Affordable Care Act

Affordable Care Act

Affordable Care Act

Submitted in partial fulfillment of Compensation/Benefits 385

By

Clayton Meyer

April 17, 2015

Affordable Care Act 2

Table of Contents

Page(s)

Cover Page/Contents ……………………………………………………………………………………………. 1-2

Introduction …............................................................................................................ 3

Description …………………………………………………………………………………………………………… 3-5

Pros …….…....……………………………………………………………………………………………………….… 5-9

Cons …………………………………………………………………………………………………………………….. 9-12

Business Article ……………………………………………………………………………………………………. 12-13

Hospital Article …………………………………………………………………………………………………….. 13-14

Obamacare Survey ……………………………………………………………………………………………….. 14-17

Improving Obamacare …………………………………………………………………………………………. 17-18

Conclusion …………………………………………………………………………………………………………… 18-19

Reference(s)………....................................................................................................... 20


Introduction

The Affordable Care Act, also known as Obamacare, was passed in 2010 in order to give

everyone the chance to have some form of health insurance to protect themselves and their

families. Obamacare has a long list of features that need to be implemented to every company,

along with every United States citizen, in order for the law to be the most effective. There are

many positives and negatives that are associated with the passing of the Affordable Care Act.

The Affordable Care Act has some key provisions which are to extend coverage to millions of

uninsured Americans, to implement measures that will lower health care costs and improve

system efficiency, and to eliminate industry practices that include recession and denial of

coverage due to pre-existing conditions (healthinsurance.org). Even though the Affordable Care

Act has some provisions, there are also many negatives that come along with the passing of this

law. Some of the negatives of Obamacare include the issues of privacy considering that

individuals have to share their personal information with the government, the rising cost of out

of pocket expense to pay for health insurance coverage, and it is difficult, nearly impossible, for

individuals to change their health plan if they find another plan that will suit them better in the

long run. There are many individuals who agree and disagree with the passing of the Affordable

Care Act and some of the reasons to why they have these points of view will be explained in a

broader sense later on. The plan of the Affordable Care Act is to make the lives of the American

individuals better when it comes to evening out the playing field regarding the costs of buying a

health care insurance package.

Description


This Act was passed on March 21, 2010 and still is the main health care

law to this day. There are many features that were included in the Affordable Care Act. One of

these features is that families who make $29,000 for a family of four will be covered through

Medicaid while families that make $88,000 or more for a family of four will receive tax credits

which will then help to pay for private insurance (Washington Post, 2012). Along with this,

people who can afford coverage but choose to not pay for it will have to pay $695 or 2.5

percent of their annual income, whichever one is greater. This forces mostly everyone to have

health insurance under the Affordable Care Act (Washington Post, 2012). When it comes to

businesses, businesses that have fewer than 10 employees, their overall wages being under

$25,000, and providing insurance to all of its employees will get a 50 percent tax credit on their

contribution (Washington Post, 2012). For businesses that have up to 50 employees with

average wages of $50,000 will also get tax credit. These tax credits get smaller as these

businesses get larger and richer (Washington Post, 2012). These tax credits last for two years

and also increases the long term cost of legislation. The Affordable Care Act prohibits the

insurance companies from discriminating individuals based on preexisting conditions. There are

a few areas, even though the act prohibits discrimination based on preexisting medical

conditions, in which the companies might be able to discriminate. Insurance companies may

discriminate based on age, premium rating area, family composition, and the amount of

tobacco use (Washington Post, 2012).

The overall effect of Obamacare is that everyone

will be insured, whether it is for a plan that does not cost much, or for a plan that has a high

cost. One other feature that the Affordable Care Act contains is starting in 2018; the law will


impose a 35 percent tax on employer-provided health care plans which exceed $10,200 for

individual coverage and $27,500 for family coverage (Washington Post, 2012). This, in turn, can

give the employers a bigger and better reason to avoid expensive insurance policies and to give

insurers a reason to hold things down. Along with this, the law also requires that insurers spend

80 percent to 85 percent of every premium dollar on their medical care. When it comes to

insurers exceeding this premium dollar threshold, then they will have to rebate the excess

amount to its customers (Washington Post, 2012). These features were all made in order to

help bring about the Affordable Care Act and to help citizens in the best way possible regarding

health insurance. The description of the Affordable Care Act will lead to the discussion of the

pros and cons of this act which will be talked about in the next section.

