Keiser Permanente in the Affordable Care Act Context

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Table of Contents

Introduction
Analysis
Summary and Recommendations
References

Introduction

Society and business are closely interrelated in the aspect that society has an impact on business through policies and laws, and diverse companies influence society through their activities. One of the fields where this impact is well observed is health care because health care is one of the fundamental rights granted to every citizen and thus regulated by the state. The Affordable Care Act (ACA), also known as “Obamacare,” is one of the most meaningful laws in health care enacted during the recent decade.

It was put into power in 2010 and was expected to provide more American citizens with affordable insurance, expand the Medicaid program, and support innovative methods of care delivery (“Affordable Care Act (ACA), n.d.). Nevertheless, Medicaid could not provide the necessary coverage, which gave an opportunity to private insurance companies to provide affordable insurance for citizens with income below the poverty level. One of the corporations involved in insurance service under ACA is Keiser Permanente.

It is an integrated managed care consortium with headquarters in Oakland, California. Founded in 1945, Keiser Permanente developed into a corporation that unites such entities as the Kaiser Foundation Health Plan, Kaiser Foundation Hospitals, and some other regional Permanente Medical Groups. The mission of the company is to “provide high-quality, affordable health care services and to improve the health of our members and the communities” they serve (“About Keiser Permanente,” 2018, para. 3). Therefore, the corporation is likely to be influenced by the adoption of ACA, which is also aimed at the provision of affordable care. The purpose of this paper is to analyze the impact of the Affordable Care Act on activities related to insurance provided by Keiser Permanente.

Analysis

Pre-Conditions of the Affordable Care Act

ACA is the law that pushed a change in the healthcare system of the United States. It was a need for time and a result of thorough preparation before it passed. ACA was expected to provide insurance coverage for more than 94 percent of Americans (“History and timeline of the Affordable Care Act (ACA),” 2018). Passage and implementation of ACA were vital for a vulnerable population such as low-income individuals. Thus, studies conducted before ACA implementation revealed from 9 to 19 percent of nonelderly adult Americans who went without health care (Glied, Ma, & Borja, 2017).

These people claimed they could not afford insurance due to its high cost. Moreover, from 18 to 26 percent of Americans did not have a usual place of care and a personal doctor or health care provider (Glied et al., 2017). Therefore, a law that could bring positive change to insurance coverage and, as a result, to a general increase in access to care, was necessary for the healthcare system of the United States.

Reform in health care has been actively discussed in the Senate since 2009 but was not supported at that time. Nevertheless, surveys showed the necessity for reform because many uninsured individuals who could not afford care plans remained deprived of high-quality cars, which had a negative impact on population health in on the whole (“History and timeline of the Affordable Care Act (ACA),” 2018).

At the beginning of March 2010, the Senate still lacked votes to pass the bill to the President’s signature. Finally, on March 21, 2010, the House approved the version of the health care plan, and on March 23, 2010, it was signed into law by President Obama (“History and timeline of the Affordable Care Act (ACA),” 2018). Still, the provisions of ACA were not evenly implemented throughout the country, and as of 2014, only 24 states and District Columbia supported Medicaid expansion (Wherry & Miller, 2016).

The Impact of ACA on Keiser Permanente

Generally, the implementation of ACA provisions in the state of California had a positive impact on the activity of Keiser Permanente. It can be explained by the fact that California, where ACA adoption is considered to be the most successful, creates opportunities for the development of the insurance providers. After ACA implementation, Keiser Permanente developed a network of facilities that provide care, conduct research, and are involved in the improvement of community health. Currently, Keiser Permanente serves over 12.2 million members who have care plans with this corporation (“Fast facts about Keiser Permanente,” 2018).

Almost 10 million are from California, while others come from different states. To satisfy the needs of new members, the company runs 39 hospitals and 684 medical offices throughout the country (“Fast facts about Keiser Permanente,” 2018). These facilities employ over 22 thousand physicians, more than 53 thousand nurses, and more than 216 thousand other employees. Keiser Permanente has demonstrated a steady performance since 2010 and a regular annual increase in operating revenue. The most significant increase was recorded after 2014 when ACA provisions resulted in a sharp need for private health insurers.

Thus, revenue was $56.4 million in 2014, $60.7 million in 2015, $64.4 million in 2016, and $72.7 million in 2017 (“Fast facts about Keiser Permanente,” 2018). Keiser Permanente, in fact, became an insurance leader in the region. Thus, health plans of Kaiser Permanente provided both in Northern and Southern California are considered to be “the only plans in the state to receive 5 stars,” which is the highest possible rating (“Keiser Permanente’s overall quality of medical care earns the highest rating,” 2018, para. 1).

This rating is awarded for the general quality of medical care assessed in the annual Healthcare Quality Report Card, which is prepared and presented by California’s Office of the Patient Advocate. Kaiser Permanente suggests care plans that can satisfy diverse populations. For example, the company serves families and individuals as well as allows coverage through an employer and has Medicaid/Medi-Cal plan with affordable health options.

Benefits of ACA

There are diverse benefits that result from ACA adoption, most of which are evidence-based and proved through research. For example, Wherry and Miller (2016) reveal an increase in insurance coverage as one of the beneficial consequences of ACA implementation. Meaningful positive changes were recorded among citizens with both private and Medicaid insurance. Moreover, the general improvement of health insurance rate improved.

