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OBAMACARE: Quick overview of the changes that went into effect January 1, 2014 due to the Affordable Care Act

The four principal changes that went into effect as of January 1, 2014, are described in this brief opinion piece published online first in JAMA: The Journal of the American Medical Association.  These four changes include:

  1. Individuals can no longer be denied the ability to buy health insurance based on preexisting medical conditions.
  2. Individuals who can afford it must either buy health insurance or pay a tax penalty.
  3. Low income individuals receive support in the form of federal tax credits to help buy insurance.
  4. Medicaid has been expanded in half of the states in the union — the other half have not implemented this option.

Source: McDonough, J.E., and Adashi, E.Y.  Realizing the promise of the Affordable Care Act: January 1, 2014.  JAMA, Jan. 2, 2014.  Click here for full text: http://jama.jamanetwork.com/data/Journals/JAMA/0/jvp130192.pdf  Posted by AHA Resource Center (312) 422-2050, rc@aha.org

How will health reform affect the physician supply?

A recent Congressional Research Service report looks at the physician supply and how the Affordable Care Act may affect it. The adequacy of the physician supply is examined from three dimensions: its size, composition [primary care vs specialties], and its geographic distribution.

The provisions of the Affordable Care Act that may impact physician demand are also reviewed; these include changes in physician training, compensation, and practice. How these ACA provisions will ultimately affect the physician supply is not yet known because the provisions are temporary or not yet implemented, will not have immediate effects, or rely on discretionary spending.

While the answer to the question about how health reform will affect the physician supply is still murky, the report provides useful background information. It concludes:

“The current and future physician supply may be inadequate. Some experts suggest that there are too few physicians overall, too few primary care physicians specifically, and that physicians are inadequately distributed throughout the United States. The ACA may intensify some of these concerns…[but] it is not yet known whether and how these provisions will affect physician supply.”

Source: Heisler EJ. Physician supply and the Affordable Care Act. Congressional Research Service, Jan. 15, 2013. http://op.bna.com/hl.nsf/id/myon-93zpre/$File/crsdoctor.pdf

Related Sources:

Huang ES and Finegold K. Seven million Americans live in areas where demand for primary care may exceed supply by more than 10 percent. Health Affairs 32(3):1, Mar. 2013. http://content.healthaffairs.org/content/early/2013/02/19/hlthaff.2012.0913.full.pdf+html

Petterson SM and others. Projecting US primary care physician workforce needs: 2010-2025. Annals of Family Medicine 10(6):503, Nov/Dec 2012. http://annfammed.org/content/10/6/503.full.pdf+html

Recent studies and reports on physician shortages in the US. Center for Workforce Studies, Association of American Medical Colleges, Oct. 2012. https://www.aamc.org/download/100598/data/recentworkforcestudies.pdf

Posted by AHA Resource Center (312) 422-2050, rc@aha.org

US: Health insurance marketplace opens October 1, 2013

There are members of my family — perhaps yours as well — who would be interested in an overview of the new Health Insurance Marketplace, a.k.a. exchanges, opening October 1, 2013.  The exchanges will offer a way to buy private insurance coverage that will start beginning January 2014.  There is an article posted online today in JAMA, written by Dr. Howard Koh, who is the Assistant Secretary for Health at the US Department of Health and Human Services and Marilyn Tavenner, who is the Acting Administrator for the Centers for Medicare & Medicaid Services — so it’s authoritative.  They provide information about options for low-income individuals and families, as well.

There is a website, of course, at http://www.healthcare.gov, and it is already populated, so I took a look.  I liked the snappy little video:  What Is the Health Insurance Marketplace? http://www.healthcare.gov/videos/2013/01/health-insurance-marketplace.html (short video)

Source: Koh, H., and Tavenner, M.  Connecting to health insurance coverage.  JAMA, Apr. 15, 2013.  Click here for free full text: http://jama.jamanetwork.com/data/Journals/JAMA/0/jama.2013.3469.pdf  Posted by AHA Resource Center (312) 422-2050, rc@aha.org

Tracking State Legislation on Federal Health Reform Implementation

The passage of the federal Affordable Care Act last year created a sizable to-do list for state action. The National Conference of  State Legislatures has created a database tracking the status of state legislative progress addressing the health reform law requirements. Relevant state legislation can be tracked in the database by state, topic, legislative status, and key sponsor. Searchable topics include:

  • Authorize/Plan/Fund
  • Challenging and Alternatives
  • Health Information Technology
  • Health Information Exchanges [HIE]
  • Health Insurance Reform
  • Medicaid
  • Prevention and Wellness
  • Workforce and Providers
  • Other

Source: Federal health reform: state legislative tracking database. Denver, CO:  National Conference of State Legislatures, 2011+ http://www.ncsl.org/research/health/new-health-reform-database.aspx