feel comfortable coming to us with questions or concerns they may have about their policy. I would provide an around the clock support line just in case they came across a situation where they needed guidance. Also something that would be extremely important would be to have a website where all the needed forms can be accessed and they would also have access to their account information online. My marketing strategy would emphasize on family and hospitality, since that’s what’s most important to people. 3. Discuss how each of the five (5) environmental forces will be affected by the new law, which you believe will be the most affected and why. -Jockeying for position among current competitors. This is the aggressive competition between current firms or companies, the fact that these insurance companies will spend so much on having the best marketing strategy will cause the return compensation to be low. This is because they spend so much money on marketing and competing with its opponents. -Threat of new entrants. Since the new law applies to everyone that means everyone will most likely have to start from scratch or updater their antics. If it’s easy for new comers to come along and get their program up and running, the competitions between the difference companies will only become fiercer. Some barriers of entries for the new comers are if existing customers can trust their current companies, or if there are elevated fixed rates or not enough access to resources. -Bargaining power of customers. If the consumers can produce enough force to affect how many boundaries and capacity they can create, then they hold an incredible amount of power. Reasons why the consumers can have so much power is if they buy large amounts of the products being sold, if the company doesn’t have very many clients, or if they have the opportunity to change companies due to products eing so easy to come about. -Threat of substitute products or services. Depending on whether or not the cost of changing up providers is low and more efficient will determine if substituting is necessary. If the insurance companies are marketing the same products and services that one is already using depending on which more is appealing to the purchaser will determine who gets the service. -Bargaining power o f suppliers. If these insurance companies can produce enough force to affect how many boundaries and capacity the companies can create, then they hold an incredible amount of power. Reasons why the companies can have so much power is if there are limited or no alternates, not many companies with products of interest, or they have something of extreme interest to the buyers and they can’t go without it. I think the rivalry between the current firms will be affected the most, because they will be so wrapped up in their marketing strategy and trying to be the best that they won’t really notice how much money they are spending on the project. Once it starts to show that they are actually losing more money than they are making then it will be too late and another company would have come in and stolen the pie. 4. Describe one (1) new target audience and include the characteristics of their demographic and psychographic profiles. The new target audiences the insurance companies are focused on are lower middle income families instead of higher income families. They base this on income brackets, which neighborhoods theses potential clients live in blue collar workers versus white collar workers. Some companies only serve them through current employment under business aspects. Another target audience is expecting women; the insurance companies are looking to insure the baby as soon as it’s born. This way they can collect premiums on the infants from the start of their lives, while insurance policies for them are extremely high. They also allow young people to be insured who are likely to die soon due to illnesses in their families and based on current health conditions. This way they can assemble the premiums and not have to pay out so much money in the process. The Patient Protection and Affordable Care Act Davis Weiss The Patient Protection and Affordable Care Act is a federal statute that was signed into law in America by President Barack Obama on March 23, 2010. It is divided into 10 titles. The bill contains provisions that will go into effect on June 21, 2010 and September 23, 2010. Also, the additional provisions will go into effect in 2014. Title I of H. R. 3590 will ensure quality affordable health care for all Americans by eliminating discriminatory practices by health insurers such as pre-existing condition exclusions. Title I also extends dependant coverage up to age 26, caps insurance companies non-medical expenses, and prevents unfair termination of insurance policies. Title II expands eligibility for Medicaid to lower income persons and assumes federal responsibility for much of the cost of this expansion. These bills provide enhanced federal support for the Children’s Health Insurance Program, simplify Medicaid and CHIP enrollment, and improve Medicaid services. Title III will strengthen the quality of healthcare by establishing The Physician Quality Reporting Initiative (PQRI) which is a value-based purchasing program for hospitals that link