Статті в журналах: "Patient Protection and Affordable Care Act 2010"

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Sun, Gordon H., and Matthew M. Davis. "The Patient Protection and Affordable Care Act of 2010." Otolaryngology–Head and Neck Surgery 146, no. 5 (January 26, 2012): 690–93. http://dx.doi.org/10.1177/0194599811435967.

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Carrigan, Martin D. "The Patient Protection And Affordable Care Act Of 2010: Constitutional?" American Journal of Health Sciences (AJHS) 3, no. 1 (December 22, 2011): 75–82. http://dx.doi.org/10.19030/ajhs.v3i1.6756.

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After decades of debates and policy discussions, in early 2010, the Obama Administration, with the Democrat party controlling both the House and the Senate, passed a National Health Insurance Act. The Patient Protection and Affordability Act was immediately challenged in court. One district court in Florida declared it unconstitutional. Two other district courts and an appellate court declared it constitutional. This paper looks at the Act and those issues.

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K. Quaye, Randolph. "The Patient Protection and Affordable Care Act (ACA) of 2010 and Ohio physicians." Leadership in Health Services 27, no. 2 (April 28, 2014): 116–25. http://dx.doi.org/10.1108/lhs-10-2012-0037.

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Purpose – This paper aims to explore the perspectives of Ohio physicians on the Patient Protection and Affordable Care Act (ACA) of 2010. While much has been debated about ACA, relatively few studies have focused on how ACA will impact on physicians' practice behavior. Design/methodology/approach – The research data came from a mailed survey of ninety physicians randomly selected from the Cigna Directory of Physicians practicing in Ohio. Study examined how informed were physicians about ACA, and explored how much the effect of ACA has been discussed in their practice, how they think ACA will impact their practice, and whether or not they are in favor of the provisions under the Act. Findings – Overwhelmingly, while the physicians surveyed were familiar with the specific provisions of ACA, almost half of them opposed it. Primary care physicians reported generally favorable opinions about ACA. All but one of the physicians concluded that ACA, much like managed care provisions, has undermined and will continue to reduce the autonomy and professional independence of physicians. Research limitations/implications – This study is limited by its small sample and reliance on a small set of physicians. Practical implications – This study has practical implications for examining how Ohio physicians are responding to the new health care reform in the United States. It has broader implications for addressing the problem of the uninsured and the role of the federal government in health care provision. Social implications – If physicians are opposed to this reform as the study seems to suggest, it might have broader implications for future career aspirations for physicians. Originality/value – So far as we can tell, there has not been any exploratory study in Ohio examining the perspectives of physicians on ACA.

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Castañeda, Heide, Nolan Kline, Mackenzie Rapp, Nicole Demetriou, Naheed Ahmed, Isabella Chan, Theresa Crocker, et al. "Assessing the 2010 Affordable Care Act: Perspectives of Future Health Care Professionals." Practicing Anthropology 33, no. 4 (September 1, 2011): 44–48. http://dx.doi.org/10.17730/praa.33.4.u3p33804m56un505.

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In March of 2010, President Obama signed into law the Patient Protection and Affordable Care Act and the Health Care and Education Reconciliation Act (known together as the Affordable Care Act or ACA). The largest legislative overhaul of the US health care system since the expansion of the Social Security Act in the 1960s, it invoked a fierce national debate about the elements required for reform. Many of the ACA's provisions do not take effect until 2014, creating a unique liminal space after passage but before implementation in which uncertainties and anxieties are expressed. This gulf between the intentions of policy and the results of implementation can lead to productive moments of investigation. Since they will undoubtedly be impacted by this legislation, this research examined the perspectives of future healthcare professionals who will enter the workforce around the time the ACA is fully implemented.

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Thompson, Denise K., Mary Jo Clark, Lois C. Howland, and Mary-Rose Mueller. "The Patient Protection and Affordable Care Act of 2010 (PL 111-148)." Policy, Politics, & Nursing Practice 12, no. 3 (August 2011): 175–85. http://dx.doi.org/10.1177/1527154411424616.

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Manchikanti, Laxmaiah, and Joshua A. Hirsch. "Patient Protection and Affordable Care Act of 2010: a primer for NeuroInterventionalists." Journal of NeuroInterventional Surgery 4, no. 2 (April 27, 2011): 141–46. http://dx.doi.org/10.1136/neurintsurg-2011-010036.

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Hasselkus, Amy. "Working With Older Adults: Impact of the Affordable Care Act and Other Trends in Health Care." Perspectives on Gerontology 16, no. 1 (July 2011): 10–17. http://dx.doi.org/10.1044/gero16.1.10.

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Rapidly increasing numbers in our aging population coupled with anticipated changes in reimbursement and health-care delivery have led to policy changes that will be implemented over time. This article will review the Patient Protection and Affordable Care Act of 2010 (ACA) and the Health Care and Education Reconciliation Act and will discuss the impact of health care changes on speech-language pathology practice with older adults.

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Pratt, William Robert, and Jerry D. Belloit. "Hospital costs and profitability related to the Patient Protection and Affordable Care Act." Journal of Hospital Administration 3, no. 3 (May 20, 2014): 100. http://dx.doi.org/10.5430/jha.v3n3p100.

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On March 23, 2010, President Barack Obama signed into law the Patient Protection and Affordable Care Act (PPACA). This law was one of the most controversial and transforming pieces of legislation impacting health care delivery in recent history. The legislation was created in response to rising health care costs and the belief that, in part, cost shifting of indigent uninsured care to paying patients would reduce the overall costs of health care. The recent Supreme Court decision upholding the individual mandate portion of the law is expected to significantly reduce the number of uninsured. Using operational data from 212 hospitals in California, this study examines the anticipated impact on hospital costs, profitability, and some patient outcome benchmarks from the restructuring of health care delivery in the United States by the PPACA.

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Manchikanti, Laxmaiah. "Patient Protection and Affordable Care Act of 2010: Reforming the Health Care Reform for the New Decade." Pain Physician 1;14, no. 1;1 (January 14, 2011): E35—E67. http://dx.doi.org/10.36076/ppj.2011/14/e35.

