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Irving Stackpoke, President of Stackpole and Associates, Inc. took a look at the Affordable Care Act (ACA) and how it could impact medical tourism.

What is the  Affordable Care Act?

The Patient Protection and Affordable Care Act (PPACA) is a United States Federal statute signed into law on March 23, 2010. The law is more commonly referred to as the “Affordable Care Act” and is the most sweeping social legislation in the US in the past 40 years. The Affordable Care Act (ACA) creates changes that will have significant impact on the way healthcare is insured, practiced, and paid for. The Federal government will play a central role in determining these practices.

What are the major provision of the ACA as they related to the medical tourism industry?

  • By 2014 all individuals will be required to obtain health insurance or pay a fine. This provision means that ACA will substantially reduce the number of 49 million individuals in the United States who are currently uninsured. Assuming that these uninsured individuals have been a good market for medical tourism, they may postpone non-urgent healthcare services until covered by ACA in 2014 anticipating that the services they want may be covered by health insurance.
  • ACA defines, expands and standardizes the services that must be offered by health insurance companies. Services such as preventive health services (weight loss clinics, routine check-ups) and mental health services must be included in health insurance. Individuals who were uninsured and who might have sought medical tourism services for uncovered procedures will now be able to obtain these services in the US as part of their insurance coverage.
  • Adding over 30 million people to the US healthcare system will increase demand on hospitals and doctors. There is already a shortage of doctors in the United States with many hospitals operating at or near capacity. More people with health insurance will increase the demands on the overburdened healthcare system resulting in delays, waiting lists for services, and postponement of non-urgent care.

What are the short and long term opportunities for the medical tourism sector? 

The traditional services that have been the most popular medical tourism services will continue to be in demand. These services include:

  • Dental and cosmetic procedures
  • Fertility treatments
  • Bariatric surgery
  • Stem cell treatments
  • Procedures that are not available in the US

In the mid to long term, healthcare providers should look for additional opportunities to deliver services for which there are delays or waiting lists or for which consumers must pay high out of pocket costs.