Medicare payments to quality performance. Title IV puts into place a new interagency council to promote healthy policies and to establish a national prevention and health promotion strategy. Title V will encourage innovations in health care workforce training, recruitment, and retention, and will establish a new workforce commission. Title VI creates new requirements to provide information to the public on the health system and promotes a newly invigorated set of requirements to combat fraud and abuse in pubic and private programs. Title VII allows certain hospitals and treatment centers to receive discounted and/or generic drugs to aid their budget. Title VIII establishes a new, voluntary, self-funded long-term care insurance program, the Community Living Assistance Services and Support (CLASS) Independence Benefit Plan, for the purchase of community living assistance services and supports by individuals with functional limitations. No taxpayer funds will be used to pay benefits under this provision. Title IX levies an excise tax of 40 percent on insurance companies and plan administrators for any health coverage plan that is above the threshold of $10,200 for individual coverage and $27,500 for family coverage. It also requires employers to disclose the value of the benefit provided by the employer for each employee’s health insurance coverage on the employee’s annual Form W-2. And lastly, Title X requires employers that offer and make a contribution towards employee coverage to provide free choice vouchers to qualified employees for the purchase of qualified health plans through Exchanges. The Patient Protection and Affordable Care Act reforms the health care system by expanding the availability of health insurance, regulating health insurance coverage, and restructuring health care delivery, including how it is paid for. The bill would reduce the number of uninsured Americans by 31 million, leaving only 6 percent of nonelderly adults uninsured. A number of different mechanisms are used to increase coverage, including expanding Medicaid, which provides insurance to low-income parents and children at very small cost; establishing state-based insurance exchanges with subsidies for low- and middle-income households; requiring individuals to obtain coverage; and mandating that most employers offer health insurance. The new act would make Medicaid available to all individuals earning less than 133 percent of the federal poverty line, or $14,500 a year ($29,500 for a family of four) while improving services for beneficiaries. The Patient Protection and Affordable Care Act also create state-based health insurance exchanges, called Health Benefit Exchanges, which are marketplaces where consumers can shop for and purchase health insurance. The Patient Protection and Affordable Care Act include numerous reforms of the health insurance market, in many cases regulating this market for the first time. The Congressional Budget Office estimates that about 8 million such persons would remain uninsured. Additionally, the bill restricts access to abortion services in the Health Benefits Exchanges and, in particular, for people receiving federal subsidies. The Patient Protection and Affordable Care Act saves money by reducing the cost of premiums that families and individuals pay to maintain their health insurance policies. It also saves money by getting rid of waste in the medical industry by establishing a center where physicians can report waste and by supporting comparison shopping for medical equipment. In addition, the act helps small businesses to save money by giving them the opportunity o offer health benefits to their employees without devastating the budget of their company. The Patient Protection and Affordable Care Act raise revenue by imposing an annual fee on the health insurance sector. Such fees would be imposed on insurance companies that sell high cost health insurance plans. The fee is designed to generate smarter, more cost-effective health coverage choices. The r econciliation bill delays this new fee until 2018 so that plans have time to implement reform and begin to save from its efficiencies. The amount of the fee is $8. 0 billion in 2014, $11. 3 billion in years 2015-2016, $13. 9 billion in 2017, and $14. 3 billion in 2018. According to the Congressional Budget Office (CBO), the legislation will reduce the deficit by $138 billion over the first decade and by $1. 2 trillion in the second decade, as compared to current legislation. The CBO has recalculated its estimates several times, first projecting a savings of $132 billion, then $118 billion, and $143 billion. It also increases the Medicare Hospital Insurance (HI) tax rate by 0. percentage points on an individual taxpayer earning over $200,000 ($250,000 for married couples filing jointly). The revenues from this tax will be credited to the HI trust fund. The taxable base of the HI tax is also broadened by including net investment income. The act would also impose a ten percent tax on amounts paid for indoor tanning services. The tax is effective for services on or after July 1, 2010. Reduces the deficit in the next ten years and beyond. The bill is fully paid for with revenue provisions that focus on paying for reform within the health care system.