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The Patient Protection and Affordable Care Act (the ACA, for short) became law with President Obama’s signature on March 23, 2010. It represents the most significant transformation of the American health care system since Medicare and Medicaid. It is argued that it will fundamentally change nearly every aspect of health care, from insurance to the final delivery of care. The length and complexity of the legislation and divisive and heated debates have led to massive confusion about the impact of ACA. It also became one of the centerpieces of 2010 congressional campaigns. Essentials of ACA include: 1) a mandate for individuals and businesses requiring as a matter of law that nearly every American have an approved level of health insurance or pay a penalty; 2) a system of federal subsidies to completely or partially pay for the now required health insurance for about 34 million Americans who are currently uninsured – subsidized through Medicaid and exchanges; 3) extensive new requirements on the health insurance industry; and 4) numerous regulations on the practice of medicine. The act is divided into 10 titles. It contains provisions that went into effect starting on June 21, 2010, with the majority of provisions going into effect in 2014 and later. The perceived major impact on practicing physicians in the ACA is related to growing regulatory authority with the Independent Payment Advisory Board (IPAB) and the Patient Centered Outcomes Research Institute (PCORI). In addition to these specifics is a growth of the regulatory regime in association with further discounts in physician reimbursement. With regards to cost controls and projections, many believe that the ACA does not fix the finances of our health care system – neither public nor private. It has been suggested that the Congressional Budget Office (CBO) and the administration have used creative accounting to arrive at an alleged deficit reduction; however, if everything is included appropriately and accounted for, we will be facing a significant increase in deficits rather than a reduction. When posed as a global question, polls suggest that public opinion continues to be against the health insurance reform. The newly elected Republican congress is poised to pass a bill aimed at repealing health care reform. However, advocates of the repeal of health care reform have been criticized for not providing a meaningful alternative approach. Those criticisms make clear that it is not sufficient to provide vague arguments against the ACA without addressing core issues embedded in health care reform. It is the opinion of the authors that while some parts of the ACA may be reformed, it is unlikely to be repealed. Indeed, the ACA already is growing roots. Consequently, it will be extremely difficult to repeal. In this manuscript, we look at reducing the regulatory burden on the public and providers and elimination of IPAB and PCORI. The major solution lies in controlling the drug and durable medical supply costs with appropriate negotiating capacity for Medicare, and consequently for other insurers. Key words: Affordable Care Act, health care costs, health care regulation, health care reform, Patient Centered Outcomes Research Institute, health exchanges, health care subsidies, health insurance premiums, uninsured, Medicare, cost control

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Schultz, David. "The Implementation and Evaluation of the United States Affordable Care Act." Medicine, Law & Society 12, no. 1 (April 26, 2019): 17–38. http://dx.doi.org/10.18690/mls.12.1.17-38.2019.

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In 2010 the United States Congress adopted the Patient Protection and Affordable Care Act (“ACA”), more commonly referred to as Obamacare. The ACA was proposed by President Barack Obama while running for president and it was passed with a near straight party-line vote of Democrats in the US House and Senate in 2010. The ACA was meant to address several problems with the American health care delivery system, including cost, access and outcomes. This article describes the major features of the ACA including the context of the US health care system, evaluates the ACA’s implementation history and assesses its fate and future reforms throughout the presidency of Donald Trump. The overall conclusion based on its implementation is that while the ACA made significant reforms in terms of access to health care, it is not clear that it addressed affordability or began to improve health care outcomes in the US.

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Joseph, Tiffany D. "What Health Care Reform Means for Immigrants: Comparing the Affordable Care Act and Massachusetts Health Reforms." Journal of Health Politics, Policy and Law 41, no. 1 (February 1, 2016): 101–16. http://dx.doi.org/10.1215/03616878-3445632.

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Abstract The 2010 Patient Protection and Affordable Care Act (ACA) was passed to provide more affordable health coverage to Americans beginning in 2014. Modeled after the 2006 Massachusetts health care reform, the ACA includes an individual mandate, Medicaid expansion, and health exchanges through which middle-income individuals can purchase coverage from private insurance companies. However, while the ACA provisions exclude all undocumented and some documented immigrants, Massachusetts uses state and hospital funds to extend coverage to these groups. This article examines the ACA reform using the Massachusetts reform as a comparative case study to outline how citizenship status influences individuals' coverage options under both policies. The article then briefly discusses other states that provide coverage to ACA-ineligible immigrants and the implications of uneven ACA implementation for immigrants and citizens nationwide.

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12

Moffit, Robert E. "Expanding Choice through Defined Contributions: Overcoming a Non-Participatory Health Care Economy." Journal of Law, Medicine & Ethics 40, no. 3 (2012): 558–73. http://dx.doi.org/10.1111/j.1748-720x.2012.00689.x.

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The Patient Protection and Affordable Care Act of 2010 (the Affordable Care Act) is the law of the land. But it faces an uncertain future.During congressional deliberations on the 2,700-page legislation leading up to its enactment, from February to March 2010, not one major survey recorded majority support for the legislation. Since its enactment, popular opposition to the Affordable Care Act has hardened, and was a significant factor in the 2010 congressional election, in which Democrats lost 63 seats and Republicans regained the majority in the House of Representatives. Ballot initiatives in Missouri and Ohio, showcasing popular opposition to the individual mandate, passed in 2010 with overwhelming majorities. While the United States Supreme Court in National Federation of Independent Business et al. v. Sebelius, 132 S. Ct. 2566 ( 2012), declared the mandate on the states to expand Medicaid unconstitutionally coercive, the majority of the Justices also upheld the individual mandate as a permissible tax. The new law thus emerged as a central topic in the 2012 election.

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Bottiglieri, William A. "Tax Changes Enacted By The Patient Protection And Affordable Care Act Of 2010 And The American Taxpayer Relief Act Of 2012." Journal of Business & Economics Research (JBER) 12, no. 1 (December 31, 2013): 11. http://dx.doi.org/10.19030/jber.v12i1.8370.

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Close to three years ago, Congress enacted legislation that overhauls the U.S. health care system and at the same times affects nearly all taxpayers, many employers, and many elements of the health care industry. The sweeping new health reform law embodied in this legislation pays for its cost through tax increases in a number of ways The American Taxpayer Relief Act of 2012 similarly affects many taxpayers with numerous changes in the tax law which either increase or decrease a taxpayers burden depending on income levels.

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Piacentino, Justin J., and Karl G. Williams. "The Affordable Care Act on Loyalty Programs for Federal Beneficiaries." Journal of Pharmacy Practice 27, no. 1 (December 27, 2013): 106–8. http://dx.doi.org/10.1177/0897190013515928.

