Key Policy Issues-Affordable Care Act

Key Policy Issues-Affordable Care Act

Affordable Care Act Integration

The Affordable Care Act, also known as Obamacare, is a health care reform policy passed in March 2010. The goal of this policy included making available affordable health insurance to many individuals in the U.S. by providing subsidies (premium tax credits) that reduce expenses for households whose incomes range between 100% and 400% according to the federal poverty level (Cassella, 2021). This law also aimed to expand the Medicaid program to cover all adults whose income was 138% and below according to the federal poverty law. This expansion was primarily known as Medicaid expansion. However, it is found that not all states in the U.S. have chosen to be part of Medicaid expansion. States that have been reluctant to accept Medicaid expansion are 12, including Mississippi, Tennessee, Texas, Kansas, Wisconsin, and South Dakota. Wyoming, South Carolina, North Carolina, Georgia, Florida, and Alabama (Cassella, 2021). This implies that for an individual to qualify for the Medicaid program in any of these states, they must be determined as disabled or have minor children in their homes and have extremely low or no income per month (Cassella, 2021).

Lastly, the law’s other primary goal is to support inventive medical delivery approaches designed to reduce the costs of health care generally. Casella (2021) acknowledges the fact that ACA has managed to address the issue of pre-existing conditions. Prior to the implementation of ACA, insurance companies denied people coverage, pretending that they had pre-existing conditions. After the policy was passed, the health insurance companies could not refuse coverage or charge patients more because of pre-existing conditions, which means a health condition that one may have before the new coverage started. The main component of the ACA is integrating behavioral health, primary health, and related services in a new national program (Kuramoto, 2014). This paper will discuss the policy issue of ensuring social workers are frontline health providers to achieve ACA integration.

Social Workers and ACA

The National Association of Social Workers (NASW) is currently working on ACA integration with Congress, involving social workers as the frontline healthcare providers. Since ACA is very ambitious and proactive, it is crucial to consider how the unique knowledge and skills of social work and other healthcare professions fit with the goals and objectives of ACA. An integrated strategy is required to maximize the potential of ACA to enhance the health of the people of America.

First, it is situated in social work that people are in social contexts where they live. According to Andrews et al. (2013), social workers comprehend that people are part of social networks, communities, and neighborhoods that affect their health choices and involvement in health care. This gives insight into the health outcomes and behaviors needed to achieve population health goals.

Second, like other healthcare professionals, social workers comprehend the association between employment, education, health, and other systems that create the connection from which resources can be drawn in the protection, maintenance, and restoration of health. They are knowledgeable about the overlapping and complex systems that should be negotiated to guarantee that groups’ and individuals’ economic, psychological, and social needs are met in a manner that underscores optimal health (Andrews et al., 2013). For example, social workers are good at ensuring that patients have what they need from various systems after discharge from the hospital. They are also good at ensuring that discharge guidelines are comprehended and that resources are disposed to ensure adherence to those instructions. With this knowledge, unnecessary readmission is avoided, which consequently saves the ACA financial penalties.

Third, social work is under the guidance of an evidence base that is informed by thorough research in collective wisdom and communities gleaned from years back of social work practice. According to Andrews et al. (2013), what is important is the research that social workers do to understand physical health and mental health interaction in enhancing or impeding patients’ operation and participation in healthcare treatment. They often establish procedures based on their understanding of how physical and psychological health interact and can be helpful in ensuring that communication happens underlying sustained and optimal wellness and functioning. Moreover, evidence-based social work starts where groups and individuals are culturally sensitive and health literacy sensitive (Andrews et al., 2013). This assists in ensuring that the recommendations for care management and disease prevention are comprehended and that families and patients can follow instructions when the individuals get sick.

