Health Insurance and the Affordable Care Act

Health Insurance and the Affordable Care Act
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Healthcare plan
The preferred provider organizations plans (PPOs) provide more flexibility than HMOS, but since employees can choose to stay or go outside the network, they have more alternatives on the choice of physicians based on their lifestyles. Even though, premiums may be higher than HMOs, the cost is typically borne by the participant rather than the employer. In any case, participants choose other alternatives outside the network even in cases they do not seek referrals from the providers (Green, 2012). The coverage in these plans can vary depending on the insurance provider for both in-network and out of network coverage. Employees may prefer the member provider choice since it is less costly than the member provider alternative.
Even though, PPOs have not been the dominant plan unlike HMO, there is less administrative burden associated with the option. Nonetheless, one of the challenges associated with the plans is that there is no certainty on the impact of increased calls for HMO accountability as well as future cost implication. At the moment, PPOs are the best option given that is possible to tailor the workers’ benefits based on the insurance coverage (Green, 2012). In any case, since there has been some skepticism about ObamaCare PPOs are likely to be well accepted by employees as they care much about choice as well as costs. In any case, since PPOs customize benefits based on the health risks of participants and demographic profile, it is likely that preventive care will be crucial in reducing the cost of insurance coverage (Green, 2012).
Affordable Care Act and purchase of insurance
The Affordable Care Act has made it necessary to expand the scope of services that can be covered by a health insurance plan. There is concern, that this may make the PPOs uncompetitive in the future since there is a need to ensure than Essential Health Benefits are well covered under the healthcare insurance plans. In other words, ...