This assessment of governance approaches for academic medical centers (AMCs) helped the University of California respond to changes in the funding environment and provides a systematic way for any AMC to weigh the strengths and weaknesses of its governance approaches..
Newly insured patients through the Affordable Care Act coverage expansion may change how civilian providers interact with the TRICARE program. Some physicians may face financial incentives to drop TRICARE patients for newly insured patients.
Americans expect affordable coverage for pre-existing conditions, access to routine services, and protection from unpredictable and significant financial risk from accidents or illness. As a product designed primarily for risk protection, insurance may not be the most efficient or affordable approach to achieving all of these objectives.
Proposals to repeal or replace the federal Affordable Care Act would likely increase the demand for service in the Veterans Affairs medical system, while also increasing the number of veterans who have no insurance coverage at all.
The American Health Care Act would increase uninsurance among veterans and demand for Department of Veterans Affairs care by a greater margin than simply returning to pre–Affordable Care Act levels of coverage.
Recent congressional proposals to repeal and replace the Affordable Care Act would increase the number of uninsured nonelderly veterans and further increase demand for VA health care. The effects would vary across states, but the largest impacts would be felt in states that expanded Medicaid.
This analysis of the dependent coverage expansion under the ACA suggests that historical trends rather than the insurance expansion itself account for increases in substance use among people ages 19-25 since 2010.
While the ACA's Dependent Coverage Expansion has increased insurance coverage, it has also widened race/ethnic disparities because it benefits only those young adults whose parents have private coverage.
Over one-third of states appear to have more stringent medical privacy laws than HIPAA (federal), which could hinder primary care and mental health providers' efforts to share information and integrate care.
Despite their differences, the Affordable Care Act and the current proposals to replace it take a similar approach to providing health insurance. What might some alternatives look like? And how could they provide coverage to more Americans?
The American Health Care Act would guarantee that individuals with pre-existing conditions could enroll in insurance even if they had a coverage lapse. But there is no guarantee that this coverage would be affordable, and coverage of some essential health benefits could be excluded.
The American Health Care Act passed by the U.S. House of Representatives to repeal and replace the Affordable Care Act allows states to waive benefits that the ACA deemed “essential.” Dropping maternity care coverage, for example, would reduce premiums by 5 percent but increase out-of-pocket spending for new mothers.