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The views expressed are those of the author and do not necessarily reflect the views of ASPA as an organization.
By Monique M. Maldonado
October 16, 2015
According to the U.S. Department of Health and Human Services, the Affordable Care Act is supposed to put “consumers back in charge of their health care.” Legislature passed in 2010 suggested that American citizens have increased freedom of managing their own health care matters. I thought citizens always had the opportunity to take control of their medical affairs? What is the difference between what the Affordable Care Act and what Americans had previously?
The Affordable Care Act
One of the largest issues the federal government continues to tackle in mandatory spending is health care. In order to stabilize the quality of health care and make it more affordable, President Obama signed the Patient Protection and Affordable Care Act, colloquially known as “Obamacare,” on March 23, 2010. This was established to improve health insurance and provide options for those who are uninsured. In addition, this act was to mitigate expenses for those who currently pay and offer tax credits for companies who provide health care for their employees. “Obamacare” ultimately covers all potential insurance holders, sanctions flat rates for all, and most importantly, provides insurance regardless of pre-existing conditions.
The government website, www.medicaid.gov, details how “Obamacare” is divided into two different entities and approved by separate legislations: the Patient Protection and Affordable Care Act and the Health Care and Education Reconciliation Act. Together, these acts “expand Medicaid coverage to millions of low-income Americans and make numerous improvements to both Medicaid and the Children’s Health Insurance Program.”
As the largest health care reform since the Health Insurance Portability and Accountability Act or HIPPA, President Obama’s ultimate goal was to:
Cited from the “Obamacare” facts website, approximately 50 percent of American employees are covered through their employers. About one-third are covered under the federal government, one-tenth of the population purchased their own health care plans and an estimated 30 million continue to be uninsured.
Half of the nation is covered through their employers and “Obamacare” should have not changed plans significantly. In fact, since its implementation, some employees received breaks such as capped deductible fees and free, quality preventative care plans. As for those depending on the government, senior citizens were similar to employers as in no significant changes to their Medicare plans, and also received breaks such as better preventative care and improved prescription programs.
The ratification of the Medicaid program showed significant changes in how the government insures low-income and poor individuals. For citizens who are ineligible for health care, which are households that make under $16,000 per person, Medicaid apparently picked up the tab under private insurance plans. The disadvantage to the development of this plan is the benefits are dependent upon governors and legislators in each state. For states that are on board with the reformed Medicaid plan, the federal government takes care of the costs. But for states that oppose, low-income and poor families continue to suffer with little to no resources.
About one in 10 Americans purchased or will purchase their own insurance as a federal requirement. Individuals and families that can afford health care purchased their plans from companies called marketplaces. With this program, potential insurance holders have the opportunity to choose their own plan and how much they want to pay.
Just like Medicaid, not all states support marketplaces. For states that oppose, the federal government will establish their own for purchase. Those who purchase their own insurance will receive a tax credit and do not have to pay full premiums, according to the “Obamacare” website. Most importantly, marketplaces must offer insurance to citizens, even if they are sick, and cannot inflate prices for pre-existing conditions. Sounds nice, but still an estimated 30 million American will not be able to afford insurance at all.
It seems “Obamacare” was a program instituted to mitigate bad practices with insurance agencies and provide better care at affordable prices. But with implementation came many loopholes. Even with tax breaks and better services, prices are still an issue.
As baby boomers (approximately 80 million) grow older and face retirement, such benefits will negatively affect federal spending. If prices are more affordable for Americans, someone still has to pay the costs. Low-income families will struggle to pay minimum plans while affluent families will pay more.
Companies with more than 50 employees are required to offer insurance to their employees, while smaller companies are not penalized, but receive incentives for offering plans. Penalties surface for those who are not insured, but those who can prove to the government that they cannot afford it will be exempt.
While I believe this is a good step in the right direction for health care, there is still an imbalance and it has to be addressed. Government shutdowns and looming sequesters every fiscal year are becoming too common. It is imperative that health care can stand on its own. Congress should focus on finding solutions.
Author: Dr. Monique M. Maldonado is a veteran of the U.S. Air Force, an educational consultant, professor, researcher and writer. She is the associate professor for the School of Security and Global Studies in Homeland Security at American Public University System. She is also a lead adjunct professor for the School of Graduate and Degree Completion programs at Tiffin University. For any questions or concerns, Dr. Maldonado can be reached at [email protected].