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Objective: To discuss changes in the law that allow community pharmacy loyalty programs to include and offer incentives to Medicare and Medicaid beneficiaries. Summary: The retailer rewards exception of the Patient Protection and Affordable Care Act of 2010 and its change to the definition of remuneration in the civil monetary penalties of the Anti-Kickback Statute now allow incentives to be earned on federal benefit tied prescription out-of-pocket costs. The criteria required to design a compliant loyalty program are discussed. Conclusion: Community pharmacies can now include Medicare and Medicaid beneficiaries in compliant customer loyalty programs, where allowed by state law. There is a need for research directly on the influence of loyalty programs and nominal incentives on adherence.

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Feldman, Heidi M., Christina A. Buysse, Lauren M. Hubner, Lynne C. Huffman, and Irene M. Loe. "Patient Protection and Affordable Care Act of 2010 and Children and Youth With Special Health Care Needs." Journal of Developmental & Behavioral Pediatrics 36, no. 3 (April 2015): 207–17. http://dx.doi.org/10.1097/dbp.0000000000000151.

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N. Brzezinska, Bogna. "Access to Gynecologic Oncologists in Ohio: The Role of Insurance Marketplaces and the Patient Protection and Affordable Care Act." Gynecology and Obstetrics Open Access Open Journal I, no. 1 (August 31, 2020): 22–25. http://dx.doi.org/10.33169/gyne.obste.gaooaoj-i-105.

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Background The Affordable Care Act was passed in 2010, which provided a platform for states to develop insurance marketplaces. The goal of this legislation was to improve insurance coverage by providing more affordable options to patients. One metric of the Affordable Care Act was to improve access to comprehensive cancer care. Objective To identify to the effect of the Affordable Care Act on access to Gynecologic Oncologists in Ohio. Study design The Patient Protection and Affordable Health Care Act increased access to health insurance in Ohio, through Medicaid expansion and creation of a healthcare marketplace. We accessed information on access and usage of the healthcare marketplace in Ohio through Healthinsurance.org. We identified Gynecologic Oncology practices in Ohio through the Society of Gynecologic Oncology, and confirmed these practices by telephone. We communicated with each practice and identified which practices took marketplace health insurance. We also gathered information on changes in usage from 2014-2018. We then used descriptive statistics to identify access to a Gynecologic Oncologist though these exchanges. Results In 2017, there were 238,843 people enrolled in marketplace insurance (2% of the Ohio population). We identified 11 practices in Ohio with 39 Gynecologic Oncologists, and 11 marketplace insurance providers. Of these insurers, 7 could be clearly identified as providing access to 5 different Gynecologic Oncology practices. Of the 11 practices, 5 were confirmed to accept marketplace insurance (46%). Interestingly, 3 practices were unsure whether they took patients on marketplace insurance (27%), and 3 definitively did not take patients on marketplace insurance (27%). Each practice varied with how many exchanges they accepted, with 4 out of 5 accepting insurance through more than one insurer. Conclusions About half of the Gynecologic Oncology practices in Ohio accepted insurance through the insurance marketplace, which may limit patient access to a Gynecologic Oncologist.

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Zhang, Shuang Qin, and Blase N. Polite. "Achieving a Deeper Understanding of the Implemented Provisions of the Affordable Care Act." American Society of Clinical Oncology Educational Book, no. 34 (May 2014): e472-e477. http://dx.doi.org/10.14694/edbook_am.2014.34.e472.

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The Patient Protection and Affordable Care Act (ACA) was signed into law by President Barack Obama on March 23, 2010. Since that time, numerous regulations have been promulgated, legal battles continue to be fought and the major provisions of the law are being implemented. In the following article, we outline components of the ACA that are relevant to cancer health care, review current implementation of the new health care reform law, and identify challenges that may lie ahead in the post-ACA era. Specifically, among the things we explore are Medicaid expansion, health insurance exchanges, essential health benefits and preventive services, subsidies, access to clinical trials, the Medicare Part D donut hole, and physician quality payment reform.

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Moy, Beverly, and Bruce A. Chabner. "Patient Navigator Programs, Cancer Disparities, and the Patient Protection and Affordable Care Act." Oncologist 16, no. 7 (May 20, 2011): 926–29. http://dx.doi.org/10.1634/theoncologist.2011-0140.

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Davis, Corey S., and Sarah Somers. "National Health Care Reform and the Public's Health." Journal of Law, Medicine & Ethics 39, S1 (2011): 65–68. http://dx.doi.org/10.1111/j.1748-720x.2011.00569.x.

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On March 23, 2010, President Obama signed the Patient Protection and Affordable Care Act (ACA or the Act) into law. ACA aims to improve access to care and health outcomes through a number of mechanisms, including requiring most individuals to carry health insurance, prohibiting insurers from denying health insurance coverage based on pre-existing conditions, and creating exchanges through which individuals and families not eligible for employer- or government-sponsored health insurance may purchase coverage. While the Act is aimed primarily at improving individual health by increasing access to health insurance, it also contains a number of provisions targeted directly at improving health at the population level. Most of these provisions, which encompass a variety of disease prevention and access-to-care initiatives, are found in ACA Title IV.

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Ng Kamstra, Joshua S., Teresa Molina, and Timothy Halliday. "Compact for care: how the Affordable Care Act marketplaces fell short for a vulnerable population in Hawaii." BMJ Global Health 6, no. 11 (November 2021): e007701. http://dx.doi.org/10.1136/bmjgh-2021-007701.

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The Patient Protection and Affordable Care Act (ACA) was passed in 2010 to expand access to health insurance in the USA and promote innovation in health care delivery. While the law significantly reduced the proportion of uninsured, the market-based protection it provides for poor and vulnerable US residents is an imperfect substitute for government programs such as Medicaid. In 2015, residents of Hawaii from three Compact of Free Association nations (the Federated States of Micronesia, Palau and Marshall Islands) lost their eligibility for the state’s Medicaid program and were instructed to enrol in coverage via the ACA marketplace. This transition resulted in worsened access to health care and ultimately increased mortality in this group. We explain these changes via four mechanisms: difficulty communicating the policy change to affected individuals, administrative barriers to coverage under the ACA, increased out of pocket health care costs and short enrolment windows. To achieve universal health coverage in the USA, these challenges must be addressed by policy-makers.

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Gable, Lance. "The Patient Protection and Affordable Care Act, Public Health, and the Elusive Target of Human Rights." Journal of Law, Medicine & Ethics 39, no. 3 (2011): 340–54. http://dx.doi.org/10.1111/j.1748-720x.2011.00604.x.

