Brandon William P
Metrolina Medical Foundation.
J Health Care Poor Underserved. 2012 Nov;23(4):1360-82. doi: 10.1353/hpu.2012.0176.
The next potential disaster facing the Affordable Care Act (ACA) is the November 2012 elections: Its opponents, who promise to "repeal and replace," may gain sufficient control of the federal government in 2013 to carry out their pledge. This commentary aims to promote understanding of the fundamental transformation that the ACA makes in Medicaid and to urge ACA opponents desiring some health reform after repeal to let the ACA's Medicaid provisions stand. After an introduction to the ACA and its vulnerabilities the commentary examines the evolution of Medicaid since its 1965 origins as a means-tested concomitant of cash welfare. It shows that Medicaid has been very adaptable as it morphed into a complex categorical program for specific populations or types of care. The ACA transforms Medicaid into a universal means-tested entitlement for anyone below 138 percent FPL. The conclusion explains why ACA opponents should retain its Medicaid provisions.
《平价医疗法案》（ACA）面临的下一个潜在灾难是2012年11月的选举：其反对者承诺“废除并取代”该法案，他们可能在2013年获得对联邦政府的足够控制权，以兑现其承诺。本评论旨在促进对ACA给医疗补助计划带来的根本性变革的理解，并敦促那些希望在废除ACA后进行一些医疗改革的反对者让ACA的医疗补助条款保持不变。在介绍了ACA及其脆弱性之后，本评论审视了医疗补助计划自1965年作为基于收入调查的现金福利配套措施起源以来的演变。它表明，医疗补助计划在演变成针对特定人群或护理类型的复杂分类项目时具有很强的适应性。ACA将医疗补助计划转变为一项针对收入低于联邦贫困线138%的任何人的普遍的基于收入调查的应享权益。结论部分解释了ACA反对者为何应保留其医疗补助条款。
