The Affordable Care Act
The Affordable Care Act (ACA), often known as Obamacare, is a law that was passed under the Obama administration to help change the state of the healthcare system in the United States (US). This law “is the largest overhaul of the US healthcare system since the 1960s” (“Why is Obamacare”,2014.p.2433-2440). The ACA was signed on March 23rd, 2010 but, didn’t take effect until January 1st, 2014 (Sperry, 2015). The primary goal for the establishment of this law, and the reason why many flocked in support of the provisions, was to provide affordable insurance and quality healthcare to Americans who would otherwise be uninsured (Sperry, 2015).
When this act debuted, it was hit with much opposition but, like with any legislation, there is always going to be benefits and drawbacks. The idea of finally having insurance that was affordable really hit home for most people. Many also liked that the act would allow them to have insurance with pre-existing conditions and would allow an expansion of the current Medicaid system (Hamel,2015). Many provisions of the act are beneficial in reforming the current healthcare system in place but, overall, the harmful effects of the ACA outweigh the benefits for the United States healthcare system.
View1: The Harmful Effects of the Affordable Care Act Overall Outweigh the Benefits
When looking from the outside, the ACA seems like a good plan for the United States but, after its implementation, it was noted that none of the main predictions came into fruition. Instead, it caused “…increased costs of care, soaring insurance premiums, …job killing, etc.” (Kantarjian, 2016.p.16).
The main goal of the ACA was to provide more quality and affordable health insurance to American families. Although it has allowed more people to become insured, it doesn’t appear to be that affordable to many. The reason that it is not as affordable as promised is because predictions accounted for higher enrollment and the coverage costs ended up being more extortionate than predicted (United States Congress, 2017). Low enrollment and higher coverage costs, thus, led to higher premiums. These high costs to the consumer also contributed to insurance companies restricting which providers families can choose (United States Congress, 2017). A reduction in the provider options means families in need of medical care are probably not receiving the best quality care for the amount that they are paying. Therefore, many are choosing to pay a penalty instead of receiving the ACA insurance so that they won’t have to pay thousands in premiums and will have more options to choose from when it comes time to seek medical care (Wilensky, 2012).
With the incorporation of the ACA and an influx of many new patients, a greater demand for medical professionals may be needed. There’s already an increased demand for nurses so, the ACA only intensifies this issue (Implications of the, 2014). The ACA also changes the way healthcare providers are paid. One way that it does this is instead of paying for the healthcare service in general, one will now “pay for performance” and if it’s not a good outcome, the provider will receive a penalty (Implications of the, 2014). The changes to pay may cause some provers to leave the industry; meaning a larger deficiency in providers to meet the demand (Implications of the, 2014).
It’s claimed that the ACA has also created a situation in which employers are deciding to cut employees instead of retaining them. This is because there is a provision within the act that companies with more than 50 full-time employees must provide affordable health insurance to their staffers (Pyrillis, 2014). Therefore, employers would rather avoid penalties for not providing insurance by reducing their number of employees or reducing their staff’s weekly hours.
View 2: Incorporation of “Obamacare” Means Greater Benefits for U.S. Healthcare
Prior to the ACA’s enactment, some 48 million Americans were uninsured. Once initiated, 20 million of those uninsured now had access to health insurance (Kantarjian, 2016). Some other major provisions of the ACA that receive bipartisan support include, dependents being able to remain on their parent’s insurance until age 26, expansion of Medicaid, and insurance companies not being able to deny coverage due to pre-existing health conditions (Hamel, 2015).
Since the enactment of the ACA, almost three million children under the age of 26 have received health insurance thanks to the provision that requires insurers to provide coverage to them under their parents’ policies. This provision, which applies despite dependency status, has allowed young Americans to avoid gaining large amounts of medical debt early. It has also allowed to start tackling childhood problems, such as obesity, earlier (Cantor, DeLia, & Lloyd, 2012). However, this has also led to the increased cost of the ACA. Without this provision, these young adults would have to get their own insurance, which in turn could help drive up the enrollment number and even out expenses for insurance companies (Rodriguez, 2017).
The expansion of Medicaid is another benefit that the ACA provides. Although it is allowed with this act, not all states have expanded the Medicaid program because it is left up to the states to decide if they want to do it or not (Hamel, 2015). The expansion would help fill some of the gap that distinguishes who is eligible to receive Medicaid; meaning more people would now be eligible for the program. The expansion will now include those whose income is at or below 138% of the poverty level (Hamel, 2015).
Another widely accepted portion of the ACA is the provision about insurers not being to deny or increase costs of coverage to those with pre-existing conditions. It also prevents insurers from canceling insurance on those once they become sick (Hamel, 2015). This has allowed more American’s to find insurance to help cover the exorbitant medical costs.
Although the ACA may potentially increase the demand for healthcare professionals that are unavailable, it has brought into light the idea of extending the scopes of practice for medical providers such as: nurses and advanced practice nurses (Implications of the, 2014). “The belief is that these providers are not working to the full extent of the education…” (Implications of the, 2014.p.16). Therefore, the idea of broadening their roles may help with the healthcare provider shortage and help with the goal of increased quality of care.