Pros of Obamacare

When it comes to the Affordable Care Act, there are many

pros that are included. One of these pros involves the increased coverage of this health care

system. What this means is that everyone in the United States is required to be covered by

health insurance. The increased coverage includes that 3.1 million Americans which are age 19

through the end of their 25th birthday may be added to their parent’s plans. This is a good idea

for the young generation because many of these individuals are working but still cannot afford

to pay for their own health benefits. As stated earlier, patients with pre-existing conditions will

no longer be denied by the health insurance companies and companies will not be able to drop

plan members if they pick up a serious illness. The last part of this positive is that the states will

be paid by the federal government in order to help individuals buy insurance even if they

cannot afford it themselves. Along with this, the next positive has to deal with reduced health


care costs. Preventative care will be more accessible to all of the individuals who obtain health

care. In addition to this, the newly insured will no longer have to wait until their negative

conditions (sicknesses) worsen so much that they will be forced to visit a hospital emergency

room. Another positive has to do with higher taxes and lower deductions. With this, Americans

who do not pay for insurance and do not qualify for Medicaid will be accessed a tax of 325

dollars in 2015. People who make more than 200,000 dollars per year will end up paying higher

taxes to help cover the costs of the health program (supplementalhealthcare.com, 2012). When

it comes to women, there are some pros that are included in the health care act. Health

insurance plans have added eight women’s health benefit plans in the areas of breastfeeding,

contraception, domestic violence, gestational diabetes, HIV screening and counseling, sexual

diseases, and wellness visits. The benefits of these programs are free and women do not need

to meet their plan deductibles to use these free services that are offered. Insurance payout

annuity limits will also end. Payout limits are where the investors can choose a lifetime payout

annuity to head off the risk of outliving the amount of money set aside for retirement. What

this means is that the guaranteed payments for life reduces a person’s longevity risk. This can

pose a problem for those individuals wanting to leave estates to beneficiaries. Payouts from a

lifetime payout annuity will often end with the death of the policyholder (investopedia.com,

2011). The last major positive that is associated with the Affordable Care Act are the new

customer health coverage reports. American individuals have started to receive standardized

reports explaining their health insurance. Along with this, the different health insurance plans

have to present their coverage details in the same format using the same language. Individuals

can accurately compare different health insurance plans (money.usnews.com, 2013). This leads


into an article from AARP regarding the 10 Essential Benefits of the Affordable Care Act.

The Affordable Care Act has positives regarding health care based on an article in

the AARP magazine. The first couple of benefits have to do with outpatient care and

prescription drugs. One of the benefits is that there will be ambulatory patient services. This is

the most common form of health care, which is also called outpatient care. This is where you

walk into a doctor’s office, get treated, and then walk out. Nearly all of the health insurance

plans cover this. The details about the plans’ networks and access will vary, but the law says

that the networks’ size must be efficient. Along with this, another positive involves prescription

drugs. Under the Affordable Care Act, all individuals and small-group plans will cover at least

one prescription drug in every category and class in the U.S. Pharmacopeia. This is the official

publication of medicines which are approved in the United States. The costs of drugs will also

be counted toward out-of-pocket caps on medical expenses. Emergency care, mental health

services, hospitalization, and rehabilitative and habilitative services will be mentioned in the

next section regarding the benefits of the Affordable Care Act (aarp.org, 2013).