Lastly, it is expected and apparent that many Americans will still not be covered after the institution of ACA, like the case of many states that have not accepted Medicaid expansion. Historically, social workers have focused their services on groups that are disenfranchised, inclusive of those without stable places in society, those who do not have housing, those who have irregular or no contact with the health system, and those who have no access to other services that are considered fundamental (Andrews et al., 2013). Through their professional ability to work with communities when it comes to research, social workers will be presented the opportunity to work with groups that are disenfranchised who are likely to be left uncovered in this post-health reformation by ACA due to unwillingness to participate in the system, state choices, inability to pay and resident status. Therefore, social workers will assist in promoting wellness among these communities that would otherwise not be covered or ignored by the ACA.

 ACA Integration Solutions

Since social workers have not been integrated into the policy, NASW is currently working with Congress to provide policy solutions, are discussed below. The first solution that NASW has proposed is to include social workers as indispensable healthcare team members in coordinated care models inclusive of patient-centered health homes and medical homes. The second solution is promoting the social workers’ role as administrators, managers, and providers of behavioral health services. Working with Congressional delegations, state regulators and legislators, NASW chapters, and concurring stakeholders would also be essential to promote Medicaid expansion and increase access to high-quality behavioral health services, especially for groups with low-income levels (NASW 2021). The other solution is to enforce and monitor provisions of Mental Health Parity to guarantee that all consumers have equal access to health insurance coverage for substance use disorder and mental health services. Lastly, NASW aims to work with the Patient-Centered Outcomes Research Institute and the Centres for Medicare & Medicaid Innovation in the analysis of workforce patterns, inclusive of social work staffing, when it comes to pilot programs as well as to dedicate their funds to the programs that include social workers in behavioral and mental health roles as well as care coordination.

Conclusion

The ACA has invested heavily in care delivery models that seek to reduce healthcare costs and enhance patient outcomes via greater integration of primary care, acute care, and other community-based services. The demonstration projects of ACA that involved accountable care organizations and health homes provide an opportunity for social workers to utilize their knowledge and skills in care coordination, behavioral health integration, mental health integration, and patient navigation. To be more successful, ACA and its involvement in accountable care organizations and health homes will have to depend heavily on the skill set of social workers. According to Collins (2013), social workers that are involved in these models, as care coordinators, behavioral health clinicians, or mental health clinicians, are also best positioned to advocate for the use of measures of qualitative outcomes to gauge the well-being and satisfaction of the patients. Therefore the involvement of social workers in ACA integration as frontline health providers will go a long way in helping the law achieve its primary goals and objectives as well as address the challenges that the disenfranchised groups face, which may not be addressed by the ACA.

References

Andrews, C. M., Darnell, J. S., McBride, T. D., & Gehlert, S. (2013). Social work and implementation of the Affordable Care Act. Health & Social Work, 38(2), 67-71.

Cassella, K. (2021). Social Welfare and Policy II. Eastern Gateway Community College.

Collins, S. (2013). Strategies for strengthening health care social work in the health reform era Practice Perspectives (Vol. June 2013). Washington, DC: The National Association of Social Workers.

Kuramoto, F. (2014). The Affordable Care Act and integrated care. Journal of Social Work in Disability & Rehabilitation, 13(1-2), 44-86.

National Association of Social Workers- NASW (2021). Affordable Care Act Integration. https://www.socialworkers.org/Advocacy/Policy-Issues/Affordable-Care-Act-Integration

ORDER A PLAGIARISM-FREE PAPER HERE

We’ll write everything from scratch

Go to the following link: https://www.socialworkers.org/advocacy/policy-issues

This link will show you the key policy issues NASW is currently working on with Congress. Take some time looking over the 7 key policy issues. After familiarizing yourself with them all, choose one to complete your final paper on. Assume the person reading your paper has absolutely no idea what your key policy issue is or why it is so important (framing this way should guide you while writing it).

Key Policy Issues-Affordable Care Act

Assignment Guidelines: Please complete in APA format that includes a title page, a reference page if external sources are used, in-text citations, quotation marks around direct quotes from external sources while also acknowledging the author of the quote/statement, written in 12 pt font double-spaced.