In addition, more individuals visited health care specialists of general practice and were admitted to hospitals after ACA adoption (Wherry & Miller, 2016). Also, ACA provisions stimulated further positive changes in the delivery and availability of health care throughout the country. One of the evident benefits mentioned by Federal agencies and other professional organizations in the field of health care is a decrease in health disparities that are considered a burden of American health care (Adepojou, Preston, & Gonzales, 2015).

Consequently, ACA is a contribution to the reduction of the disparity gap in the healthcare of the United States. In fact, ACA has already resulted in a decrease in discriminatory insurance practices that led to uninsurance among unprotected and low-income populations. It happened due to the fact that insurance became more affordable. Finally, ACA presents the first National Prevention Strategy and provides support for many public health programs.

Pressures and Costs of the Law on the Corporation

Despite evident benefits provided by the adoption of ACA, there are certain pressures that were put by this law on health insurers, including Keiser Permanent. Since the idea of ACA is to make health insurance affordable for those population groups that could not afford the premium care plans or could not qualify due to the health condition, the task of insurers was to develop such plans. Evidently, private insurers such as Keiser Permanente could not plan care and lose profit.

It resulted in an increase in cost for premium plans for individuals who could pay, which, in turn, led to the dissatisfaction of this group of clients. Nevertheless, the law banned charging higher premiums for existing clients, and insurance companies were at risk of losing costs. Still, ACA caused a significant increase in new clients. These were not only underserved poor-income individuals who could not afford care plans earlier, but many young people who did not have any care plans because they were healthy enough not to purchase insurance until it became obligatory.

As a result, bigger insurance companies such as Keiser Permanente obtained more benefits than losses due to an increase in a number of clients whose care plans covered the losses due to the provision of cheaper plans for low-income citizens. On the whole, Keiser Permanente had more benefits than pressures from the adoption of ACA in California.

Possible Causes of Amendments or Changes

ACA is being implemented successfully for almost eight years. Still, there are some triggers that can result in changes in this law. The major moving power in legislation is government and the President. Thus, changes in these political forces are likely to lead to amendments and changes in ACA and its provisions. After Donald Trump becoming the President of the United States, ACA has been much criticized.

Further attention to ACA from state legislators can result in amendments or reduction of its power, which will lead to change in the insurance market. Another possible cause of amendments or changes in ACA as one of the primary laws regulating American health care is an economic crisis. Economic problems usually lead to a decrease in the income of the population, thus reducing their ability to pay for premium insurance plans or any insurance at all.

Thus, a change can be needed to preserve coverage of population in case of deteriorated economic conditions. Also, a change in ACA provisions can be needed when private insurance companies refuse to provide affordable care plans due to the loss of income. In this case, there will be a need for amendments that consider current condition of health care system and demands of insurance providers. Finally, a change or some amendments are possible when the needs of population change. It may happen when insured individuals want to enlarge the services included in their coverage or, due to some reasons, the number of uninsured individuals starts to grow again.

Summary and Recommendations

On the whole, the example of the Affordable Care Act and Keiser Permanente provides evidence that business and laws produced by society are closely interrelated. The adoption of ACA was the demand of time because society needed a change in health care. In turn, ACA adoption had an impact on one of insurance providers, Keiser Permanente. In the case under consideration, both society and a business corporation benefited from the adoption of the law.

People who could not afford insurance or did not qualify for care plans received coverage and access to high-quality care, which means that the law met the needs of population and the business corporation had an opportunity to satisfy these needs. Thus, the following recommendations related to the interrelation of society, laws, and business can be provided. First of all, policies and regulations should be aimed at general wellness of society in different aspects including social, economic, and political. Secondly, adoption of a law demands careful preparation and research to make it working and useful for society. Thirdly, business corporations that are expected to be affected by new laws should be allowed to participate in discussions of legal acts because people involved in politics are not always aware of the economic consequences of their decisions.

Finally, there is a need for public discussions of new laws that are related to burning social issues to consider thoughts of people whom these laws are expected to serve. In case these basic recommendations are followed, new laws are likely to be beneficial both for business corporations and society and lead to an increase in both economic performance and public satisfaction. This approach will result in the more effective legislature and more productive regulation of social issues that involve the participation of business corporations.

References

About Keiser Permanente. (2018). Web.

Adepoju, O., Preston, M., & Gonzales, G. (2015). Health care disparities in the post-Affordable Care Act era. American Journal of Public Health, 105, 665-667.

Affordable Care Act (ACA). (n.d.). Web.

Fast facts about Keiser Permanente. (2018). Web.

Glied, S. A., Ma, S., & Borja, A. (2017). Effect of the Affordable Care Act on health care access. Web.

History and timeline of the Affordable Care Act (ACA). (2018). Web.

Keiser Permanente’s overall quality of medical care earns highest rating from the Office of Patient Advocate. (2018). Web.

Wherry, L. R., & Miller, S. (2016). Early coverage, access, utilization, and health effects associated with the Affordable Care Act Medicaid expansions. Annals of Internal Medicine, 164(12), 795-803.

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