Healthcare Policy and Law

This article discusses the point-of-service plan for purchasing health insurance for companies, advantages and disadvantages of ACA, and the impact of ACA on small businesses. It also explains the benefits of Small Business Health Options (SHOP) and the penalties associated with uninsured employees.

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Healthcare Policy and Law
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Healthcare Policy and Law 2
Healthcare Policy and Law
The plan that I would use to purchase health insurance for the company is the point-of-
service plan (POS). POS health insurance plan is a hybrid of health maintenance organization
(HOME) and preferred provider organizations (PPO). Just like in HMO, patients are allowed to
visit an in-network physician as their primary provider. However, just like in PPO, the patients
have the right to go outside of the provider network for health care services (Brice, Kimberly &
Woodard, 2017). Other than that, venturing outside the network will force the patients to pay
most of the cost, except when the main care provider has made a referral to the out-of-network
provider. This type of plan is vital to the employee’s lifestyle and health because the services
provided by the primary doctor are not subjected to deductible and the preventive care benefits
are also included. On the other hand, the plan is flexible because the patients can easily visit any
specialist and those using outpatient medical services can also benefit (Brice, Kimberly &
Woodard, 2017). Other than that, employees may get health service anywhere and still gain
medical coverage.
The federal care reform law also known as the Affordable Care Act (ACA) is that it is
meant to increase the number of the Americans who are covered by health insurance. It does this
by creating health insurance exchanges that are the new markets for purchasing insurance
(Moran, 2014). Additionally, it imposes fines on some employers that do not provide coverage
and to people who do not have the private or public insurance. Besides, ACA requires almost all
the Americans to obtain health insurance. It requires that most of the employees should get
covered through their employers; hence, has developed a system of penalties and subsidies to
make that possible (Moran, 2014). On the other hand, ACA has got some of the advantages and
disadvantages to the small companies that have purchased health insurance to their employees.

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Advantages of ACA
ACA provides an exchange program for small businesses, called Small Business Health
Options (SHOP) that allows the companies with less than 100 employees to pool together to
increase their purchase power. Due to that, the companies will be able to provide health
insurance to their employees at the same rate to those available to large companies (Moran,
2014). Additionally, the small businesses that purchase health insurance for their employees
through the Small Business Health Options can get a two-year small business tax credit of up to
fifty percent of the cost of the premium.
Disadvantages
The Affordable Healthcare Act may force companies to increase their offer to be able to
respond to employee preferences that will change in response to the mandates of an individual.
Particularly, employees will have higher demand for insurance because of the existence of the
penalty, which is associated with uninsured (Moran, 2014). Another disadvantage is associated
with the insurance exchanges. Even though, the employer will remain the primary source of
health insurance coverage, however, the nature of the coverage provided by the employer will
change due to the option to offer insurance through exchange.

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References
Brice, R. A., Kimberly, M., & Woodard, T. (2017). eACOs: Fixing the Broken Triangle in
Health Care. Benefits Magazine, 54(11), 30-39.
Moran, G. (2014). Prognosis: uncertain. Entrepreneur, 42(5), 50-54.