Morrison 1 Amy Morrison Tammy Frailly HUM 220-2W1 10 February 2014 Final Research Proposal In the last ten

years, healthcare costs in the United States have skyrocketed beyond the income increases. According to a study published in 2008 by Cathy Schoen, Sara Collins, Jennifer Kriss, and Michelle Doty, in 2007 approximately 42% of the US adult population was either uninsured or underinsured (298). As these numbers have increased the government has attempted to enact reforms that would have a lasting impact and help those that were either uninsured or underinsured. With that in mind, Congress voted on and passed the Affordable Care Act in 2010. One of the main goals of the ACA was to strengthen health care while curbing costs, and ensuring quality care for the uninsured and underinsured (HHS Strategic Plan). The reading on this matter in addition to conversations regarding the new insurance exchange the responses have been varied; ranging from my up-front costs are more to I had to take a plan that covers less, so I can afford it. Additionally, the CEO of Aetna, Mark Bertolini, told CNBC, that of the new signups they have received through the marketplace only 11% were previously uninsured. This led to the question: Is the Affordable Care Act making insurance more accessible for the uninsured or underinsured than before the ACA implementation? As a result of some preliminary research, I would say that the majority of the people signing up of health care through the ACA marketplace, were already insured, and that the ACA is not actually helping the targeted demographics. Although the Affordable Care Act was enacted starting in October 2013, there is little research to this point on whether or not those that needed help before are actually being helped by the provisions of the ACA. Through some of

Morrison 2 my own forays into the healthcare marketplace, I have encountered some difficulties and cost prohibitive measures. I have also encountered stories from others of premiums being estimated and then receiving bills for different amounts. I would like to investigate through survey and research if the ACA is meeting its primary goal, and how it is affected by states choices to either expand/not expand Medicaid Roles. This new law purports to be the way for those that are uninsured or underinsured to obtain affordable healthcare, but is it really? If there are loopholes that are leaving the very people this intends to help out of the insurance pool, then addressing problems with implementation and provisions could eliminate them. This exploration will show areas that need shoring up in the law and could potentially be the downfall of the system if not fixed. In an attempt to determine the extent to which the targeted demographics are being assisted by the ACA, two different methods will be employed: review of information and statistics available and quantitative. Up to this point, there are numerous articles, studies, and predictions about what ACA is going to mean to the average person; however, none of them specifically address whether or not the people enrolling are currently uninsured or previously uninsured. The research of materials will give my study a firm background and allow for the basic frame work of the results of the surveys. After researching the topic and laying the foundation, I want to survey people from a few different sources: students and professors from the college; employees in a healthcare setting, and out of state companies through my contacts. I also intend to send surveys to people outside the state of North Carolina to get the data regarding insurance premiums before and after ACA. This is going to show any differences between states that have expanded their Medicaid rolls versus those that didnt.

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Sample Questions: 1. Did you have insurance prior to the implementation of ACA? a. If so answer these questions: i. Was the insurance through an employer or private? ii. What was your deductible? iii. What was your premium? iv. How many people are covered under this policy? Single, Married, family plan 2. Did you have to change insurance policies with the implementation of ACA? a. Answer these questions regarding post ACA implementation plan? i. Is it an employer paid plan? ii. What is your deductible? iii. What is your premium? iv. How many people are covered under this policy? Single, Married, Family Plan This research will open the door for others to build on. By giving some initial numbers on how well people are or are not being served by the new provisions of the ACA, there is a baseline and allows people to look for areas that need to be improved for the maximum effectiveness.

Morrison 4 Works Cited Belvedere, Matthew. Aetna could be forced out of Obamacare: CEO. CNBC. Web 25 Jan. 2014. Crowley, Ryan A., and Thomas G. Tape. "Health Policy Basics: Health Insurance Marketplaces." Annals Of Internal Medicine 159.11 (2013): 784-786. Consumer Health Complete - EBSCOhost. Web. 01 Feb. 2014. HHS Strategic Plan: Goal 1. Department of Health and Human Services. Web. N.d. Accessed on 27 Jan 2014. Schoen, Cathy, et al. "How Many Are Underinsured? Trends Among U.S. Adults, 2003 And 2007." Health Affairs 27.(2008): w298-w309. Academic Search Complete. Web. 01 Feb. 2014.