• Uncategorized



SocialPolicy Paper

Thispaper involves a review of a matter of promoting healthcare cover tofamilies and children, which is under the process of legislation atthe federal level in the United States. Indeed, matters of healthcarereform have been of great concern to the citizens of the UnitedStates for a long time. Healthcare Reform associates withestablishment or improvement of health policies in a country with theaim of bettering healthcare delivery to families and children(DeNavas-Walt, 2010). From this perspective, it is evident for one tosee that the country is in serious need of making amendments to itslaw for purposes of establishing and or enhancing policies on healthcare coverage with the aim of facilitating universal health cover.

of the bill

Thepiece of legislation under discussion in this paper is the MedigapConsumer Protection Act of 2016 (H.R. 6265). Important to note isthat Medigap is also referred to as the “Medicare SupplementInsurance.” As hinted before in this paper, Medicare ischaracterized by significant gaps that make the people incurconsiderable costs for healthcare services via deductibles andcoinsurance. Even though Medigap helps the people to cut back on somemajor healthcare costs, the policy relies on laws that have neverbeen changed or amended ever since 1990. This establishes a majormotivational factor for the introduction of the bill under questionto Congress by Congressman&nbspJim McDermott&nbsp(D-WA) RankingMember of the Ways and Means Subcommittee on Health. An in-depth lookat the prevailing situation shows that consumer protection in thecountry has been left to the mercy of commonplace market practices,which have changed significantly since 1990 (DeNavas-Walt,2010).What is more is that the beneficiaries of the policies have limitedinformation regarding their plan options, making them enroll inlow-quality health coverage as a result.

Alook at the Bill shows that it has a capacity of improving Medigap insome ways. To begin with, the guaranteed issue rights will beexpanded for purposes of inhibiting issuers from denying health carecoverage to disabled persons and those with End-Stage Renal Disease,over and above other beneficiaries, who are currently unprotected.What is interesting is that passing of the Bill would placelimitations on the pricing of Medigap products by issuers based onthe age of the beneficiary. The National Association of InsuranceCommissioners will also be required to update ratio standards ofmedical loss to improve effectiveness and efficiency of Medigappolicies (Congress.Gov, 2016).

Forpurposes of ensuring appropriate dissemination of information isachieved, the amendment calls for improvements on the existentMedicare Plan Finder website, which beneficiaries can easily access.Additionally, there will be requirements for transparency on the partof issuers. They will be obliged to disclose information aboutpayments to brokers that are charged with responsibilities of sellingMedigap policies publicly. Finally, the Bill seeks to restore accessto Medigap plan options based on the provision of first-dollarcoverage (Congress.Gov, 2016).


Alook at Medigap, as a policy of healthcare, shows that supplementalprivate insurance covers coinsurances and deductibles of Medicare inthe United States. Even so, other healthcare policies cover somehealth care costs that are not under Medicare. Some of such costs aredirect in nature, such as the costs for emergency care for a citizenof the United States in another country. So far, Medigap serves as aunique healthcare cover that takes care of charges from health careproviders that do not consent to the assignment. Despite the factthat Medigap has some valuable benefits for American families, in amanner that it does not restrict them to some networks of healthcareproviders, the policy only covers a relatively small portion of thenation’s population- eleven million people. With the recentendeavors by the government of the United States to facilitateuniversal healthcare cover for citizens, Medigap poses as a desirableplatform for enhancing healthcare cover for the people.

Onthe other hand, matters of healthcare cover in the United States alsoshows that the citizens of the nation have been in need of universalhealth coverage (UHC) for a long time. Unlike the situation in otherdeveloped countries in Europe, the United States has always fallenbehind regarding the strength and reliability of its health policies.Undeniably, the citizens of the country have not enjoyed equal accessand rights to healthcare services (Rodney, &amp Hill, 2014). Mostpeople link the situation with the existence of influential playersin the healthcare industry that have the power to influence theestablishment of the policies at the expense of citizens withfinancial difficulties and for purposes of safeguarding theirprofitability. The Obama administration promised to engage in effortsof facilitating UHC in the country. According to World HealthOrganization (WHO), assurance of UHC implies that citizens of acountry have equal access and rights to healthcare services devoid oftheir financial capabilities (WHO, 2013). Apparently, the Obama careor the Patient Protection and Affordable Care Act (PPACA), whichbecame law on March 23, 2010, hardly relates to achievement of UHC(Antos,Capretta, &amp Wilensky. 2016)


Allthe proposals outlined above represent updates to federal law thatare nothing short of overdue, to say the least. Without any doubts,such updates to the legislation of the United States would mean thatthe beneficiary experience will be enhanced and that many familiesand children will realize a sense of health security. What is more isthat more people would be enrolled in Medicare. Undoubtedly, thelegislation deserves much-needed support.


Antos,J., Capretta, J., &amp Wilensky, G. (2016). Replacing the AffordableCare Act and other suggested reforms.&nbspJAMA,&nbsp315(13),1324-1325.

Congress.Gov.(2016). H.R.6265 – Medigap Consumer Protection Act of 2016. RetrievedOnline fromhttps://www.congress.gov/bill/114th-congress/house-bill/6265/text?r=32

DeNavas-Walt,C. (2010).&nbspIncome,poverty, and health insurance coverage in the United States (2005).DIANE Publishing.

Rodney,A. M., &amp Hill, P. S. (2014). Achieving equity within universalhealth coverage: a narrative review of progress and resources formeasuring success.&nbspInternationaljournal for equity in health,&nbsp13(1),1.

WorldHealth Organization (WHO). (2013).&nbspResearchfor universal health coverage: World health report 2013.Retrieved online from&nbsphttp://www.who.int/whr/2013/report/en/