About the Affordable Care Act

On February 19, 2018, I lost a man who I considered a family to cancer. Brother Wells worked for the church for a majority of his life, serving God and the people who attended Cornerstone Revival Center. Because of high premiums and outrageous out of pocket costs, he and his wife couldn’t afford health insurance.

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Later into 2017, he was offered a job in Louisiana that would give him that coverage. When he accepted the job, he visited the doctor for the first time in years. It was there that he learned he had Stage 3 Colon Cancer – a disease that can easily be treated if caught early with a routine colonoscopy. According to an article in the Human Rights Journal, over 50 million people in the United States were uninsured in 2009. Because of this, the Affordable Care Act was created. (Jost 6-9)

The Affordable Care Act was created to make health insurance more accessible to the general public as well as to those on or below the poverty level. A common misconception is that Affordable Care Act, otherwise known as Obamacare, was created by Barack Obama. The Human Rights Journal explains that while he did sign it into law on March 23, 2010, the House of Representatives and Senate formulated the entirety of the bill two years before it reached the executive branch. (Jost 6-9) Health Care has always been a very pertinent issue within the United States because of the sky-high rates and costs with exclusive coverage. According to Forbes, the number one cause of personal bankruptcy is Medical Bills- and this is if they have insurance. (Cohen) Often times, especially with those on or below the federal poverty level, it comes down to a personal choice of whether they want to pay their rent or get treatment. In a study found in The Impact Poverty Has on Women’s Health, it’s estimated that 1in 4 women will go without or delay care to stay financially secure. Because they don’t receive the proper treatment they need, low income women are more likely to suffer more financial losses like losing their jobs or not getting paid for their absence. (Borchelt 16) It creates a cycle where people either get the care they need and go into tremendous debt, or they go without and have to miss work because of their untreated illness.

The Affordable Care Act consists of ten titles ranging from private insurance regulations, expansion of coverage, as well as tax credits and fees for citizens, insurance carriers, and those in the healthcare workforce. According to an article from the Pain Physician Journal, the ACA would enact regulations on private insurers that would make healthcare more inclusive. The bill does this by requiring all insurers to provide coverage to anyone, regardless of preexisting medical conditions, income, or a covered category status. This also allows children up to 26 years old to be on their parent’s plan as dependents. (L, Manchikanti et al E40) This is especially helpful for families in poverty, post-graduate college students, and those with children with more serious issues that may need more medical attention. From this same article, the ACA would also make it mandated for employers, with exceptions to business with 25 or less employees, to provide adequate health insurance to workers. If the business had less than 25 employees who made less than $40,000, the ACA would provide tax credits if they offered health benefits to workers. (L, Manchikanti et al E39) These incentives and regulations create a desire for employers and insurance carriers to provide more extensive healthcare to more consumers. According to a news article from the US Conference of Mayors, the uninsured rates in Arizona dropped by 36% or 400,000 people when the ACA was fully enacted while in New York City over 1.6 million people use the bill. (Nation’s)

While on paper the bill seems to solve the high uninsured rates in the United States, there are two questions that arise from the bill. How is this bill being funded? Are these government regulations and taxation constitutional? In order to fund the bill, the ACA created new mandates on individuals who chose not to be insured or employees who failed to provide coverage for their workers. According to the same article from the Pain Physician Journal, individuals who chose not to be insured would be taxed up to $695 up to three times depending on the family, or around 2.5% of annual income. (L, Manchikanti et al E38) Citizens became outraged at the tax penalties they would face if they chose not to be insured. A study from the same article shows that an individual who makes $50,000 will face a penalty up to $1,250 – not including other taxes. This means that by making the choice not to have insurance, people would encounter large dents in their incomes because of their choice. The validity of the ACA was called in to question by numerous states and brought to the Supreme Court in 2012. In The Washington Post, it states that while many of the titles within the ACA are flawed, Congress had the authority to have a tax penalty. (Gayle and Goldstein) Because of this case, states now had the right to choose whether or not to enact the ACA within their borders. (Jost 6-9) This is what created expansion states like New York that enacted the ACA, or nonexpansion states like Alabama that chose not to enact it.

Many people think that with the 2016 election of President Trump, the Affordable Care Act would no longer be in place. This has proven to be incorrect. While his campaign openly went against Obamacare, the executive branch cannot repeal laws by themselves. According to the same article from the Washington Post, The GOP filed a lawsuit in February against the ACA in efforts to get it repealed, however the Supreme Court found the law constitutional as well as useful to Americans. (Gayle and Goldstein) While the Supreme Court ruled in favor of the ACA twice, the new administration is still desperately trying to get rid of the law – or at least, make it extremely difficult for new member enrollment. In reference to an article from the Wall Street Journal, Trump plans to take away several titles from the ACA, including regulation of Private Insurance. (Armour) This means that insurance companies could charge higher rates for those with preexisting conditions, as well as allow them to charge more based on age and gender. From the same article, it states that while Trump is trying to enact these regulations, he won’t have a sturdy team by his side. Jeff Sessions has openly gone against Trump’s revisions of the ACA and refuses to back the unconstitutional provisions. (Armour) If this disagreement cannot be solved, it can prove to be deadly for the healthcare market. With old regulations for private insurers on the brink of disappearing and new regulations that target certain consumers, the insurance market is being pulled into chaos which in turn hurts consumers and the economy the most.

While I can’t go back in time to help Brother Wells or those affected by the dangers of being uninsured, the Affordable Care Act provided substantial strides to fixing a broken healthcare system. The bill has its flaws, as well as it’s promising results that came with it. Ultimately with the Affordable Care Act, over 20 million people gained insurance and healthcare.

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