There are some benefits that are associated with the Affordable Care Act that

has to do with emergency care, mental health services, and rehabilitative and habilitative

services. When it comes to emergency care, this is already covered under most plans. This is

when a patient goes to a hospital with a serious condition, such as a heart attack. Under The

Affordable Care Act, the emergency room visits will not require preauthorization, and you also

cannot be charged extra for an out-of-network visit. Mental health services are not covered by

many health insurance plans. This has been changed under the Affordable Care Act. Individuals,

or patients, may be billed around $40 per session regarding mental health. In other instances,


some states may be limited to a set number of therapy visits every single year. With regards to

the new Obamacare law, an insurer must cover an individual’s hospitalization, even though the

individual will have to pay 20 percent of the bill or more if the patient has not reached their out

of-pocket limit. Another section of the Affordable Care Act talks about the rehabilitative and

habilitative services. For example, if an individual were to become injured or ill, many plans

today would cover the rehabilitation therapies to help relieve pain and help that individual

regain their ability to speak, walk, or work. The plans will also, more likely than not, cover

medical equipment. Under Obamacare, habilitative services will be covered. These are

therapies that are used to help overcome long-term disabilities, such as down- syndrome. AARP

lists the last four benefits regarding the new health care law which include: preventative and

wellness services, laboratory services, pediatric care, maternity car, and newborn care

(aarp.org, 2013).

Preventive and wellness services are covered under the Affordable Care Act. The overall

idea of this benefit is to get individuals to see doctors and make heathier choices before they

get sick and run up their medical bills. Another benefit that Obamacare includes is that children

under the age of 19 will be able to get their teeth cleaned twice a year, as well as receive X-

rays, fillings, and medically necessary orthodontia. In addition to this, children under the age of

19 will be entitled to have an eye exam and one pair of glasses or a set of contact lenses a year.

With regards to health plans today, very few plans cover children’s dental or vision, but the law

is going to change that during the present and future. The last major benefit that comes with

the Affordable Care Act is the law covering maternity and newborn care. The law classifies the

prenatal care as a preventive service which must be provided at no additional cost. In addition


to this, the law requires the insurers to cover childbirth as well as the newborn infant’s care.

These benefits are a welcome breakthrough for young individuals, as two-thirds or individual

plans have traditionally excluded this maternity and newborn type of coverage (aarp.org,

2013).When it comes to the Affordable Care Act, the law also possesses many negatives which

impact the lives of the American people.

Cons of Obamacare

Obamacare has many issues which include the inability of patients to

make a decision that can only be made between them and their doctor, the inability of the

patients to choose their doctors, and the rising out of pocket expense for individuals. One of

the big negatives regarding the Affordable Care Act is that choosing a treatment for a particular

condition will no longer be a decision that is made solely by the doctor and his/her patient.

Instead of this process occurring, the government will be able to decide which treatments it

considers to be effective in any situation, while taking into consideration the factors such as a

patient’s age and health history. In the long run, the government will ration the treatments to

those individuals whom they feel deserve those treatments (obamacare.net, 2011). Before the

Affordable Care Act was passed, the patient and his/her doctor could make a decision that the

patient would want to make instead of having the government make the decision for them.

This, as a result, has made a lot of American individuals, along with families, upset and

outraged. In addition to this, the Obamacare health insurance policies limit the amount of

choices a patient can make in order to choose what doctor he or she wants. This also upsets

patients because they now have to go and deal with a doctor that is picked out for them by the

government. Obamacare health insurance policies also cost a lot more than previous health


insurance costs, and have caused many people’s premiums to double. The Affordable Care Act

increases individuals out of pocket expense as well as doubling and even tripling the

deductibles that they must pay before the coverage kicks into gear (wnd.com, 2014). This puts a

lot of pressure on individuals who had cheaper health insurance costs before losing their

insurance. Many individuals that had health insurance, which they could actually pay for, lost

their insurance and were, forced to enroll in a new health insurance plan on the health plan

coverage website. This negatively impacted some middle class families because now they are

paying a lot more for their current health insurance instead of paying less, which in turn, can

hurt them economically. This issue leads into another issue that arises from Obamacare, which

is the loss of privacy. When it comes to the Affordable

Care Act, formerly known as Obamacare, the right to privacy can also be at risk. With regards to

the Affordable Care Act, the government can make the decisions about what treatment and

medications they should provide for different types of individuals. With this comes the ability or

the job of the government to maintain people’s personal information about their medical

history, health conditions, financial information, and other health related topics. This

information was once confidential between a patient and their doctor. Many individuals are

uncomfortable with having to share every single detail of their lives with the government, even

if the government claims that they will not share the information with any other organizations.

