Impact to North Carolina from Health Reform Act

Topics: Universal health care, Health economics, Healthcare reform Pages: 6 (1846 words) Published: October 13, 2014
The Affordable Care Act and North Carolina's Uninsured Population


October 2, 2014

Affordable Care Act and North Carolina's Uninsured Population
The Workings of an Affordable Care Act

The PPACT is more widely referred to as the Affordable Care Act (ACA). The ACA is the product of years of political debates and movements to reform the American health care system. Originally, conceived as an alternative to a single-payer health care system, the concepts behind the ACA date back as far as the 1980’s. Although progression of the ACA was stunted for several years, it was eventually redesigned and signed into law on March 23, 2010. The purpose behind the ACA is to control healthcare cost while providing equitable and cost-effective health care coverage to millions of uninsured Americans. The ACA’s was drafted using  two  pathways for which delivery its reform mandates would be executed.  According to Brad (2024, "individuals with incomes falling within 138 percent of the federal poverty level and (2) creation of state-based virtual insurance exchanges to service the needs of individuals and small businesses".(p. 2) As a safety net, federal subsides were centered under individuals with earned incomes between 100 percent and 400 percent of the federal poverty line. The aforementioned points noted, are not comprehensive of the 2000 plus page ACA,; however, they are the basis for this topic.

Impact of the Affordable Care Act

One key element of the ACA that has proven vulnerable to unfavorable political action or retaliatory efforts in general is the power given to the states regarding expansion of Medicaid benefits. “For states that do expand Medicaid, the law provides that the federal government will pay for 100% of the expansion for the first three years and then gradually reduce its subsidy to 90% by 2020” (Medicaid Eligibility, para. 6). As Searing stated in his briefing, Governor Pat McCrory and the North Carolina General Assembly chose not to expand Medicaid eligibility, therefore disallowing citizens with income below 133% of the federal poverty line a pathway to health care coverage. (para. 1) More specifically, the refusal to expand Medicaid benefits directly resulted in the loss or creation of coverage gaps among 319,000 North Carolinians. (Searing, 2014) Furthermore Searing states, “because Medicaid was intended for low-income people, as policymakers of the ACA envisioned, citizens who fell below the poverty line are not eligible for financial assistance through subsidies” (para. 4) Conversely, some North Carolinians will find themselves in a “coverage gap” because they are earning too much for Medicaid premium tax credits. (Health Reform, 2014)

Economical Impact

As of January 1, 2014, nearly $5 million a day in federal Medicaid dollars was being missed out on due to the states refusal to expand, and this number is expected to grow over time. (Searing, 2014) Additionally, impacts to the states economy are expected but are dependent on the enrollment of additional eligible uninsured citizens. (Health Reform, 2014) The Center on Budget and Policy Priorities stated t, “North Carolina will spend $2.0 billion more on Medicaid to cover additional enrollment of currently eligible children and parents through 2022 with or without the expansion. The expansion would increase state spending by $3.1 billion. Altogether, this additional spending is just 7.7 percent more than what North Carolina would have spent on Medicaid in the absence of the ACA” (Affects of Medicaid Expansion, n.d., para. 5).

Slow Rise of Health Care Cost

Since the enactment of the ACA, financial figures regarding the cost of healthcare cost have been modestly optimistic. A successive year-to-year reduction in anticipated Medicare spending has been proven noteworthy although unexpected. Since the year 2010, there is ample evidence that indicates overall...

References: Blumenthal, D., & Collins, S. (2014, July 17). Health Care Coverage under the Affordable Care Act — a progress report. The New England Journal of Medicine, 275-281.
Dukes, T., & Leslie, L
Luhby, T. (2013). States forgo billions by opting out of Medicaid expansion [Entire issue]. CNN. Retrieved from
Murawawski, J
Ricketts, T. C. (2013). How the affordable care act will affect access to health care in North Carolina. North Carolina Medical Journal, 74, 324-329.
Searing, A. (2014). North Carolins’s medicade chioice:Options and implications [Fact sheet]. Retrieved from North Carolina Justice Center:
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