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Impact of the Health Reform Policies and Affordability Act on the State Governing Bodies and Medical Fraternity

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Health care in North Carolina, along with other states in the United States is becoming too expensive. The health care system faces specific problems and costs are rising with the increase in inflation rates. The fact that many Americans do not have insurance coverage and the economic conditions are creating the fear that many people may lose their existing content is adding to the problems. The scenario of health care in the US compelled the federal government to decide to impose a new law making insurance coverage mandatory. The purpose of the paper is to analyse the impact of the health reform policies and affordability act on the state governing bodies and the medical fraternity. The report will involve an analysis of supporting and contrasting views on federal law. The supporters of the federal law believe that it will ensure affordable health care to all the citizens.

Impact of the Health Reform Policies and Affordability Act on the State Governing Bodies and Medical Fraternity

State Governing Body’s Response to Healthcare and the Affordability Act

Governor Bev Purdue said creativity would help minimise the cost of health care and improve health care in North Carolina. At the State Health Directors’ Meeting, the Governor met with many health officials in Raleigh. Governor Purdue said, “The work being done at the local level, combined with the help of all state agencies, through health departments, educators, colleges, non-profit organisations and the business community, is vital to encourage people to act.” Via some priorities set out in the “Safe North Carolina 2020 Strategy,” A unique drive to enhance the health of all people of North Carolina has been adopted. The main focus of this initiative will be on tobacco use, unhealthy sex, dietary and physical activity, environmental hazards, infectious diseases, mental health, the health of babies and mothers, chronic illnesses, and, to name a few, dental health. North Carolina’s health ranking in the nation is 35th. The Safe North Carolina 2020 Plan focuses on coordinated measures to enhance health in North Carolina against specific goals by the state, localities and regions. Several evidence-based techniques are being introduced, such as biking, for instance. Different targets against resource limitations set in the safe NC 2020 (NC Department of Health and Human Services, 2011) have to be met by the public health division.

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To incorporate health care reforms, the Patient Safety and Affordability Act was passed. President Mr Barrack Obama, turning the act into a statute, signed a comprehensive health reform on March 23, 2010. This act tackles the concerns of raising spending on health and access to better health care. The show provides individuals with reliable access to health insurance, shifts the demand for health insurance, increases coverage and lowers health care costs (RUPRI Center for Rural Health Policy Research, 2010).

The State Governing Body’s Response to the Health Care Law, Funding Issues, Impact of the Law on the Economy and State’s Healthcare

Federal law on health care overhaul has been established in North Carolina compelling people to get mandatory health insurance cover by the beginning of 2014 or else to get penalised. This federal law has been viewed as unconstitutional (Sun News, 2011).

This act has been considered as an infringement by the government. The House Judiciary Committee had approved legislation against the federal law. It was the foremost issue taken up by the Republican legislative candidates. Roy Cooper, the attorney general, had stated that both federal and state laws should be upheld, but federal regulations will have priority over state laws. The primary intention of the federal law was to provide insurance coverage to the maximum number of people, and insurance companies would not be able to refuse coverage to ill people. The existing 1.6 million people in North Carolina who do not have insurance coverage would get it through the enforcement of the federal law. The fight against the federal law would involve significant expenditure which is not justified in the present economic scenario. The state of North Carolina would prefer not to indulge in the lawsuits against federal law as is being done by other countries (Bloomberg Businessweek, 2011).

A ‘grim diagnosis’ report published by two doctors, Coburn and Barrasso, highlighted the effect of the federal health care law on businesses, the economy and the workers in the US. The report states that this health care law will cause the elimination of jobs, reduce the income of people and increase overall expenditures. It is estimated that the law can eliminate 800,000 jobs; cause reduction of real income and the high costs involved will discourage the recruitment of young Americans. The rising health care costs are taking a toll on employers. The new law has not been able to implement the actual reform that was needed. The report’ grim diagnosis’ states “the new law focused on some of the symptoms in our health care system, but failed to address the underlying disease”. It has been recommended that the new law should be replaced with reasonable provisions that can lower the costs, reduce the bureaucracy and interference of the government, increase the patient’s control and make available affordable and high-quality health insurance to every American citizen (Health Reform Report, 2010).

