The Affordable Care Act (ACA) was executed in 2010 under President Barack Obama and was a major step in the direction of universal health care for all United States residents (Source 1). There are many aspects of the act that have caused lots of controversy. For example, though it has since been repealed, there was an individual mandate (instituted in 2014) that required everyone to have health insurance unless they paid a fine.
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Many thought this was a tyrannical move that took choices away from the public and made the government overstep its boundaries. Additionally, though many like the thought of universal health care, certain groups in society didn’t want to pay more (for themselves and for others) for services that didn’t apply to them at all. Also, part of the act included the expansion of Medicaid and not all of the states agreed to adapt that provision, meaning the effects of the act are different throughout the country, demonstrating yet another point of controversy. All in all, there are many aspects of the ACA and one must fully understand the premise before they come to a conclusion.
Despite the controversy surrounding the ACA, there are a few benefits to be considered. For example, a noteworthy part of the bill includes free preventive services including HIV screening, influenza vaccinations, and more to promote a healthier society in the long term (Source 2). As noted in the textbook, the Healthy People documents that are issued every ten years outline measurable health goals for the country (Source 3 pg 16). By providing U.S. citizens with the opportunity to protect themselves against these illnesses and afflictions, the overall health of the population will improve. One must also consider the benefits of allowing children to stay on their parents’ plans until the age of 26. Older insurance plans didn’t cover children past the age of 22 or college graduation (source 5). It is very difficult for these young adults to find good jobs right after college, let alone one with quality health insurance. By allowing them to stay on their parents’ plans for just a few extra years, the children know they are covered should some extraneous event occur, and it gives them more time to find good benefits in their new jobs.
Despite the pros of the ACA, one must also remember a few cons as well. For example, it is very unclear as to whether or not patients are allowed to keep their same doctors (Source 6). Because of the complicated insurance networks and their increasingly complicated rates, some doctors can’t stay in the network that a patient is a part of. However, patients often form personal connections with their doctors, giving them an environment they feel completely comfortable in. If one were to lose that relationship, they might not receive the quality of care they were previously used to. Additionally, the ACA created Health Insurance Marketplaces in an attempt to simplify the purchasing process. Though it’s simpler than before, the Marketplaces are still very confusing and often require the advisement of one educated about insurance, costing the patient even more (source 4, 6).
One must also take into account the changes that the Trump administration has enacted in the last few years. Most notably, the repeal of the individual mandate has greatly affected many aspects of the ACA. For example, younger adults who can’t afford nor really need the expensive health insurance plans are offered insufficient plans, often referred to as junk plans, outside of the Marketplaces for a cheaper price (Source 7). However, these plans undermine the main aspect of the ACA where those who are healthy pay more to help those who are sick. If healthy people buy skimpy plans while those who are unhealthy and in dire need of those funds buy the full-fledged ones, the balance will not work out and the much-needed treatments will have to be stopped. Similarly, subsidies for the poor have decreased because the Trump administration has decided to stop payments to insurance companies called cost-sharing reductions which helped offset said subsidies (sources 7, 8). This limits the availability of health insurance and places an increased pressure on those who can’t afford the medical treatments they need. On another note, the advertising budget has been cut by 90% and though those who are sick will most likely know they can enroll at this point after the act’s passing, those who are young and just entering the eligible field will not know nearly as much about it (source 9). This would further contribute to the lack of healthy people paying for those who need the treatments as mentioned earlier. Overall, the Trump administration has made many changes to the ACA, and depending on one’s views, they could see them as either beneficial or truly detrimental to the advancement of universal health care for the United States.
Personally, I didn’t know anything about the ACA before this discussion outside of the fact that it was a step towards universal health care enacted by Barack Obama. After all of this research, I realize that it might not be the most cohesive plan, but for the time being I think it is doing a good job of accomplishing its main goal of covering the majority of people with health insurance since millions of people have gotten covered since 2010. On another note, I have learned to appreciate the fact I can stay on my mom’s plan for longer than before. Because I was put in a year late, I wouldn’t be covered in my junior year and that would be highly inconvenient. Overall, I’ve developed a much deeper appreciation for the concept of the ACA and I wish those who want to repeal it would stop dismantling aspects of it until they’ve come up with a legitimate plan to replace it.
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