Healthcare in the United States has traditionally been a continuous debate with issues such as healthcare insurance cost and coverage for the ordinary Americans becoming the focus of Medicare and Medicaid services and healthcare reforms. On March 23, 2010, the Obama administration made the Patient Protection and Affordable Care Act (ACA) a law. This legislation, also called Obamacare, was set to reduce healthcare costs on the part of the government and individuals while increasing insurance coverage. For instance, before the implementation of ACA, insurance companies conventionally removed registered children from their parents’ insurance plans as soon as they reached 19 years old for non-students and 23 years for full-time students. The new legislation made provisions that allowed parents to maintain their children as dependents until they turn 26 years old. Subsequently, this allowed young adults to access healthcare services much easier and at more affordable costs. Nevertheless, the Democratic Party repealed the ACA and its replacement as one of President Trump’s agendas. The politics of the United States is majorly known to be partisan, as the processes of replacing the ACA is taking place, there is a need to know the benefits and challenges the legislation brought to the American public. For years, America has continued to wrestle with the vexing question over what is best for the majority population when it comes to the government providing healthcare services. President Obama’s administration developed the Patient Protection and Affordable Care Act (ACA), a legislation that was based on reducing healthcare costs while increasing coverage for the less privileged and the youth.
The ACA’s increase of coverage was done in two phases focusing on young adults and corporate entities. As stated by Sommers et al. (2012), the ACA required all mid-level and large enterprise employers to cover their employees or pay penalties. Additionally, the legislation provided tax incentives for particularly small businesses as a means to cover some healthcare insurance costs for their employees. As indicated by Davis, Abrams, and Stremikis (2011), by focusing on corporate entities provision of insurance on their staff members, the ACA was able to increase its coverage by introducing about 6 million individuals into better healthcare policy. Financial hardship or religious beliefs are significant hindrances to attaining an effective personal insurance policy. The ACA went ahead to require the development of state-based insurance exchanges to aid individuals and small businesses to procure insurance. The Federal subsidies limited premium costs to between 2% of income for individuals earning incomes at 133% of federal poverty guidelines, while raising the costs of those earning 300% and 400% of the poverty guidelines to 9.5%. This lowered the burdens on low earning citizens while maintaining resources for better quality health care for all. The development of temporary high-risk pools for individuals who do not have the resources to purchase insurance on the private market because of preexisting health conditions was covered by the cost shifts, as presented by the ACA. With the information mentioned above, it is clear that the majority of the U.S population had their costs cut in addition to providing better quality care.
Contrary to the notion that young adults do not necessarily need health insurance because they are active, a sixth of young adults in the U.S are suffering from chronic illnesses such as cancer, asthma, or appendicitis (Blumenthal, Abrams, and Nuzum, 2015). Besides, young adults habitually partake in conducts such as overeating, smoking, excessive drinking, unprotected sex, and various sedentary lifestyle activities that pose long-term risks to their health. A comparison of insured young adults and their uninsured counterparts showed that the latter are 25% more likely to delay healthcare because of costs (Kocher, Emanuel, & DeParle, 2014). Lacking health insurance as a young adult has a direct link to health and economic problems in later adulthood (Sommers et al., 2012). As aforementioned in the paper, with the implementation of ACA, parents can maintain their children in their insurance plans as dependable. This allows more young adults to access healthcare services at an affordable rate, thus maintaining a good healthy future generation.
The ACA, in part, has been the best policy that covers most Americans while maintaining low healthcare costs by diverting costs to various healthcare stakeholders, particularly insurance companies. However, this legislation was debatable in the 2016 presidential elections in the U.S. According to the Republican Party, the ACA seems to have centered on delivering services to the African American as well as other minority groups while punishing the Whites. Repeal and replace has been the agenda for President Trump’s administration. As such, there is a need to know why ACA is considered bias.
