Michael Maddalena X02102615 10/19/2011 The Patient Protection and Affordable Care Act and Its Components

Dr. Robert Mangione PAS 2301

The Patient Protection and Affordable Care Act (PPACA) was passed by Congress and was signed into law by President Barack Obama on March 23, 2010. The federal statute initiated a reform program which includes numerous provisions that will, over the course of a decade, amend certain aspects of the private health insurance industry and public health insurance programs. The ultimate goal is to bring health care insurance to every American, with overall minimal investment. This 940 billion dollar program is projected to reduce the countrys deficit by more than 100 billion dollars over the next decade, and one trillion dollars over the next 20 years. 1 The Act is divided into 10 different parts, each being enacted at a different set date over the next 10 years. Since the PPACA was signed into law, numerous insurance plans have become available, each with certain components that provide the best assistance possible for the patient. Despite the increase in insurance plans available, patients covered by employer-provided insurance, those whose earnings exceed the 400% poverty level and illegal immigrants are not able to be covered by these programs. 2 These insurances also cannot deny coverage to children (and adults starting in 2014) with pre-existing health conditions and children will now be covered under their parents till the age of 26 or when they finish college. All of these new laws

are an attempt to reduce the doughnut hole or coverage gap. By 2020, this coverage gap should be closed entirely. Anyone who does not buy insurance by the year 2014 will be fined roughly $700 a year. Exceptions may be made for those who are economically disadvantaged. Businesses that employ more than 50 persons must also provide insurance for their employees, lest they be fined $2000 per employee (after the 30th employee).3 Tax credit would be given to participating businesses to help cover the cost of insurance. Despite the overall initial cost of this new Healthcare program (between 2011 and 2019, drug manufactures will have to pay the government a total of $16 billion and insurance companies will have to pay the government $47 billion due to readjusted taxes) 4, it is believed that these new strides in U.S. Healthcare will circulate more money into the economy. A board would also be created to think up strategies that would make this initiative more efficient and less costly throughout the 20 year process. Up until recently, many non-insured individuals would refuse to go to the doctor, even for the most trivial of illnesses. Overtime, these trivial illnesses became serious medical conditions and patients would become severely sick and end up in the hospital, an expensive endeavor. I strongly believe that patients feel more comfortable going to their doctor for checkups and other problems now that they do not have to fear an expensive copayment due to a lack of proper insurance.

Pharmacies and pharmacists will also benefit by the PPACA. Due to more patients visiting their respective doctors, the national script volume will increase, positively affecting pharmacists. In response to the influx of prescriptions, new stores and positions will become available. I believe that this will cause the profession of pharmacy to expand greatly. Overall, the responsibility of the pharmacist would also increase. In an ideal pharmacy, the pharmacist would council each and every patient, however, with the amount of prescriptions pharmacies fill daily, counseling every patient would prove inefficient and cost ineffective. Now, pharmacists may possibly receive grants for performing some type of medication management service, such as counseling in disease management and immunizations, and assisting a patient in organizing a schedule to take their medication in the most safe and effective manner possible (even though pharmacists provide this service already, free of charge). Offering the grant will entice the pharmacists to become more involved in the patients healthcare, keeping the patient out of the hospital and preventing the patient from making unnecessary trips to the doctor, thus, saving the patient and their insurance provider, money. Despite all of ways the PPACA benefits the health industry, how the program is being financed leaves a lot to be desired. Money is being demanded from pre-existing insurance companies and taxes are being raised for the wealthy5. Wealthy business owners cannot expand their businesses or hire more workers due to the tax increases and many insurance companies will have to lay off workers in order to make the expected payment. Actions like these can cause an even further divide between the economic classes.

Another aspect of the PPACA that faces a great deal of opposition is the proposed cut in Medicare spending. Medicare provides health insurance for the elderly, insurance that the patient has paid into their whole life. By cutting down spending on Medicare, the price of insurance premiums, out-of-pocket prescription drug expenses, and prescription drug premiums will increase for those under Medicare.6 Not only is this unfair to the aged members of society, it shows that we, as Americans, disregard their past, present, and future contributions to the nation. The PPACA was signed into law in March of 2010, and will continue to change the American medical industry over the next 10 years. With the overall goal of insuring every American citizen; more prescriptions will be written due to the influx of new patients eligible for drug coverage. With this increase in prescriptions, more pharmacists will be needed to fill them; and with the increase in pharmacists, the role the pharmacy plays in a community will be even greater. While the PPACA has its strengths, weaknesses, advocates, and critics, as a pharmacist-in-training, I strongly believe that we, as a nation, are moving in a healthy direction.

Works Cited 1.Galewitz, Phil. "Consumers Guide To Health Reform - Kaiser Health News." Kaiser Health News. The Kaiser Family Foundation, 13 Apr. 2010. Web. 19 Oct. 2011. <http://www.kaiserhealthnews.org/Stories/2010/March/22/consumers-guide-healthreform.aspx>. 2."US Health-care Reform: Victory, at Last : The Lancet." TheLancet.com - Home Page. Elsevier Inc., 3 Apr. 2010. Web. 19 Oct. 2011. <http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(10)60495-3/fulltext>. 3.Mandelbaum, Robb. "How the Health Care Law Affects Your Business - NYTimes.com." Small Business Blog - You're the Boss Blog - NYTimes.com. The New York Times, 31 Mar. 2010. Web. 19 Oct. 2011. <http://boss.blogs.nytimes.com/2010/03/31/how-thehealth-care-law-affects-your-business/>. 4.Grier, Peter. "Health Care Reform Bill 101: Who Will Pay for Reform? - CSMonitor.com." The Christian Science Monitor - CSMonitor.com. The Christian Science Monitor, 21 Mar. 2010. Web. 19 Oct. 2011. <http://www.csmonitor.com/USA/Politics/2010/0321/Health-care-reform-bill-101-Whowill-pay-for-reform>. 5.Dubay, Curtis. "Tax Increases in the Patient Protection and Affordable Care Act."Conservative Policy Research and Analysis. The Heritage Foundation, 20 Jan. 2011. Web. 28 Oct. 2011. <http://www.heritage.org/research/reports/2011/01/obamacare-and-new-taxesdestroying-jobs-and-the-economy>. 6."70% of Seniors Think PPACA Will Hurt Medicare Benefits The Extend Health Blog." The Extend Health Blog. Extend Health, 11 Mar. 2011. Web. 30 Oct. 2011. <http://extendhealth.wordpress.com/2011/03/11/70-of-seniors-think-ppaca-will-hurtmedicare-benefits/>.