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The passage of the Patient Protection and Affordable Care Act (ACA) in March 2010 represents a significant turning point in the evolution of health care law and policy in the United States. By establishing a legal infrastructure that seeks to achieve universal health insurance coverage in the United States, the ACA targets some of the major impediments to accessing needed health care for millions of Americans and by extension attempts to strengthen the health system to support key determinants of health. Yet, like many newly passed legislative provisions, the ultimate effects and significance of the ACA remain uncertain. Those charged with implementing the ACA face formidable obstacles — indeed, some of the same obstacles that have been erected to impede other major pieces of social legislation in the past — including entrenched political opposition, constitutional challenges, and what will likely be a prolonged struggle over the content and direction of how the law is implemented. As these debates continue, it is nevertheless important to begin to assess the impact that the ACA has already had on health law in the United States and to consider the likely effects that the law will have on public health going forward.

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Albright, Heidi W., Mark Moreno, Thomas W. Feeley, Ronald Walters, Marc Samuels, Alissa Pereira, and Thomas W. Burke. "The implications of the 2010 patient protection and affordable care act and the health care and education reconciliation act on cancer care delivery." Cancer 117, no. 8 (November 8, 2010): 1564–74. http://dx.doi.org/10.1002/cncr.25725.

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Song, Jihee, Jeong Nam Kim, Scott Tomar, and Lauren N. Wong. "The Impact of the Affordable Care Act on Dental Care: An Integrative Literature Review." International Journal of Environmental Research and Public Health 18, no. 15 (July 25, 2021): 7865. http://dx.doi.org/10.3390/ijerph18157865.

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The goal of the Patient Protection and Affordable Care Act (ACA) is to increase access to health insurance and decrease health care cost while improving health care quality. With more articles examining the relationship between one of the ACA provisions and dental health outcomes, we systematically reviewed the effect of the ACA on dental care coverage and access to dental services. We searched literature using the National Library of Medicine’s Medline (PubMed) and Thomson Reuters’ Web of Science between January 2010 and November 2020. We identified 33 articles related to dental coverage, and access/utilization of dental care services. This systematic review of studies showed that the ACA resulted in gains in dental coverage for adults and children, whereas results were mixed with dental care access. Overall, we found that the policy led to a decrease in cost barriers, an increase in private dental coverage for young adults, and increased dental care use among low-income childless adults. The implementation of the ACA was not directly associated with dental insurance coverage among people in the U.S. However, results suggest positive spillover effects of the ACA on dental care coverage and utilization by people in the national level dataset.

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Groman, Rachel F., and Koryn Y. Rubin. "Neurosurgical practice and health care reform: moving toward quality-based health care delivery." Neurosurgical Focus 34, no. 1 (January 2013): E1. http://dx.doi.org/10.3171/2012.9.focus12308.

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In an effort to rein in spending and improve patient outcomes, the US government and the private sector have adopted a number of policies over the last decade that hold health care professionals increasingly accountable for the cost and quality of the care they provide. A major driver of these efforts is the Patient Protection and Affordable Care Act of 2010 (ACA or Pub.L. 111–148), which aims to change the US health care system from one that rewards quantity to one that rewards better value through the use of performance measurement. However, for this strategy to succeed in raising the bar on quality and efficiency, it will require the development of more standardized and accurate methods of data collection and further streamlined federal regulations that encourage enhanced patient-centered care instead of creating additional burdens that interfere with the physician-patient relationship.

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Jefferson, Theresa, Gloria Phillips-Wren, and Phoebe D. Sharkey. "Assessing Individual Health Insurance Coverage and Utilization Before and After the Patient Protection and Affordable Care Act." International Journal of Strategic Decision Sciences 7, no. 4 (October 2016): 55–70. http://dx.doi.org/10.4018/ijsds.2016100105.

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The adoption of the Patient Protection and Affordable Care Act (PPACA) in 2010 with the intent to improve the U.S. health care delivery system by expanding health insurance coverage and controlling health care costs has generated intense debate regarding its implementation. Marketplaces known as insurance exchanges have been established to provide coverage for Americans who otherwise could not get affordable health care benefits. These exchanges have been plagued with financial losses and other challenges leading to several large insurance providers discontinuing participation in the program. There are many possible remedies under consideration to make the program work better. This research seeks to support program evaluation as well as potential modifications to the law by providing baseline data to compare access and costs in states with state-based exchanges compared to states with federal exchanges. The authors perform an analysis by state for the years 2012 and 2013 (pre-PPACA implementation) using data from the Current Population Survey (U.S. Census) as well as de-identified claims data from Inovalon, Inc.

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Manchikanti, Laxmaiah. "Obamacare 2012: Prognosis Unclear for Interventional Pain Management." Pain Physician 5;15, no. 5;9 (September 14, 2012): E629—E640. http://dx.doi.org/10.36076/ppj.2012/15/e629.

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The Patient Protection and Affordable Care Act (ACA), informally referred to as ObamaCare, is a United States federal statute signed into law by President Barack Obama on March 23, 2010. ACA has substantially changed the landscape of medical practice in the United States and continues to influence all sectors, in particular evolving specialties such as interventional pain management. ObamaCare has been signed into law amidst major political fallouts, has sustained a Supreme Court challenge and emerged bruised, but still very much alive. While proponents argue that ObamaCare will provide insurance for almost everyone, with an improvement in the quality of and reduction in the cost of health care, opponents criticize it as being a massive bureaucracy laden with penalties and taxes, that will ultimately eliminate personal medicine and individual practices. Based on the 2 years since the passage of ACA in 2010, the prognosis for interventional pain management is unclear. The damage sustained to interventional pain management and the majority of medicine practices is irreparable. ObamaCare may provide insurance for all, but with cuts in Medicare to fund ObamaCare, a limited expansion of Medicaid, the inadequate funding of exchanges, declining employer health insurance coverage and skyrocketing disability claims, the coverage will be practically nonexistent. ObamaCare is composed of numerous organizations and bureaucracies charged with controlling the practice of medicine through the extension of regulations. Apart from cutting reimbursements and reducing access to interventional pain management, administration officials are determined to increase the role of midlevel practitioners and reduce the role of individual physicians by liberalizing the scope of practice regulations and introducing proposals to reduce medical education and training. Key words: Patient Protection and Affordable Care Act, ObamaCare, interventional pain management, Patient-Centered Outcomes Research Institute, Independent Payment Advisory Board, Centers for Medicare and Medicaid Services, Accountable Care Organizations, Medicare, Medicaid

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Li, Gabriel Miao, Josh Pasek, Jon A. Krosnick, Tobias H. Stark, Jennifer Agiesta, Gaurav Sood, Trevor Tompson, and Wendy Gross. "Americans’ Attitudes toward the Affordable Care Act: What Role Do Beliefs Play?" ANNALS of the American Academy of Political and Social Science 700, no. 1 (March 2022): 41–54. http://dx.doi.org/10.1177/00027162221098020.

