Ryan A. Crowley, BSJ; Sue S. Bornstein, MD; for the Health and Public Policy Committee of the American College of Physicians *
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Financial Support: Financial support for the development of this guideline comes exclusively from the ACP operating budget.
Disclosures: Disclosures can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=M18-3401.
Corresponding Author: Ryan A. Crowley, BSJ, American College of Physicians, 25 Massachusetts Avenue NW, Suite 700, Washington, DC 20001; e-mail, email@example.com.
Current Author Addresses: Mr. Crowley: American College of Physicians, 25 Massachusetts Avenue NW, Suite 700, Washington, DC 20001.
Dr. Bornstein: 3111 Beverly Drive, Dallas, TX 75205.
Author Contributions: Conception and design: R.A. Crowley, S.S. Bornstein, T.L. Henry, J.D. Lenchus, J. Quinton.
Analysis and interpretation of the data: R.A. Crowley, J.K. Carney, T.G. Cooney, T.L. Henry, J. Quinton.
Drafting of the article: R.A. Crowley, J.K. Carney, F. Syed.
Critical revision for important intellectual content: R.A. Crowley, J.K. Carney, T.G. Cooney, L.S. Engel, H.E. Gantzer, T.L. Henry, J.D. Lenchus, B.M. McCandless, M.B. Southworth, J. Quinton, M.A. Wallace.
Final approval of the article: R.A. Crowley, S.S. Bornstein, J.K. Carney, T.G. Cooney, L.S. Engel, H.E. Gantzer, T.L. Henry, J.D. Lenchus, B.M. McCandless, M.B. Southworth, F. Syed, A. Valdrighi, J. Quinton, M.A. Wallace.
Administrative, technical, or logistic support: R.A. Crowley, S.S. Bornstein.
Collection and assembly of data: R.A. Crowley.
The coverage reforms of the Patient Protection and Affordable Care Act have fundamentally changed the U.S. health care system. The law's health insurance regulations, which include protections for persons with preexisting conditions, have made health insurance more accessible. The premium tax credit and cost-sharing subsidies have made nongroup coverage more affordable. The essential health benefit package and coverage for preventive services without cost sharing have made insurance more comprehensive. Perhaps most important, the Medicaid expansion extended coverage to millions of low-income adults. Despite these gains, more needs to be done to bring the United States closer to achieving universal coverage. In this position paper, the American College of Physicians recommends action to enhance and expand eligibility for health insurance financial subsidies; stabilize health insurance marketplaces; provide sustained funding for outreach, education, and enrollment assistance activities; test and implement a mechanism to encourage enrollment; expand Medicaid in all states; and establish a public insurance option to increase competition.
Crowley RA, Bornstein SS, for the Health and Public Policy Committee of the American College of Physicians. Improving the Patient Protection and Affordable Care Act's Insurance Coverage Provisions: A Position Paper From the American College of Physicians. Ann Intern Med. [Epub ahead of print 16 April 2019]:. doi: 10.7326/M18-3401
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Published: Ann Intern Med. 2019.
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Print ISSN: 0003-4819 | Online ISSN: 1539-3704
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