The principle changes in the Patient Protection and Affordable Care Act, signed into law on 23rd March 2010, mean that it is mandatory for people to buy healthcare insurance (or face fines), and encourages insurers to insure people who are deemed as high-risk, and would have previously been denied coverage.

The PPACA takes a step in the right direction for US healthcare in terms of reducing the number of people who are uninsured. One of the most notable aspects of the Act is the creation of health insurance exchanges, which will provide federal assistance for those who are not covered by Medicare, Medicaid, by an employer, or able to buy their own insurance. Given that this assistance will be available to up to 400% of the federal poverty level, there are predictions that by 2019, 24 million people will be entitled to such coverage.

The PPACA does however maintain the integral role of the health insurance companies within US healthcare, which has led to criticisms such as the debate being based on health insurance rather than healthcare. Given the role of the media within US politics in general, there were wide ranging exaggerations, particularly from those against the passage of the Bill, that the reforms would lead to “socialism”. ObamaCare, a term coined by the Republican Party and later adopted by the Obama Administration, also led to the introduction of The Independent Payment Advisory Board, which will be responsible for making savings within the Medicare bill, although no recommendations to ration healthcare will be permitted by PPACA. The Act also sees the introduction of Accountable Care Organisations, bringing together hospitals, doctors, and other providers, to coordinate and deliver care to Medicare patients.

Many reforms have also taken place at a state level. One such example is the Oregon Health Plan.

Ian has been working with us for the last year and this is part of his undergraduate dissertation submitted to the University of Sheffield.

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