HEALTH CARE SYSTEM: Affordable Care Act

Health Care System: Affordable Care Act in Hawaii

The Affordable Care Act was passed by Congress and signed into law by President
Obama on March 23, 2010; it was upheld by the Supreme Court on June 28, 2012 (Sorrell,
2012). The purpose and goal of the ACA was expand insurance coverage, control costs, and
target prevention. (Gable, 2011). The main parts of this act are the 1) Patient Protection and
Affordable Care Act and the 2) Health Care and Education Reconciliation Act of 2010; these two
pieces of legislation act together to expand Medicaid insurance (Medicaid, 2014). The ACA
gives Americans control over their healthcare by letting them choose their insurance coverage
and reducing the costs of premiums (HHS, 2015). Cost of prescription drugs will also decrease,
saving taxpayer money. ACA aims to promote prevention, wellness and public health by
providing funding commitment and reduce preventable illness (HHS, 2015). ACA will increase
healthcare workforce recruitment by providing scholarships/funding for healthcare professional
programs.
In Hawaii, the ACA would benefit small businesses and close the insurance coverage gap
(HAH, 2012). The ACA would allow small business employers to receive up to 50% tax credits
to help pay for health insurance. This is significant since nearly 27,000 businesses in Hawaii
have less than 20 employees (HAH, 2012). The ACA would close the insurance coverage gap
by offering options for the following parties: part time workers who do not meet the 20 hour
minimum for four consecutive weeks: new immigrants, early retirees not eligible for Medicare,
and dependents not eligible for coverage (HAH, 2012).
Hawaii State Legislature
HB582. HD1. SD2. CD1
Relating to the Nursing Facility Sustainability Program
Act 069(15)
Signed into law on May 29, 2015 by Governor David Ige

HEALTH CARE SYSTEM: Affordable Care Act

This bill enhances the rate to enhance capitated rates to Medicaid managed care health
plans for the purpose of increasing Medicaid payments to private nursing facilities. Nursing
facility sustainability fees are used as permitted by this bill. At least 88% of the sustainability fee
is used to match Medicaid funds to increase Medicaid payment to private nursing facilities. The
remaining 12% is used for other department purposes. This bill increases reimbursements to
private nursing facilities to support the availability of services and to ensure access to care to the
Medicaid managed care. Rate enhancement requires department documentation to the nurse
facility trade association to ensure the revenue is used in accordance with this bill. The nursing
facility sustainability fee is discontinued if the waiver is unapproved by Centers for Medicare
and Medicaid Services, funding is below state appropriation, the department uses funds for
purposes not permitted in this section, or federal funding becomes unavailable.

HEALTH CARE SYSTEM: Affordable Care Act

References
Gable, L. (2011). The Patient Protection and Affordable Care Act, public health, and the elusive
target of human rights. Journal of Law, Medicine and Ethics, 39(3), 340-354.
Healthcare Association of Hawaii (HAH). (2012). Affordable Care Act Implementation in
Hawaii. Retrieved from: http://hah.org/wp-content/uploads/2013/12/Affordable-CareAct-Implementation-in-Hawaii.pdf
Medicaid: The Affordable Care Act, Baltimore, MD, 2014, Centers for Medicare and Medicaid
Services.
Sorrell, J. (2012) Ethics: The Patient Protection and Affordable Care Act: Ethical Perspectives in
21st Century Health Care. OJIN: The Online Journal of Issues in Nursing, Vol. 18 No. 1.
Retrieved from:
http://www.nursingworld.org/MainMenuCategories/ANAMarketplace/ANAPeriodicals/O
JIN/Columns/Ethics/Patient-Protection-and-Affordable-Care-Act-EthicalPerspectives.html
US Department of Health and Human Services (HHS). (2015). The Affordable Care Act: Section
by Section. Assistant Secretary for Public Affairs. Retrieved from:
http://www.hhs.gov/healthcare/about-the-law/read-the-law/index.html