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Your mother has a chronic healthcare condition which requires many visits to her



Your mother has a chronic healthcare condition which requires many visits to her healthcare provider. She is concerned that you just turned 25 years of age and will be graduating from college. As her child, you have been covered under her healthcare plan but she is afraid you will lose coverage. She recently changed jobs, which will require your family to move to a new state. She is also afraid that she will not receive healthcare insurance from her new company and is worried about finding a new provider to take care of her. She wonders if she does find health insurance, whether her children will be covered under her healthcare plan or not. Explain to her about the new healthcare reform bill and how that will impact her situation.

For your Dropbox Assignment:

Explain to her about the new healthcare reform bill and how all or some of the new regulations and changes will/may impact her and your situation. A minimum of 500 words is expected for this dropbox assignment utilizing Standard English protocol and the APA writing guide.

Your mother has a chronic healthcare condition which requires many visits to her

Title: Summary of the Affordable Care Act Apr 25, 2013


On March 23, 2010, President Obama signed comprehensive health reform, the Patient Protection and Affordable Care Act, into law. The following summary of the law, and changes made to the law by subsequent legislation, focuses on provisions to expand coverage, control health care costs, and improve health care delivery system.

our mother has a chronic healthcare condition which requires many visits to her

Patient Protection and Affordable Care Act (P.L. 111-148)

Overall approach to expanding access to coverage • Require most U.S. citizens and legal residents to have health insurance. Create state-based American Health Benefit Exchanges through which individuals can purchase coverage, with premium and cost-sharing credits available to individuals/families with income between 133-400% of the federal poverty level (the poverty level is $19,530 for a family of three in 2013) and create separate Exchanges through which small businesses can purchase coverage (American Psychological Association [APA]. (2003)). Require employers to pay penalties for employees who receive tax credits for health insurance through an Exchange, with exceptions for small employers. Impose new regulations on health plans in the Exchanges and in the individual and small group markets. Expand Medicaid to 133% of the federal poverty level.

Your mother has a chronic healthcare condition which requires many visits to her


Requirement to have coverage • Require U.S. citizens and legal residents to have qualifying health coverage. Those without coverage pay a tax penalty of the greater of $695 per year up to a maximum of three times that amount ($2,085) per family or 2.5% of household income (APA, p 199 2003). The penalty will be phased-in according to the following schedule:  $95 in 2014, $325 in 2015, and $695 in 2016 for the flat fee or 1.0% of taxable income in 2014, 2.0% of taxable income in 2015, and 2.5% of taxable income in 2016. Beginning after 2016, the penalty will be increased annually by the cost-of-living adjustment. According to Berndt, T. J., & Keefe, K (1995), Exemptions will be granted for financial hardship, religious objections, American Indians, those without coverage for less than three months, undocumented immigrants, incarcerated individuals, those for whom the lowest cost plan option exceeds 8% of an individual’s income, and those with incomes below the tax filing threshold (in 2009 the threshold for taxpayers under age 65 was $9,350 for singles and $18,700 for couples) (Berndt, T. J., & Keefe, K. (1995).

Your mother has a chronic healthcare condition which requires many visits to her


Research by Wegener and Petty (1994), show that requirement to offer coverage • Assess employers with 50 or more full-time employees that do not offer coverage and have at least one full-time employee who receives a premium tax credit a fee of $2,000 per full-time employee, excluding the first 30 employees from the assessment (Wegener & Petty, 1994). Employers with 50 or more full-time employees that offer coverage but have at least one full-time employee receiving a premium tax credit, will pay the lesser of $3,000 for each employee receiving a premium credit or $2,000 for each full-time employee, excluding the first 30 employees from the assessment (Kernis, Cornell, Sun, Berry, & Harlow, 1993). (Effective January 1, 2014) • Exempt employers with up to 50 full-time employees from any of the above penalties (Berndt, T. J. (1981).


Other requirements • Require employers with more than 200 employees to automatically enroll employees into health insurance plans offered by the employer. Employees may opt out of coverage (Berndt, T. J. (1999).