The Impact of the Law on the State’s Health Care

The Affordable Care Act has ensured the availability of a tax credit to small businesses to make it easier for them to provide health insurance coverage to their employees and at affordable premiums. The small companies have to pay much higher premiums than the massive businesses, and the premiums are also rising at a rapid rate. The tax credits will help in bringing down these costs. In 2010, an early retiree reinsurance program was introduced to ensure the stabilisation of the ‘early retiree coverage’. This made sure that companies continued to provide health insurance to the early retirees.

Moreover, insurance companies shall not be able to impose lifetime limits on their insurance coverage, and thus customers would not face the problem of content expiring. A ban will be charged on the insurance companies prohibiting them from not providing range to sick people. The target limits of insurance plans will be strictly regulated. Extended coverage will be provided to young adults. The community health centres will be strengthened through additional funding. Additional funding will be provided for National Health Service Corps to provide scholarships and help in the repayment of loans to health care providers, doctors and nurses to ensure that they offer services in areas which lack medical facilities. The federal Medicaid funding has been established in North Carolina that will provide coverage to the low-income group (Health Reform.gov, 2011).

Support for and Against the Issue

The proponents of the new law believed that it would result in cost reduction by providing coverage to the uninsured 30 million people in the US and subsequently “the uncompensated care cost” would be reduced. It was said that uncompensated people do not bear the entire cost of their emergency care. This cost is transferred in the form of higher premium to families and businesses. People with contrasting viewpoint believe that emergency room (ER) waiting times will increase, ER costs will increase, and finally, the national sending also increases. Various other problems associated with the new law have already been cited (Coburn & Barrasso, 2010).

The perspective of the Medical Community, the Nursing Community, State Governing Body and the Constituents in the State and Challenges to the Implementation of the Law

The medical community’s perspective is presented through a report by two physicians, Senator Tom Coburn and Senator John Barrasso. The new law has an impact on job opportunities in the health care industry. Section 6001 of the new law restricts hospitals owned by doctors from expansion and Medicare reimbursements have been denied to the hospitals owned by doctors and which have not been certified by Medicare. The Physician Hospitals of America (PHA) had declared that 39 projects had been cancelled because the owners felt that they would not be able to obtain the Medicare certification. The project could have generated job opportunities. The law has restricted the extension of ownership of a physician in the hospital. Companies that manufacture medical devices are also facing the brunt of the law. A $20 billion excise tax will be imposed on the medical device manufacturing industry. The law, in general, has set greater control of the government over the nursing and the medical community. Thus, they do not have a positive outlook on the law.

The North Carolina state governing body has supported the republican bill which has challenged the health overhaul by the federal government. A bill backed by Republicans aims to protect the forms from the mandatory insurance cover. Attorney General Roy Cooper is also being forced to join the lawsuit. The Democrats feel that the opposing measures will prevent many people’s claim to health insurance. However, Republicans hold a negative opinion about the benefits of the law (Daily Reporter, 2011).

The implementation of the law has thus become difficult due to oppositions from various directions towards the law. These issues have made the performance of the law difficult.

 Technical Developments

Patient Protection and Affordability Act of 2010 relies on Health Information Technology (HIT) to bring about a radical transformation in the sector of health care in North Carolina. The federal government is investing heavily on HIT. The healthcare providers are being encouraged to use the HIT. The insurance providers and hospitals will be encouraged to integrate electronic health records (EHR) (NC Department of Health and Human Services, 2011).


It can thus be said that the federal health coverage overhaul imposed by the federal government has been severely criticised and it has not been viewed favourably by the medical fraternity or the state governing bodies. The Affordability Act was enacted to ensure affordable health care to all the citizens and bring about essential healthcare reforms. Nevertheless, opponents to this view believe that it will further aggravate health care costs and would result in several other associated problems. The severe protests made against the law have made its implementation difficult. The effectiveness of the new law is uncertain, and hopefully, a solution can be reached by incorporating specific changes within the extent of the existing law.


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