Health care coverage and access


Access to high quality health care services is essential to everyone as to  achieve and maintain health. To achieve good quality health, it is necessary to have affordable, quality health insurance coverage. According to world health organisation’s universal health coverage concept, all people have access to the health services they need, when and where they need them, without financial hardship. It includes the full range of essential health services, from health promotion to prevention, treatment, rehabilitation, and palliative care. To achieve this everybody must have a good and affordable public or private coverage plan because uninsured people are less likely to have timely health care services and often represent poor status of health. In United States, a lot of people have no coverage plan and that’s why they can not access right health care services at right time. Medicaid is the nation’s largest single source of coverage primarily serving low income populations. Although the Medicaid program provides health care coverage to more than 70 million people, or one in five Americans, and is the nation’s largest single source of health coverage still a large number of Americans don’t have a coverage plan. Beneficiaries of medicaid program are are primarily low income populations so that everyone has a chance to achieve good health irrespective of financial status. In medicaid, beneficiaries include,  children and their families, adults, seniors and disabled individuals. Medicaid provides coverage for health care services, such as primary and acute care, as well as long term care services and supports.

Beside public coverage plans, health Insurance Marketplaces have become a major source of health care coverage, and millions of low income individuals rely on the marketplaces to access subsidies to lower the cost of their premiums and cost sharing.  However insurance marketplaces are unstable in certain regions and a number of factors have contributed to marketplace instability. In some cases, demographic factors, such as a small population base and disproportionately unhealthy population, can make a market unattractive to health plans.

For millions of Americans living in vulnerable rural and urban communities, hospitals are often the only source of care. Many of these hospitals are fighting to survive and potentially leaving their communities at risk for losing access to health care services.

Before the implementation of affordable care act, health care across United States presented a very different scenario. All the individuals without coverage plans were less likely to get high quality health care services and all the individuals with coverage plans had certain limitations to achieve good quality services.

After the affordable care act implementation, it was mandated that health insurance plans sold on the individual and small group markets must cover ambulatory patient services, emergency services, hospitalization, maternity and newborn care and mental health and substance use disorder services, including behavioral health treatment. It was also mentioned that health care coverage plans must cover prescription drugs, rehabilitative and habilitative services and devices,  laboratory services, preventive and wellness services and chronic disease management and pediatric services, including oral and vision care.