This year will likely make or break the Affordable Care Act as it faces a Challenge in the Supreme Court, a repeal and replace effort by the House of Representatives, numerous funding questions and finally a political election where it will be a central issue. Businesses will continue to see rising insurance costs, individuals may see less take-home pay as their premiums continue to rise, and they may be asked to pay a larger percentage of said premium.
This writer would have a better chance beating Lebron James in a game of Horse, than ever coming close to scratching the surface of the challenges this country faces on this subject. A national effort is probably the best hope of truly fixing the problem, but unfortunately people are too busy talking at each other instead of with each other. Nevertheless, below are five timely challenges that we are going to face as a nation regarding health care in the short an mid-term.
- Health care reform lags at the State level. Twenty-six states are challenging the law, and many have adopted a “wait and see” approach which could prove problematic. States have enormous responsibilities to set up health insurance exchanges, expand their Medicaid programs to cover more individuals, and others. Another problem is that nearly ¾ of the people who are uninsured live in states that are lagging behind on implementing the ACA.
- Annual health care costs continue to increase. There was some good news as cost increases slowed this year, but experts attribute this to the fact that many Americans forgo medical treatment due to financial hardship from the continued economic downturn. Spending on healthcare has reached an all-time high, and this is expected to continue to grow at rates faster than the economy, eventually consuming a larger share of the economy as measured by GDP.
- We still have 46 million people who were without health insurance at some point last year. While getting these people covered will be a long-term benefit, coverage only guarantees coverage, not access to quality care longer and wait times may persist.
- Workforce issues must be addressed as well. The ACA included funding for loan forgiveness, and other incentives to encourage individuals to practice primary care in rural and under-served areas. There is expected to be a shortage of 40,000 physicians, and when you couple this with a bunch of new people with insurance you can see how there could be some problems.
- The final challenge will be budget cuts, particularly their impact on public health, safety net programs, and others for disaster preparedness. States have also been forced to cut their Medicaid programs which is troubling for the beneficiaries. Other programs to help with the looming workforce shortages are threatened in the short term, and more budget cuts are coming.
An exciting year indeed so check back soon. My New Year’s resolution will be more content on this site, and exciting projects are coming for this site in the next few months.