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The Patient Protection and Affordable Care Act (herein known as the
Affordable Care Act [ACA]) was signed into law on March 23, 2010.
Several provisions of the law went into effect in 2010 (including
requirements to cover children up to age 26 and to prohibit
insurance companies from denying coverage based on preexisting
conditions for children). Other provisions will go into effect
during 2014, including the requirement for all individuals to
purchase health insurance. In 2014, insurance purchasers will be
allowed, but not obliged, to buy their coverage through newly
established health insurance exchanges (HIEs)--marketplaces
designed to make it easier for customers to comparison shop among
plans and for low and moderate income individuals to obtain public
subsidies to purchase private health insurance. The exchanges will
offer a choice of private health plans, and all plans must include
a standard core set of covered benefits, called essential health
benefits (EHBs). The Department of Health and Human Services
requested that the Institute of Medicine (IOM) recommend criteria
and methods for determining and updating the EHBs. In response, the
IOM convened two workshops in 2011 where experts from federal and
state government, as well as employers, insurers, providers,
consumers, and health care researchers were asked to identify
current methods for determining medical necessity, and share
decision-making approaches to determining which benefits would be
covered and other benefit design practices. Essential Health
Benefits summarizes the presentations in this workshop. The
committee's recommendations will be released in a subsequent
report.
The goal of eliminating disparities in health care in the United
States remains elusive. Even as quality improves on specific
measures, disparities often persist. Addressing these disparities
must begin with the fundamental step of bringing the nature of the
disparities and the groups at risk for those disparities to light
by collecting health care quality information stratified by race,
ethnicity and language data. Then attention can be focused on where
interventions might be best applied, and on planning and evaluating
those efforts to inform the development of policy and the
application of resources. A lack of standardization of categories
for race, ethnicity, and language data has been suggested as one
obstacle to achieving more widespread collection and utilization of
these data. Race, Ethnicity, and Language Data identifies current
models for collecting and coding race, ethnicity, and language
data; reviews challenges involved in obtaining these data, and
makes recommendations for a nationally standardized approach for
use in health care quality improvement.
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