The Debate Surrounding Health Care Administration and Reform Continues

Guest blogger Cheryl Jacque is a contributing researcher and writer to the online health administration resource The Health Administration Project. Today, Cheryl examines what health care reforms mean to health care administration and its clients, including women that are now eligible to receive certain services without being charged co-pay fees.

As many estimate that health care in the US could soon rise to 20% of GDP spending, lawmakers have been debating a massive overhaul of the entire system. Passed in 2010, the Affordable Care Act (ACA) estimates that its reforms will allow 32 million more Americans to receive insurance. Although many of these changes are already underway, debate continues on how to best care for the country’s large and uniquely diverse population.

For many struggling American families, the ACA undoubtedly offers many appreciated benefits. Under the new regulations, those with family plans can keep their children covered until age 26 regardless of marital status, student status, living situation, or if they have a pre-existing condition. As increasing numbers of young people are graduating from college without immediate job prospects, parents and their children are collectively breathing a sigh of relief knowing they can remain covered while looking for work in a struggling market.

This measure has increased the number of insured Americans aged 19 to 25 from 64% to 73% between 2010 and 2011, suggesting that while the US health care crisis has not yet been solved, some actions are having a positive affect.

One of the most controversial aspects of the health plan has been the changes to Medicare, which don’t begin til 2014. Under some Medicare drug plans, after an individual’s drug plan has spent a certain amount of money for covered drugs, the individual is responsible for paying the full costs of prescription drugs until they reach the amount required for catastrophic care coverage, a period widely referred to as the coverage gap, or “donut hole.” While the Affordable Care Act is making an effort to shrink the coverage gap, it won’t be fully closed until 2020, a fact that the plan’s opponents continue to criticize.

Perhaps the most surprising group to see major changes in coverage is also the largest. Beginning this past summer, all women were given assured access to preventative health services and are no longer subject to additional insurance fees and charges. These services will include annual visits to doctors, AIDS virus screening and counseling about sexually transmitted infections, breastfeeding supplies, and even screening and counseling services for domestic violence. Women aged 30 and over will be offered even more services, including DNA testing for the human papilloma virus, which can lead to cervical cancer. In addition, beginning in 2014, insurers will no longer be allowed to charge women higher premiums than men. It is estimated that these additional preventative services will save millions annually.

The final aspect of the health care bill that is causing opponents, like the CEO of Papa John’s pizza, to declare reform akin to socialism is that all companies with more than 50 employees will be subject to fines if they do not provide their employees with health insurance. Many industry analysts say this will cost companies millions annually and will continue to give the United States a reputation that is unfriendly towards business interests.

Health care reform is still a work in progress. While the Affordable Care Act provides coverage at lowered rates to millions who would otherwise go uninsured, the coverage gap in Medicare illustrates that there will still be those that do not receive the care they need. Many also argue that until Americans begin to make health decisions, health care will always be expensive, and this reform still fails to address that.


  1. Great post! If I were a betting woman, I’d say Papa John won’t be going bust anytime soon (nor will his anti-choice pizza buddy Mr. Domino’s) but a woman can hope … I know business owners are in a bind, especially real small business owners–which, I’m sorry, Papa John is not! (If you can afford national television commercials you ain’t small.)
    But I don’t see any way to improve the system except by legislating it. As Papa so plainly shows, neither business owners nor insurance companies are going to do anything for the greater good on their own.

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