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How do people form their attitudes toward complex policy issues? Although there has long been an assumption that people consider the various components of those issues and come to an overall assessment, a growing body of recent work has instead suggested that people may reach summary judgments as a function of heuristic cues and goal-oriented rationalizations. This study examines how well a component-based model fits Americans’ evaluations of the Patient Protection and Affordable Care Act of 2010, an important and highly contentious piece of legislation that contained several constituent parts. Despite strong partisan disagreement about the law, we find that Democrats and Republicans both appear to evaluate the law as a function of their beliefs and what the law would do as well as their confidence in those beliefs. This finding implies that correcting misperceptions and increasing awareness of the components of legislation have the potential to change attitudes.

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Alexander, Cheryl Ann, and Lidong Wang. "Public Health Promotion: Autonomy of the Emergency Nurse Practitioner." International Journal of Public Health Science (IJPHS) 4, no. 1 (March 1, 2015): 27. http://dx.doi.org/10.11591/ijphs.v4i1.4708.

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The purpose of this paper is to examine several key issues in health care reform. From the Patient Protection and Affordable Care Act of 2010 to the cholera epidemic in Haiti, global health care reform is necessary to promote health and wellness among all nations. There is an international shortage of nurses and nursing faculty. Among the providers, it is also necessary to examine autonomy of the most up and coming nurse provider: the emergency nurse practitioner.

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Alexander, Cheryl Ann, and Lidong Wang. "Public Health Promotion: Autonomy of the Emergency Nurse Practitioner." International Journal of Public Health Science (IJPHS) 4, no. 1 (March 1, 2015): 27. http://dx.doi.org/10.11591/.v4i1.4708.

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The purpose of this paper is to examine several key issues in health care reform. From the Patient Protection and Affordable Care Act of 2010 to the cholera epidemic in Haiti, global health care reform is necessary to promote health and wellness among all nations. There is an international shortage of nurses and nursing faculty. Among the providers, it is also necessary to examine autonomy of the most up and coming nurse provider: the emergency nurse practitioner.

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Koku, Paul Sergius. "Effect of the Patient Protection and Affordable Care Act on for-profit hospitals in the USA." International Journal of Pharmaceutical and Healthcare Marketing 14, no. 2 (April 1, 2020): 201–15. http://dx.doi.org/10.1108/ijphm-12-2018-0060.

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Purpose This study aims to examine the effect of the Patient Protection and Affordable Care Act (PPACA) on for-profit hospitals in the USA. Design/methodology/approach The study uses the event study methodology to examine the stock market’s reaction to the passage of the PPACA. Findings The results of the analysis do not show a negative effect; on the contrary, the stock prices of for-profit hospitals increased, on average, by 6%. The cumulative abnormal returns were 5.64% with a generalized z-value of 3.851 with a significance level of 0.001 (two-tailed test). This translates into an average gain of $230,537,096 for the four days (dates) that a positive step was taken in making the Affordable Care Act (ACA) a law of the country. Practical implications Because the study suggests that for-profit hospitals will be profitable under the PPACA, one could expect to see growth or, at the minimum, expansion in for-profit hospitals under the Act. Furthermore, and consistent with the principles of marketing, one would expect all the for-profit hospitals, at this nascent stage of the ACA, to pull resources together to promote the benefits of having the ACA. Originality/value To the best of the author’s knowledge, this is the first study to examine the effect of the PPACA on the operations of for-profit hospitals.

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Camarata, Andrew S., Dana C. Nickleach, Ashesh B. Jani, and Peter J. Rossi. "Locoregional Prostate Cancer Treatment Pattern Variation in Independent Cancer Centers: Policy Effect, Patient Preference, or Physician Incentive?" Health Services Insights 8 (January 2015): HSI.S24092. http://dx.doi.org/10.4137/hsi.s24092.

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Surveillance, Epidemiologic, and End Results (SEER) registry data abstracted from a priority 2 or higher reporting source from 2006 to 2008 were used to compare treatment patterns in 45–64-year old men diagnosed with locoregional prostate cancer (LRPC) across states with or without radiation therapy-directed certificate of need (CON) laws and across independent cancer centers (ICCs) compared to large multi-specialty groups (LMSGs). Adjusted treatment percentages for the five most common LRPC treatments (surgery, external beam radiation therapy (EBRT), combination brachytherapy with EBRT, brachytherapy, and observation) were compared using cross-sectional logistic regression between CON-unregulated and -regulated states and between LMSGs and ICCs. LRPC EBRT rates were no different across CON regions, but are increased in ICCs compared to LMSGs (37.00% vs. 13.23%, P < 0.001). Variation in LRPC treatment patterns by reporting source merits further scrutiny under the Affordable Care Act of 2010, considering the intent of incentivized accountable care organizations (ACOs) established by the Patient Protection and Affordable Care Act of 2010 (PPACA) and the implications of early descriptions of these new healthcare provider organizations on prostate cancer treatment patterns.

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Grooms, Jevay, and Alberto Ortega. "Examining Medicaid Expansion and the Treatment of Substance Use Disorders." AEA Papers and Proceedings 109 (May 1, 2019): 187–91. http://dx.doi.org/10.1257/pandp.20191090.

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As the drug epidemic continues to cripple communities and disrupt our country, identifying and understanding state and federal policies which have helped alleviate the burden of substance use disorders (SUDs) is imperative. In 2010, the passage of the Patient Protection and Affordable Care Act (ACA) expanded health coverage and services offered to millions of Americans. Prior to the ACA, treatment for substance use disorders was not included in all medical coverage. We examine the brief literature on ACA Medicaid Expansion and SUDs and complement this literature by including the effects on measures of supply and efficacy of SUD treatment.

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Caffrey, Arden, Carolyn Pointer, David Steward, and Sameer Vohra. "The Role of Community Health Needs Assessments in Medicalizing Poverty." Journal of Law, Medicine & Ethics 46, no. 3 (2018): 615–21. http://dx.doi.org/10.1177/1073110518804212.