This issue can, in fact, infringe on the rights of the patient’s privacy even though the

government promises to keep their information as private as possible (obamacare.net, 2011).

In addition to this, individuals have an increased risk of being a victim with regards to identity

theft since individuals provide their personal information to “Obamacare navigators.” This


makes processes easier for hackers since the information of patients are on the internet. Even

though the government has many forms of security that protect the patients information, it is

only a matter of time when a hacker will break through the security wall and will, in turn, have

the ability to negatively impact an individual’s health insurance plan. Along with this, the

Affordable Care Act may infringe on an individual’s Second Amendment Rights, such as medical

databases being able to collect personal information on gun ownership. People who have

enrolled in Obamacare find it difficult or impossible to cancel their current plan if they find a

better health care option. What this means is that it is nearly impossible for an individual to get

rid of his or her existing plan in order to sign onto a better plan that will have better benefits for

that individual (wnd.com, 2014). The last major negative that is associated with Obamacare has

to do with the universal drawbacks. Obamacare has one last drawback,

and that has to do with individuals who take care of themselves and those who do not, from an

overall health standpoint. When it comes to individuals who take care of themselves physically

and obtain good health, they will, more than likely, end up carrying the burden for people who

may be obese, alcoholic, heavy smokers, or people who have made poor health decisions. This

type of program unintentionally punishes people who are healthy and rewards those who are

unhealthy. What this statement means is that individuals who are overweight, have alcohol

problems, or are heavy smokers have programs that they can join in order to help fight their

addiction, while the healthy taxpayers have to pay for their treatments (obamacare.net, 2011).

Some people believe that this is not right, and that the healthy individuals should have some

form of reward for being healthy, instead of having to pay for the medical programs for

individuals who are fighting addictions. This leads into an article that describes how small


businesses have been impacted by the passing of the Affordable Care Act.

Business

Article The passing of the Affordable Care Act has

resulted in there being a relatively big and negative impact on small businesses. One of the

main issues that arise for small businesses is how they will be able to cope with the increased

costs of providing healthcare to their full time employees, or what steps they will have to take

in order to avoid the costs that are involved. When it comes to businesses that are near the 50

employee threshold, the businesses will more than likely freeze hiring, terminate some full time

employees, or reduce the hours of current employees to make sure that they do not fall into

the 50 employee bracket. If the company were to fall into the 50 employee bracket, then the

business would be required to provide not only health insurance plans to their workers, but

also pay the fees and extra taxes that would be involved. This, in turn, makes it much harder for

small businesses to grow, along with workers being able to find jobs, especially full time jobs

(cobra). This leads into the ability for businesses to expand and the ways in which a business

may be impacted. Businesses are always finding ways to

expand, but the ability to expand has been tougher ever since the Affordable Care Act was

passed. When it comes to small businesses, it would not be worth it to expand until they are

able to cover the additional costs that are involved in the new health care system. For bigger

businesses however, the companies may reduce the hours of many employees and keep as few

full time workers as possible. The mandate for the Affordable Care Act only requires the

availability of the health care coverages that the full time employees acquire. In this case, if the

company has more than the equivalent of 50 full time employees, then they will have to


provide the health care packages to the actual full time employees, and not the part time

employees (cobra). The Affordable Care Act has had an influence on the job market which, in

turn, has impacted the overall economy. Obamacare has really impacted the

overall health of small businesses, which also impacts the economy. The impact of Obamacare

has more of an effect on the job market and its employees, than the ability for employers to

expand. As a result, the impact is still negative for the overall economy. Along with this, even

though there are many employees who will be eligible for health care, there will also be many

who will lose work hours and income. In addition to this, these employees will not be eligible

for health care coverage through their employer (cobra). Despite all of the negative parts of

Obamacare, there is one area in which this health care plan has been beneficial, and that area is

hospitals. Hospital Article

Hospitals have benefited a lot from the Affordable

Care Act, especially in the last couple of years. According to a report from the Department of

