PPACA下员工健康计划的扩大为残障人士的医疗保险增加了额外的障碍。

Journal of law and health Pub Date : 2016-01-01
Amy B Cheng
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引用次数: 0

摘要

多年来有记录表明,一般人群在获得医疗保健方面存在许多障碍,其中一个特别受影响的群体是残疾人。一个确定的残疾人医疗障碍是无法通过健康保险进入医疗保健系统。虽然为解决这一问题作出了许多努力,但仍有一些严重的问题有待解决。《患者保护平价医疗法案》(PPACA)试图通过扩大1996年《健康保险流通与责任法案》(HIPAA)对员工健康计划的现行规定来解决这一问题。管理员工健康计划的相关法规允许雇主为达到雇主规定的健康目标的员工提供更大的奖励。这种扩张会产生不利影响,因为当残疾人无法达到健康目标时,它会通过更高的保费或费用分摊来惩罚他们,从而使残疾人等群体处于不利地位。本文认为,PPACA对员工健康计划的要求为残障人士提供了额外的医疗保险障碍。本评论的第一部分描述了医疗保健行业如何歧视残疾人,继续通过支付更高的保费来拒绝他们获得有意义的医疗保健。第二部分考察了健康计划条款如何允许雇主将医疗保险费用转移到未参加健康计划的员工身上。第三部分概述了《美国残疾人法》的合理要求如何使雇主有义务为残疾人士提供合理便利,从而改善残疾人士的健康状况。第四部分是进一步改革的建议。
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Expansion of Employee Wellness Programs Under PPACA Creates Additional Barriers to Healthcare Insurance for Individuals with Disabilities.

There are many barriers to healthcare for the general population that has been documented throughout the years, with one particularly affected group being individuals with disabilities. One identified healthcare barrier for individuals with disabilities is the inability to gain access to the healthcare system through health insurance. While many attempts have been made to resolve this issue, serious problems have yet to be resolved. The Patient Protection Affordable Care Act (PPACA) attempted to solve the issue by expanding Health Insurance Portability and Accountability Act of 1996's (HIPAA) current regulations on employee wellness programs. The relevant regulations govern employee wellness programs to allow employers to offer their employees greater incentives for meeting employer-defined health targets. This expansion has an adverse effect because it disadvantages groups like individuals with disabilities by penalizing them through higher premiums or cost sharing when they are unable to meet wellness targets. This article argues PPACA's requirement for employee wellness programs provides additional barriers to healthcare insurance for individuals with disabilities. Part I of this Comment describes how the healthcare industry discriminates against individuals with disabilities by continuing to deny them meaningful access to healthcare through payment of higher premiums. Part II examines how the wellness program provision allows employers to shift the cost of medical coverage to the employee for failure to participate in the wellness program. Part III summarizes how the ADA's reasonable requirement places an obligation on employers to make reasonable accommodation to individuals with disabilities, which will improve the health of working individuals with disabilities. Part IV concludes with suggestions for further reform.

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