Your mother has a chronic healthcare condition which requires many visits to her


Treatment of Medicaid • Expand Medicaid to all non-Medicare eligible individuals under age 65 (children, pregnant women, parents, and adults without dependent children) with incomes up to 133% FPL based on modified adjusted gross income (as under current law undocumented immigrants are not eligible for Medicaid) (Kernis et al., 1993). All newly eligible adults will be guaranteed a benchmark benefit package that meets the essential health benefits available through the Exchanges. The Supreme Court ruling on the constitutionality of the ACA upheld the Medicaid expansion, but limited the ability of HHS to enforce it, thereby making the decision to expand Medicaid optional for states. According to (Henry, W. A., III. (1990) and Wooldridge, M.B., & Shapka, J. (2012)), to finance the coverage for the newly eligible (those who were not previously eligible for at least benchmark equivalent coverage, those who were eligible for a capped program but were not enrolled, or those who were enrolled in state-funded programs), states will receive 100% federal funding for 2014 through 2016, 95% federal financing in 2017, 94% federal financing in 2018, 93% federal financing in 2019, and 90% federal financing for 2020 and subsequent years (Henry, W. A., III. (1990). States that have already expanded eligibility to adults with incomes up to 100% FPL will receive a phased-in increase in the federal medical assistance percentage (FMAP) for non-pregnant childless adults so that by 2019 they receive the same federal financing as other states (93% in 2019 and 90% in 2020 and later) (Mothers Against Drunk Driving [MADD], 2000). States have the option to expand Medicaid eligibility to childless adults beginning on April 1, 2010, but will receive their regular FMAP until 2014. In addition, increase Medicaid payments in fee-for-service and managed care for primary care services provided by primary care doctors (family medicine, general internal medicine or pediatric medicine) to 100% of the Medicare payment rates for 2013 and 2014. States will receive 100% federal financing for the increased payment rates (MADD, 2000). (Effective January 1, 2014)


Treatment of CHIP • Require states to maintain current income eligibility levels for children in Medicaid and the Children’s Health Insurance Program (CHIP) until 2019 and extend funding for CHIP through 2015. CHIP benefit package and cost-sharing rules will continue as under current law. Provide states with the option to provide CHIP coverage to children of state employees who are eligible for health benefits if certain conditions are met. Beginning in 2015, states will receive a 23 percentage point increase in the CHIP match rate up to a cap of 100% (Berndt, 2002; Harlow, 1983). CHIP-eligible children who are unable to enroll in the program due to enrollment caps will be eligible for tax credits in the state Exchanges (Harlow, H. F. (1983) and Wegener, D. T., & Petty, R. E. (1994).

Your mother has a chronic healthcare condition which requires many visits to her


Eligibility • Limit availability of premium credits and cost-sharing subsidies through the Exchanges to U.S. citizens and legal immigrants who meet income limits. Employees who are offered coverage by an employer are not eligible for premium credits unless the employer plan does not have an actuarial value of at least 60% or if the employee share of the premium exceeds 9.5% of income (E. Johnson, 2001; L. Johnson, 1998 and Schultz, S. (2005). Legal immigrants who are barred from enrolling in Medicaid during their first five years in the U.S. will be eligible for premium credits.


Premium credits • Provide refundable and advanceable premium credits to eligible individuals and families with incomes between 100-400% FPL to purchase insurance through the Exchanges (Funk & Kolln, 1992). The premium credits will be tied to the second lowest cost silver plan in the area and will be set on a sliding scale such that the premium contributions are limited to the following percentages of income for specified income levels: Up to 133% FPL:  2% of income

133-150% FPL: 3 – 4% of income

150-200% FPL: 4 – 6.3% of income

200-250% FPL: 6.3 – 8.05% of income

250-300% FPL: 8.05 – 9.5% of income

300-400% FPL: 9.5% of income

  • Increase the premium contributions for those receiving subsidies annually to reflect the excess of the premium growth over the rate of income growth for 2014-2018. Beginning in 2019, further adjust the premium contributions to reflect the excess of premium growth over CPI if aggregate premiums and cost sharing subsidies exceed .504% of GDP (E. Robbins, personal communication, January 4, 2001 and Scruton, R. 1996).
  • Provisions related to the premium and cost-sharing subsidies are effective January 1, 2014.


Your mother has a chronic healthcare condition which requires many visits to her


Reference Page

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Mothers Against Drunk Driving [MADD], 2000, Introduction. In E. W. Ludlow (Ed.), Understanding English grammar (pp. 1-2). Needham, MA: Allyn and Bacon.

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Henry, W. A., III. (1990, April 9). Making the grade in today’s schools. Time, 135, 28-31.

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Kernis, M. H., Cornell, D. P., Sun, C. R., Berry, A., Harlow, T., & Bach, J. S. (1993). There’s more to self-esteem than whether it is high or low: The importance of stability of self-esteem. Journal of Personality and Social Psychology, 65, 1190-1204.

Merriam-Webster’s collegiate dictionary (10th ed.).(1993). Springfield, MA: Merriam-Webster.

Schultz, S. (2005, December 28). Calls made to strengthen state energy policies. The Country Today, pp. 1A, 2A.

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Wooldridge, M.B., & Shapka, J. (2012). Playing with technology: Mother-toddler interaction scores lower during play with electronic toys. Journal of Applied Developmental Psychology, 33(5), 211-218.