Physicians who may have been skeptical of the Affordable Care Act when it was first signed into law by President Barack Obama and in its early rollout years have changed their tune over a five-year period, a new analysis shows.
A majority of U.S. physicians see the ACA as a “net positive” for the U.S. healthcare system, according to a study of doctor “reactions to ACA implementation” led by researchers of the Mayo Clinic, who wrote a seven-page analysis in the Journal Health Affairs.
“A slight majority of U.S. physicians, after experiencing the ACA’s implementation, believed that it is a net positive for U.S. health care,” Mayo Clinic researchers Lindsey Riordan, Jon Tilburt and several colleagues from across the country wrote in the September issue published this week. “Their favorable impressions increased, despite their reports of declining affordability of insurance, increased administrative burdens, and other challenges they and their patients faced.”
In 2017, 53% of doctors who responded to a mailed survey agreed that the ACA, “if fully implemented, would turn United States health care in the right direction,” according to the analysis. That compares with just 42% in 2012 so there was an 11 percentage point swing in opinion over five years.
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Having physicians on board is key to long-term success of the Affordable Care Act, its commercial coverage offered on public exchanges as well as the expansion of Medicaid benefits to more poor Americans under the law. Health insurance companies who largely provide the ACA’s health benefits via contracts with the government need doctors in their health plan networks, particularly as they expand into new regions as they are for 2020.
The Health Affairs report come two months after the 5th U.S. Circuit Court of Appeals heard a challenge to the ACA brought by 18 Republican-led states. The lawsuit, which has the backing of the Trump White House, puts healthcare coverage of more than 20 million Americans at risk as well as patient protections for tens of millions more U.S. consumers.
Most major doctor groups, including the American Medical Association, the American Academy of Family Physicians and the American College of Physicians have opposed efforts by the Trump administration and Republicans in Congress to derail the ACA.
As the case wends it way through the legal system and a potential airing before the U.S. Supreme Court, the financial footing of health plans selling such coverage is strong. Insurers also say their profits are growing because patient care is improving for the customers.
Already, Centene, Cigna, Oscar Health and other health plans are announcing plans to expand individual Obamacare coverage into new states and regions of the country. Some of these health insurers give some credit to physicians who are willing to participate in their health plan networks.
“When asked about specific ACA provisions in 2017, physicians reported favorable impressions about improved insurance access and coverage of preexisting conditions, while reporting unfavorable impressions about the law’s impact on the affordability of insurance, patient demand, and the role of employers in providing insurance,” Mayo Clinic researchers and their colleagues wrote in Health Affairs. “Physicians’ experiences of the overall impact of the ACA on their own practices were split or neutral and tended to be aligned with concerns about broader undesirable practice trends not directly attributable to the ACA, including growing time pressures and administrative burden, challenges in managing patients’ opioid use, and worsening staffing concerns.”
Date: September 05, 2019