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The Patient Protection and Affordable Care Act (ACA), passed in 2010, is considered by many to be the most significant healthcare overhaul since the 1960s, but part of its promise — improvement of population health through requirements for non-profit hospitals to provide “community benefit” — has not been met. This paper examines the history of community benefit legislation, how community benefit dollars are allocated, and innovative practices by a few hospitals and communities that are addressing primarily non-medical factors that influence health such as social disadvantage, attitudes, beliefs, risk exposure, and social inequalities.

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Rovin, Kimberly, Rebecca Stone, Linda Gordon, Emilia Boffi, and Linda Hunt. "Better Than Nothing: Participant Experiences in Using a County Health Plan." Practicing Anthropology 34, no. 4 (September 1, 2012): 13–18. http://dx.doi.org/10.17730/praa.34.4.754915t6lkh712q1.

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The United States health care system has reached a crisis point, with 49.9 million Americans now living without health insurance (DeNavas-Walt, Proctor, and Smith 2011). The United States government has responded to this crisis in a variety of ways, perhaps the most visible being the enactment of the Patient Protection and Affordable Care Act (ACA) in March 2010. With a goal of expanding access to health insurance to 32 million Americans by 2019, the ACA marks an important moment in the history of United States health care reform with the potential to drastically change the United States health insurance landscape (Connors and Gostin 2010). The law delineates only general categories of required benefits and leaves it to each state to decide the specific benefits that will be provided by the insurers in their state (Pear 2011).

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Sparer, M. S. "Federalism and the Patient Protection and Affordable Care Act of 2010: The Founding Fathers Would Not Be Surprised." Journal of Health Politics, Policy and Law 36, no. 3 (January 1, 2011): 461–68. http://dx.doi.org/10.1215/03616878-1271099.

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Kapp, Marshall B. "Conscripted Physician Services and the Public's Health." Journal of Law, Medicine & Ethics 39, no. 3 (2011): 414–24. http://dx.doi.org/10.1111/j.1748-720x.2011.00611.x.

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The Patient Protection and Affordable Care Act of 2010 (PPACA) purportedly assures almost all Americans of the right to health insurance coverage. The long-term success of this legislation in improving the public’s health in the United States will likely hinge in no small part on the degree to which statutorily establishing a right to health insurance coverage translates into actual timely, meaningful access to health services, particularly physician services, for specific individuals.

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Kinney, Eleanor D. "Comparative Effectiveness Research under the Patient Protection and Affordable Care Act: Can New Bottles Accommodate Old Wine?" American Journal of Law & Medicine 37, no. 4 (December 2011): 522–66. http://dx.doi.org/10.1177/009885881103700402.

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The Patient Protection and Affordable Care Act (PPACA), as amended by the Health Care and Education Reconciliation Act of 2010, initiated comprehensive health reform for the healthcare sector of the United States. PPACA includes strategies to make the American healthcare sector more efficient and effective. PPACA's comparative effectiveness research initiative and the establishment of the Patient-Centered Outcomes Research Institute are major strategies in this regard. PPACA's comparative effectiveness research initiative is one in a long line of federal initiatives to address the rising costs of healthcare as well as to obtain better value for healthcare expenditures. The key question is whether the governance and design features of the institute that will oversee the initiative will enable it to succeed where other federal efforts have faltered. This Article analyzes the federal government's quest to ensure value for money expended in publically funded healthcare programs and the health sector generally. This Article will also analyze what factors contribute to the possible success or failure of the comparative effectiveness research initiative. Success can be defined as the use of the findings of comparative effectiveness to make medical practice less costly, more efficient and effective, and ultimately, to bend the cost curve.

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Rambur, Betty A. "What’s at Stake in U.S. Health Reform: A Guide to the Affordable Care Act and Value-Based Care." Policy, Politics, & Nursing Practice 18, no. 2 (May 2017): 61–71. http://dx.doi.org/10.1177/1527154417720935.

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The U.S. presidential election of 2016 accentuated the divided perspectives on the Patient Protection and Affordable Care Act of 2010, commonly known as Obamacare. The perspectives included a pledge from then candidate Donald J. Trump to “repeal and replace on day one”; Republican congressional leaders’ more temperate suggestions in the first weeks of the Trump administration to “repair” the Affordable Care Act (ACA); and President Trump’s February 5, 2017 statement—16 days after inauguration—that a Republican replacement for the ACA may not be ready until late 2017 or 2018. The swirling rhetoric, media attention, and the dizzying rate of U.S. health and payment reforms both within and outside of the ACA makes it difficult for nurses, both United States and globally, to discern which health policy issues are grounded in the ACA and which aspects reflect payer-driven “volume to value” reimbursement changes. Moreover, popular and controversial elements of the ACA—for example, the clause that prohibits insurance carriers to deny coverage to those with preexisting health conditions and the more controversial individual mandate that bears Supreme Court support as a constitutional provision—are paired in ways that might be unclear to those unfamiliar with nuances of insurance rate determination. To support nurses’ capacity to maximize their impact on health policy, this overview distills the 906-page ACA into major themes and describes payment reform legislation and initiatives that are external to the ACA. Understanding the political and societal forces that affect health care policy and delivery is necessary for nurses to effectively lead and advocate for the best interests of their patients.

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McCabe, Heather A., and Elizabeth A. Wahler. "The Affordable Care Act, Substance Use Disorders, and Low-Income Clients: Implications for Social Work." Social Work 61, no. 3 (April 29, 2016): 227–33. http://dx.doi.org/10.1093/sw/sww030.

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Abstract Social workers are leaders in the substance abuse services field and may often work in substance use disorder (SUD) education, prevention, assessment, treatment, or resource coordination and case management roles. As the Patient Protection and Affordable Care Act (ACA) (2010) drives changes in the fields of health and behavioral health, social workers have an opportunity to lead structural changes at the micro and macro levels that will have a positive impact on low-income clients with SUDs. In this article, authors examine the current state of SUDs and health care access, the impact of the ACA on the field, and implications for social work practice and education. Social workers should seek specialized education and credentialing in SUD services, know how to help clients apply for health care coverage, and advocate for integrated substance abuse treatment and health care programs and an expansion of Medicaid in their local communities. Social workers are well positioned to be a voice for clients to ensure that the current structural changes result in a better, integrated system of care that is able to respond to the needs of low-income clients with SUDs.

