Reforming of the U.S. Health Care System
Overview
The United States needed to reform health care because the cost
was too high.
The rising of health care costs threatened to consume the entire
federal budget.
It made the cost of preventive care unaffordable. That sent
many low-income people to the emergency room, raising costs
even higher.
High costs made the U.S. health care system cost twice as much
per person compared to any other developed country.
The impact of the Health Reform
in the Hispanic Community
Hispanics make up the most substantial and fastest-growing

minority group in the U.S.
Hispanics live longer and have lower death rates from heart
disease, cancer, and many of the other leading causes of death
than non-Hispanic white residents
Despite having social disadvantages, including lower incomes
and worse access to health coverage.
The new health reform law will significantly expand access to
affordable health coverage which is especially important for
“Latinos”. In 2008, nearly 31 percent of “Latinos” were
uninsured compared to a national average for all racial and
ethnic groups of 15 percent and 11 percent for non-Hispanic
whites.
Affordable Care Act
Other Names
Patient Protection and Affordable Care Act – (Officially)
Obamacare – (commonly known)
Primary goals:
Make affordable health insurance available to more people.
Expand the Medicaid program to cover all adults with income
below 138% of the federal poverty level. (Not all states have
expanded their Medicaid programs.)
Support innovative medical care delivery methods designed to
lower the costs of health care generally.
Health Reform Actions
Expanding Medicaid
Medicaid coverage was expanded to cover children and adults
with incomes up to 133 percent of the federal poverty level—
roughly $14,403 for an individual and $24,352 for a family of

three in 2010.
This Medicaid expansion provided coverage to many Latino
individuals and families.
Health reform increased funding to the Territories, such as
Puerto Rico
Health Reform Actions

Create New Marketplaces
The creation of a state health exchanges for individuals who do
not qualify for Medicaid or who cannot get affordable coverage
from their employer started in 2014.
These exchanges allowed individuals to shop for insurance and
compare prices and benefits.
To ensure the affordability of the health insurance, the law
provided refundable tax credits to offset a portion of the cost of
health insurance premiums.
Health Reform Actions
Eliminates Discrimination Due to Pre-Existing Conditions
The health reforms offered protection to individuals who have
pre-existing conditions today, as well as to those who are
healthy, but who may develop a health problem in the future.
No individual with a pre-existing condition will be denied
coverage, charged a higher premium, or sold a policy that
excludes coverage of essential health benefits, just because she
or he has a pre-existing condition.
Pre-existing conditions – DM, Ca, HTN, HF, Obesity, CRF, HIV
Health Reform Actions
Increases Funding for Community Health Centers
Community Health Centers play a critical role expanding access
of health services to communities of minorities or ethnic
groups.

Typically located in medically underserved areas, community
health centers provide culturally and linguistically appropriate
care to all residents regardless of insurance status, citizenship
status, or ability to pay.
Between 2011 and 2015, the health reform law provided $11
billion to community health centers for services, construction
and renovations.
Community Health Centers play a very important role giving
access to care to our most vulnerable populations.
Health Reform Actions
Improves Data Collection
It is well known that disparities in health exist across racial and
ethnic minority groups, but there are limited coordination,
documentation, and analysis of data that examine the nature of
health disparities by race and ethnicity.
Collecting and reporting these data are crucial for identifying
and monitoring the health problems that exist among vulnerable
populations and for developing the proper solutions to
eliminate disparities in these communities.
The health reform law collect and report data by race, ethnicity,
sex, disability, and the primary language of participants for all
federally conducted or supported health care or public health
programs.
Health Reform Actions
Improves Data Collection (cont.’)
It is crucial for identifying and examining variations between
subpopulations, especially ethnic minorities.

It will help to generate reliable estimates of populations for
surveillance, research, and analysis purposes.
Data and analyses will also be available to agencies within the
Department of Health and Human Services (HHS), as well as to
other federal agencies, nongovernmental organizations, and the
public.
Promotes Culturally and Linguistically Appropriate Services
Effective communication among patients, health care providers,
and insurance companies.
Health Reform Actions
Supports Community Health Workers
Community Health workers provide a link between members of
the community and health care services. They provide
information and resources in a culturally appropriate manner.
The law provides funding for training, supervision, and support
of community health workers.
Health Reform Pros and Cons
Health Care Reform
It is essential to remember that the Affordable Care Act is not

the only process of reform to consider.
Since the 1970s, many of the world’s developed nations have
reformed their health care in numerous ways.
The goal is to improve care access.
References
Estes, C. L, Chapman, S. A., Dodd, C., Hollister, B. &
Harrington, C. (2013). Health Policy: Crisis and Reform. (6th
Ed). Boston: Jones and Bartlett Learning
https://www.govinfo.gov/content/pkg/PLAW-
111publ148/pdf/PLAW-111publ148.pdf
https://www.healthcare.gov/glossary/affordable-care-act/
PROS’ CONS’
1. Reforms attempt to address deficiencies
within the system
1. It may create negative results instead of
positive results

2. It can reduce health care costs 2. There is always a financial
cost to pay for
reforms
3. Health care reform change which services
are received
3. Reforms tend to gut the existing systems
that are in place
4. Reforms allow people to manage their
expenses wisely
4. Health care reforms tend to cost more at the
individual level over time
5. It allows for continued access to the health
care market
5. It changes the structure of how care is
delivered
6. Reforms can change who is permitted care
access under specific plans
6. Reforms create uncertainty
7. It can remove benefit expirations 7. It may create penalties to
keep people in
compliance
8. It may improve medication access 8. Health care reforms take
a lot of time to
implement
9. Reforms can change the access point for
care received