Health and Human Services (HHS), hospitals have saved at least 7.4 billion dollars last year,

thanks to the Affordable Care Act. These savings resulted from a reduction of the

“uncompensated care” that the hospitals have provided to uninsured Americans. Since

individuals without insurance typically do not have any means to cover their own medical bills,

the cost of their treatments end up falling onto the hospitals. As a result, more people can gain

health care coverage, which in turn, becomes less expensive for hospitals to care for their new

patients. More than 16 million individuals who were previously uninsured have received health

care coverage under Obamacare, which contributed to the biggest drop in the national

uninsurance rate over the past 40 years. The savings which have been most pronounced were


those in states that agreed to accept Obamacare’s optional Medicaid expansion, which seeks to

extend public insurance to additional low-income individuals. With regards to the savings

documented in the HHS report, nearly 70 percent of these savings occurred in the 29 states

that have expanded Medicaid. When it comes to states that had agreed to add more people to

their Medicaid rolls, their hospitals could have saved an extra 1.4 billion dollars. There have

been several outside studies which have confirmed that the pro-expansion states are saving a

good amount of money. In addition to the reduction in overall uncompensated costs, the states

which are implementing this Obamacare provision are also benefiting from the additional

federal funding which goes towards the Medicaid expansion. In addition to this, those states

are creating more jobs in the health care sector to keep up with the demand for individuals who

are newly insured (thinkprogress.org, 2015). The future looks bright, regarding the overall

United States economy when it comes to individuals finding jobs in the health care sector. This

is only the start to something better for the United States even though there are some

negatives that must be fixed in order to have a more positive effect from Obamacare. This

information leads into a survey that was taken to see what random people believe when it

comes to rating the overall plan of Obamacare, whether 18 year olds should contribute to the

health care system, whether or not Obamacare is beneficial to low income families along with

businesses, and if individuals should be offered subsidies for different types of wellness

benefits. Obamacare Survey

An Obamacare survey was taken with a random

group on 10 individuals, who gave their beliefs on the new Affordable Health Care Act. These

individuals had multiple responses when it came to how they would rate the Affordable Care


Act, if they believe that individuals who are 18 years and older should contribute to the overall

health care system, whether or not they believe that Obamacare is beneficial to low income

families and businesses, if they believe in offering subsidies to low income earners, and if

individuals should be offered subsidies for wellness benefits. Below is a table that has all of the

recorded information that was taken from a survey of 10 people.

1 = worst5 = best

How would you rate

Obamacare?

Beneficial to low income

families?

Beneficial to

businesses?

Do you believe in offering

subsidies to low income

earners?

Should people be

offered subsidies

for wellness benefits?

18 and older

people should

contribute to health

care system?

Participant 1

3 2 3 4 4 4

Participant 2

1 5 5 3 3 1

Participant 3

2 2 1 2 5 1

Participant 4

1 3 1 3 5 3

Participant 5

5 4 3 5 5 4

Participant 6

5 2 3 4 4 2

Participant 7

1 4 4 3 5 4

Participant 8

2 3 5 5 5 1

Participant 9

4 2 3 4 4 3

Participant 10

5 3 2 3 3 4

Total 2.9 3.0 3.0 3.6 4.3 2.7

One of the questions that was asked had to do with the rating of Obamacare. The


overall average rating from the random poll was 2.9 out of 5. When it came to this question,

there were a couple of answers that stood out. One individual believed that Obamacare is not

in the best interest for the United States. This individual said that if a patient decides not to

have a health care plan from Obamacare, then the government should also have the choice to

not pay for their health care coverage. The other opinion to this question was that the law

should be implemented the way it already is. This person believes that the Affordable Care Act

would give low income families a better chance for getting affordable health care coverage. Not

every low income family wants a hand out. The second question was whether Obamacare is

beneficial to low income families. The rating from the survey for this question was 3.0 out of 5.