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Sismondo, Sergio. "Key Opinion Leaders and the Corruption of Medical Knowledge: What the Sunshine Act Will and Won’t Cast Light on." Journal of Law, Medicine & Ethics 41, no. 3 (2013): 635–43. http://dx.doi.org/10.1111/jlme.12073.

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In 2010, in connection with the Patient Protection and Affordable Care Act (Obamacare), the United States Congress passed the Physician Payment Sunshine Act. This legislation requires pharmaceutical companies, medical device companies, and other manufacturers of medical supplies to collect information on their payments to physicians, beginning on August 1, 2013, and to annually report this information to the Centers for Medicare and Medicaid Services (CMS), beginning on March 31, 2014. All payments of over $10 are to be reported and aggregate payments of more than $100 to a single physician in a single year must also be reported.

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Liang, Bryan A., and Tim Mackey. "Quality and Safety in Medical Care: What Does the Future Hold?" Archives of Pathology & Laboratory Medicine 135, no. 11 (November 1, 2011): 1425–31. http://dx.doi.org/10.5858/arpa.2011-0154-oa.

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Context.—The rapid changes in health care policy, embracing quality and safety mandates, have culminated in programs and initiatives under the Patient Protection and Affordable Care Act. Objective.—To review the context of, and anticipated quality and patient safety mandates for, delivery systems, incentives under health care reform, and models for future accountability for outcomes of care. Design.—Assessment of the provisions of Patient Protection and Affordable Care Act, other reform efforts, and reform initiatives focusing on future quality and safety provisions for health care providers. Results.—Health care reform and other efforts focus on consumerism in the context of price. Quality and safety efforts will be structured using financial incentives, best-practices research, and new delivery models that focus on reaching benchmarks while reducing costs. In addition, patient experience will be a key component of reimbursement, and a move toward “retail” approaches directed at the individual patient may supplant traditional “wholesale” efforts at attracting employers. Conclusions.—Quality and safety have always been of prime importance in medicine. However, in the future, under health care reform and associated initiatives, a shift in the paradigm of medicine will integrate quality and safety measurement with financial incentives and a new emphasis on consumerism.

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Kline, Jeffrey A., and Jennifer D. H. Walthall. "Patient Protection and Affordable Care Act of 2010: Summary, Analysis, and Opportunities for Advocacy for the Academic Emergency Physician." Academic Emergency Medicine 17, no. 7 (July 6, 2010): e69-e74. http://dx.doi.org/10.1111/j.1553-2712.2010.00802.x.

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Sethi, Manish K., and Kevin J. Bozic. "Where the Rubber Meets the Road: Understanding Key Changes in the Patient Protection and Affordable Care Act Since 2010." Clinical Orthopaedics and Related Research® 472, no. 4 (November 21, 2013): 1086–88. http://dx.doi.org/10.1007/s11999-013-3384-x.

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Wang, Virginia, Lindsay Zepel, Bradley G. Hammill, Abby Hoffman, Caroline E. Sloan, and Matthew L. Maciejewski. "Rates of Medicare Enrollment Among Dialysis Patients After Implementation of Medicare Payment Reform and the Affordable Care Act Marketplace." JAMA Network Open 5, no. 9 (September 20, 2022): e2232118. http://dx.doi.org/10.1001/jamanetworkopen.2022.32118.

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ImportanceMedicare finances health care for most US patients with end-stage kidney disease (ESKD), regardless of age. The 2011 Medicare prospective payment system (PPS) for dialysis reduced reimbursement for hemodialysis, and the 2014 Patient Protection and Affordable Care Act (ACA) Marketplace increased patient access to new private insurance options, potentially influencing organizations that provide health care, such as hospitals, nursing homes, and dialysis facilities, to adjust their payer mix away from Medicare sources.ObjectiveTo describe Medicare enrollment trends among patients with incident ESKD in 2006 to 2016.Design, Setting, and ParticipantsThis retrospective cohort study involved US patients aged 18 to 64 years who were not enrolled in Medicare at dialysis initiation in 2006 to 2016, with 1-year follow-up through 2017. Data analysis was conducted April 2021 to June 2022.ExposuresThe exposure of interest was a 3-category indicator of time, whether patients initiated dialysis before policies were enacted (2006-2010), in the first years of the Medicare ESKD PPS (2011-2013), or during the Medicare ESKD PPS and implementation of the ACA Marketplace (2014-2016).Main Outcomes and MeasuresPatient-level Medicare enrollment through the first year of dialysis. Logistic regression and Cox models were used to examine associations of time, patient characteristics, and Medicare enrollment, adjusting for patient demographic, clinical, and market-level characteristics.ResultsOf 335 157 patients aged 18 to 64 years with ESKD not actively enrolled in Medicare when they initiated dialysis in 2006 to 2016, the mean (SD) age was 49.9 (10.8) years, 198 164 (59.1%) were men, 188 290 (56.2%) were White, and 313 622 (93.6%) received in-center hemodialysis. New Medicare enrollment was higher in 2006 to 2010 (110 582 patients [73.1%]) than after the Medicare ESKD PPS and ACA Marketplace in 2014 to 2016 (55 382 patients [58.5%]). In adjusted analyses, declining Medicare enrollment was associated with implementation of 2011 Medicare ESKD PPS and 2014 ACA policies and was disproportionately lower among younger, racially minoritized, and ethnically Hispanic patients.Conclusions and RelevanceThere was declining Medicare enrollment among new dialysis patients associated with the 2011 Medicare ESKD PPS and 2014 ACA Marketplace that raise concerns about benefits and harms to patients and payers and continued disparities in kidney care. As the dialysis payer mix moves toward higher proportions of patients not covered by Medicare, it will be important to understand the implications for health care system and patient outcomes.

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D'Arcy, Laura P., and Eugene C. Rich. "From comparative effectiveness research to patient-centered outcomes research: policy history and future directions." Neurosurgical Focus 33, no. 1 (July 2012): E7. http://dx.doi.org/10.3171/2012.4.focus12106.

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Containing growth in health care expenditures is considered to be essential to improving both the long-term fiscal outlook of the federal government and the future affordability of health care in the US. As health care expenditures have increased, so too have concerns about the quality of health care. Better information on the clinical effectiveness of alternative treatments and other interventions is needed to improve the quality of care and restrain growth in expenditures. This article explains the key role played by the federal government in defining the context and process of comparative effectiveness research as well as its funding. Subsequently, the article explores the mission, priorities, and research agenda of the Patient-Centered Outcomes Research Institute, which is an independent, nonprofit corporation established in 2010 by the Patient Protection and Affordable Care Act.

