University of Phoenix Material

Health Care Reform Matrix

HCS/455 Version 5


Universityof Phoenix Material

Health Care Reform Matrix

With your learning team, complete the Health Care Reformmatrix below. Listed in this matrix are some of the topics addressedby the Patient Protection and Affordable Care Act policy. You arerequired to describe the issue, in your own words, and list 2-3points about each topic under each heading in the matrix.

Describe the issue:

Key concerns regarding the issue:

How is this issue addressed in the current health care environment?

How will this issue be addressed by the Patient Protection and Affordable Care Act?

Patient Bill of Rights

Medical Loss Ratio

State-based Health Insurance Exchange

Federally-facilitated Insurance Exchange

Useful in serving as insurance marketplaces for individual consumers and small businesses from different providers.

Creation of state healthcare exchanges as primary means to expand coverage in the whole nation (CMS, 2014)

The current healthcare environment views this issue as a great step towards purchasing insurance that has minimum essential coverage, receiving federal subsidies and being granted exemptions.

Individuals who qualify for the exchange insurance known as qualified health plans undergo a certification process prior to market entry and continue being subjects to the federal oversight.

Consumer Assistance Programs

Helps consumers with health related problems through direct contact with them (Rachel et al. 2013)

Provision of close health coverage to consumers through communication channels like emails or phone calls

The issue of consumer assistance program is addresses adequately with with map points and links to individual state departments of insurance for any enquiries,

It will be addressed as an effective tool of reaching to consumer’s directly through communicating on phone and emails to get first hand information.

Pre-existing Condition Insurance Plan

Insurance plan that for people with preexisting conditions who have been denied coverage by private companies

To offer affordable health insurance choices which prohibit discrimination due to preexisting conditions and be a US citizen

The issue is addressed through high risk pools by states as a key step towards giving equal healthcare opportunities for everyone including those with preexisting conditions

The insurance plan ensures that all patients benefit through private insurance plans despite their conditions (CMS, 2014)

Annual Limits

Coverage for Young People

Grandfathered Plans


Review of Insurance Plans

Student Health Plans

Self-funded, Non-federal Governmental Plans

Medicaid Expansion


CMS Center for medic care and Medicaid services, (2014). HealthInsurance marketplaces, Boulevard, Baltimore MD

Rachel, G. Mark, S., Sarah, D. Deborah, C. and Joshua, L. (2013).‘The affordable act’s plan for consumer assistance with insurancemoves states forward, ‘healthaffairs,doi:10.1377/hlthaff.2012.1090,February2013vol.32&nbspno.2&nbsp347-356

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