Obamacare can benefit families because of the ability to get routine checkups and have

coverage that they normally would not have had before. Another issue for low income families

is that they are already trying to make ends meet but now, they have to take whatever money

they currently have and buy health care coverage. The third question on the survey asked

whether Obamacare is beneficial to businesses. The survey results for this question were 3.0

out of 5. The overall opinion on this issue was that it is cheaper for the employers to lower their

work hours from 40 hours a week to 38 hours a week, which allows the employer to have

control, and not have to offer the employee health coverage. This will force the employee to go

purchase their own health care policy. The fourth question on the survey asked whether these

individuals believe in offering subsidies to low income earners. The survey results averaged out

to be 3.6 out of 5. The majority of the opinions agreed that subsidies should be given to low

income families. This would help low income families in being able to afford health care

coverage. The fifth question asked whether individuals should be offered subsidies for wellness


benefits. Survey results averaged out to be 4.3 out of 5. The majority of the individuals believe

that everyone should be eligible to receive subsidies for wellness benefits, whether they are

low income or high income families. The final question on the survey asked whether individuals

who are 18 years or older should contribute to the overall health care system. When it came to

the survey result, the result was 2.7 out of 5. One opinion stated that individuals who are 18

years or older should make their own decision on whether to contribute to the overall health

care system. This person believes that these individuals are just transitioning from being young

adults to being adults and should make their own decisions. When it comes to the opposing

view, another person who took the survey believes that young people need to learn how to be

responsible and not take advantage of the system. The overall survey showed a variety of

different opinions and beliefs about Obamacare. There are a variety of opinions on how good or

bad Obamacare is, but there are some ways in which to improve the overall positive impact of

the Affordable Care Act.

Improving Obamacare

There are some ways in which Obamacare can be improved. One of the ways to

improve the Affordable Care Act is for the United States government to talk to another country,

which currently has the universal health care plan in place. The United States government

officials need to meet up with the Canadian officials and figure out the best way to properly

finance the health care system to make health care plans easier on Americans. Another way to

improve Obamacare is to make it affordable to everyone. When it comes to affordable

insurance, individuals who are currently working should automatically have health care

insurance. The amount of hours worked per week should not matter. The benefit to this plan is


that employers would not have a choice to cut down the number of hours an employee works

just so they can deny them health care coverage. The last recommendation that can be used to

improve the Affordable Care Act is to give the individuals the ability to choose their own health

care provider such as your primary care physician. In this case, if an individual has had the same

doctor for 10 years, then that individual would have gained trust in their doctor and the doctor

would know their overall health care history. With Obamacare, these individuals do not have a

choice to stay with their original health care provider who they have come to know and trust.

Conclusion

In conclusion, Obamacare was designed to make health care coverage affordable

for high income and low income families. Obamacare has some positives with one being that

individuals cannot be denied health care insurance for pre-existing conditions. Another pro to

the Affordable Care Act is that children under the age of 19 will be able to get two routine oral

exams per year which includes X-rays, fillings, and orthodontia care. The last major benefit to

Obamacare is the prenatal, childbirth, and infant care coverage. When it comes to the prenatal

care, this is considered a preventative service that must be provided at no additional cost.

However, there are also many negatives that come as a result from Obamacare. One of the

major cons of Obamacare is the releasing of personal health information, known as PHI, to the

United States government. This would be a violation of the privacy act. Another concern

regarding the Affordable Care Act is that individuals receive the same plan but are paying more

than what they would have paid before Obamacare was implemented. This is a concern

financially for all families across the country. The last major con of Obamacare is the impact

that it has on small businesses. When it comes to small businesses, they have to keep an eye on


how many individuals they employ. This is bad for small businesses because they can freeze

hiring, lay off current employees, or reduce hours just so they can maintain their business, only

if they are at risk of having more than 50 employees. If the company goes over the 50 employee

threshold, then the company would have to pay for both the health insurance plans for the

employees along with paying taxes and fees that would also be involved. When it came to the

survey, there were a lot of various opinions of what is good and/or bad about Obamacare.

Obamacare has proven that there are both good and bad aspects to the policy that can affect

the everyday lives of Americans.


Works Cited

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Documents

Affordable Care Act