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Auld, M. Elaine. "Health Education Careers in a Post–Health Reform Era." Health Promotion Practice 18, no. 5 (August 16, 2017): 629–35. http://dx.doi.org/10.1177/1524839917726495.

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Since enactment of the Patient Protection and Affordable Care Act in 2010, health education specialists (HES) have made important contributions in implementing the law’s provisions at the individual, family, and population levels. Using their health education competencies and subcompetencies, HES are improving public understanding of health insurance literacy and enrollment options, conducting community health needs assessments required of nonprofit hospitals, modifying policies or systems to improve access to health screenings and preventive health services, strengthening clinical and community linkages, and working with employee benefit plans. In addition to educating stakeholders about their complementary training and roles with respect to clinical providers, HES must keep abreast of rapid changes catalyzed by the Affordable Care Act in terms of health standards, payment models, government regulations, statistics, and business practices. For continued career growth, HES must continually acquire new knowledge and skills, access and analyze data, and develop interprofessional partnerships that meet the evolving needs of employers as the nation pursues health for all.

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Mondal, Wali I. "The Health Insurance Exchange: An Oligopolistic Market In Need Of Reform." Journal of Business & Economics Research (JBER) 11, no. 12 (November 29, 2013): 569. http://dx.doi.org/10.19030/jber.v11i12.8264.

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Until the Patient Protection and Affordable Care Act commonly known as the Affordable Care Act (ACA) was signed into law in March 2010, United States was the only industrialized rich country in the world without a universal healthcare insurance coverage. While pioneering works by Burns (1956, 1966) focused on the Social Security Act of 1935 in addressing the health insurance needs of U.S. retired population through Medicare, and later Medicaid was created by the Social Security Amendments of 1965, U.S. health insurance has remained a private, for-profit venture. The passage of ACA was one of the most contentious legislations of modern times. Soon after it was signed into law, various groups of private citizens and a number of States challenged some provisions of the ACA; however, the Supreme Court of the United States upheld its key provisions. A segment of the Congress remains opposed to the ACA on ideological ground and continues to challenge it with a variety of legal maneuvers. Notwithstanding the political or ideological arguments for or against the ACA, the objective of this paper is to analyze the competitiveness of the health insurance marketplace which opened on October 1, 2013. In doing so, the paper will address the structure of the health insurance exchange and suggest ways and means to make it more competitive.

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Richard, Patrick, Kristina D. West, Peter Shin, Mustafa Z. Younis, and Sara Rosenbaum. "Community health centers cost savings: Ambulatory care patients in North Carolina." Journal of Public Budgeting, Accounting & Financial Management 26, no. 2 (March 1, 2014): 271–91. http://dx.doi.org/10.1108/jpbafm-26-02-2014-b002.

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In 2010 the Patient Protection and Affordable Care Act boosted the expansion of community health centers (CHCs) with $11 billion in mandatory funding from 2011 to 2015. This study used data from the Medical Expenditure Panel Survey (MEPS) and the North Carolina Behavioral Risk Factor Surveillance System (BRFSS) to assess the cost savings associated with the use of community health centers compared to other primary care providers. After controlling for various demographic, socioeconomic characteristics and health conditions, we found savings at an average of $3,437 in total expenditures and $1,211 in ambulatory care expenditures. These results suggest that continuing investment in health centers are important during times of budget cuts in order to improve access to care and to generate cost savings to the healthcare system.

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Thomson, Kyle. "State-Run Insurance Exchanges in Federal Healthcare Reform: A Case Study in Dysfunctional Federalism." American Journal of Law & Medicine 38, no. 2-3 (June 2012): 548–69. http://dx.doi.org/10.1177/009885881203800212.

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On March 23, 2010, President Barack Obama signed the Patient Protection and Affordable Care Act (ACA) into law, resulting in the most sweeping reform of the healthcare marketplace and one of the largest expansions in access to healthcare in American history. A key component to both restructuring the healthcare marketplace and improving access are the health insurance exchanges contained in the ACA. Today, individual and small group purchasers have difficulty finding affordable health insurance in the marketplace because they lack the tools to gather information about plans and because they lack the bargaining power to negotiate for affordable rates the way large purchasers can. In conjunction with the individual mandate, the health insurance exchanges aim to solve inefficiencies in the current marketplace by creating a centralized venue to connect insurers with individual and small business purchasers. Thus it both creates a place for insurers to readily find customers, who are now guaranteed to be there because of the individual mandate, and provides a place for customers to shop for insurance.

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Roth, Michael, Amy Berkman, Clark R. Andersen, Branko Cuglievan, J. Andrew Livingston, Michelle Hildebrandt, and Archie Bleyer. "Improved Survival of Young Adults with Cancer Following the Passage of the Affordable Care Act." Oncologist 27, no. 2 (February 1, 2022): 135–43. http://dx.doi.org/10.1093/oncolo/oyab049.

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Abstract Background Compared with their ensured counterparts, uninsured adolescents and young adults (AYAs) with cancer are more likely to present with advanced disease and have poor prognoses. The Patient Protection and Affordable Care Act (ACA), enacted in 2010, provided health care coverage to millions of uninsured young adults by allowing them to remain on their parents’ insurance until age 26 years (the Dependent Care Expansion, DCE). The impact of the expansion of insurance coverage on survival outcomes for young adults with cancer has not been assessed. Participants Utilizing the Surveillance, Epidemiology, and End Results database, we identified all patients aged 12-16 (younger-AYAs), 19-23 (middle-AYAs), and 26-30 (older-AYAs) who were diagnosed with cancer between 2006-2008 (pre-ACA) and 2011-2013 (post-ACA). Methods In this population-based cohort study, we used an accelerated failure time model to assess changes in survival rates before and after the enactment of the ACA DCE. Results Middle-AYAs ages 19-23 (thus eligible to remain on their parents’ insurance) experienced significantly increased 2-year survival after the enactment of the ACA DCE (survival time ratio 1.25, 95% confidence interval: 0.75-2.43, P = .029) and that did not occur in younger-AYAs (ages 12-16). Patients with sarcoma and acute myeloid leukemia accounted for the majority of improvement in survival. Middle-AYAs of hispanic ethnicity and those with low socioeconomic status experienced trends of improved survival after the ACA DCE was enacted. Conclusion Survival outcomes improved for young adults with cancer following the expansion of health insurance coverage. Efforts are needed to expand coverage for the millions of young adults who do not have health insurance.

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