The U.S constitution states that all Americans now have the legal right to access healthcare coverage; however, healthcare may be costly to some citizens, thus robbing them of the privilege of good health. The ACA provides free preventive services as well as wellness examinations, it lowers prescription drug costs and reduces Medicare and Medicaid fraud abuse for the less privileged. Additionally, the legislation has incentives for hospitals as well as Medicare Advantage Plans, subsequently improving care, Comparative Effectiveness Research, and coordinated medical care.
The U.S health costs have been on the rise yearly, causing significant budgetary constraints. Blumenthal, Abrams, and Nuzum’s (2015) study on U.S healthcare costs between 1990 and 2008 showed that health spending increased by 7.2% a year. Nevertheless, since the ACA was implemented in 2014, the revenues reduced. It grew by 5.3% in 2014 and by about 5.8% in 2015 (Blumenthal, Abrams, & Nuzum, 2015). With such a trend, it can be calculated that the ACA could reduce the U.S healthcare budget deficit by an estimated $143 billion over its first decade of operation. When health care is less expensive, then Medicare and Medicaid will take a similar trend. The ACA is able to achieve this by shifting cost burdens to health care providers as well as pharmaceutical companies as well as raising taxes for the middle class earning at least $200,000 a year. Consequently, the legislation provided limit out-of-pocket costs to an estimated $7,150 for a single person policy plan and about $14,300 for a family plan in 2017. In the process, ACA expanded Medicaid to an unprecedented 138% of the federal poverty level in addition to providing coverage to adults without children for the first time.
The ACA emphasized prevention, as it was critical in reducing health care in the short and long-term. As explained by Kocher, Emanuel, & DeParle (2014), the ACA required all insurance plans to cover ten vital health benefits, much of which was preventive care that ought to be offered at no cost. These encompassed well-woman visits, domestic violence scanning, as well as chronic ailment management. Additionally, the benefit provisions covered issues such as lab tests, including mammograms as well as colonoscopies, maternity, in addition to newborn care, as well as free dental and vision care for children. Theoretically, preventive care cuts cost by identifying and treating diseases before they become disasters. The ACA helps people with preexisting conditions from the reduction of health insurance under any circumstance and negates discrimination against individuals per their preexisting health conditions.
The most significant critics of the ACA is based on the transferred costs. The ACA increased insurance companies’ expenditures by an estimated 85% for large employer plans on health care services as well as quality improvement. Additionally, an estimated three million people lost their employment-based health insurance because the employers opted to pay fines as they found it more cost-effective than paying for their employees’ insurance plans on the exchanges. As explained by Blumenthal, Abrams, & Nuzum (2015), by increasing tax rates for individuals earning above $200,000 seemed biased.
Currently, President Trump’s administration withheld reimbursements to some insurance companies despite the ACA provisions making insurance affordable by offering subsidies. The Trump administration also removed the mandate to buy insurance in addition to making it easier for states to drop Medicaid coverage.
The Patient Protection and Affordable Care Act (ACA), also called Obamacare, was set to reduce healthcare costs on the part of the government and individuals while increasing insurance coverage. From the information provided, it could be argued that the legislation was partially successful. The increase of insured young adults and employees from medium and large companies made healthcare available to a majority of U.S citizens. However, the ACA has been seen as biased to the whites and the middle class, thus repealed and replaced. President Trump’s administration has been working to take away some of the controversial issues, but in the process led to increased medical health issues.
Blumenthal, D., Abrams, M., &Nuzum, R. (2015). The affordable care act at 5 years.
Davis, K., Abrams, M., &Stremikis, K. (2011). How the Affordable Care Act will strengthen the nation’s primary care foundation. Journal of general internal medicine, 26(10), 1201.
Kocher, R., Emanuel, E. J., &DeParle, N. A. M. (2014). The Affordable Care Act and the future of clinical medicine: the opportunities and challenges. Annals of internal medicine, 153(8), 536-539.
Sommers, B. D., Buchmueller, T., Decker, S. L., Carey, C., &Kronick, R. (2012). The Affordable Care Act has led to significant gains in health insurance and access to care for young adults. Health Affairs, 32(1), 165-174.