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The affordable Health Care for America Act was a bill that crafted by the United States in the year 2009. The executive has been instrumental in enacting the affordable health care Act as they encourage new and increased taxes for cost insurance (Tate, 2013). The families with income of more than one million are being taxed highly, secondly, the high-cost insurance plans are also taxed more. The executive has also been able to enact insurance reforms by removing anti-trust exemption in order to define qualified health benefit plan.
The Veterans Health Administration can be described as the component of the United States Department of Veteran Affairs that led by the Under Secretary of Veterans Affairs for Health which implement the medical assistance program through administration and operation of numerous VA medical centers. The Veteran Health administration has played a very important role in outreach efforts to include men and women veteran as well as homeless veterans (Emanuel, 2014).
The VHA has been able to strategically place their medical centers near medical schools. Further, the VHA has been able to establish car for the wounded veterans in order to repair their damaged bodies as well as their minds. The organization has embarked on a unique campaign to also repair the crumbling the intimate relationships.
The Affordable Health care Act has been able to ensure that every person in the United States get health care that is affordable and which is almost free. This is importance as it has helped societies to be able to progress in terms of their economic activities as they are able to save more on health care. The single payer system is a term that describes a type where the government as compared to the private insurers pays for all health costs. The free-market health system involves where the government and private insurers pay for the health care costs. I would prefer the free market health system in the United States. The state government will participate in the federal health exchange.
Emanuel, E. J. (2014). Reinventing American health care: How the Affordable Care Act will improve our terribly complex, blatantly unjust, outrageously expensive, grossly inefficient, error prone system.
Tate, N. J. (2013). Obamacare survival guide.
The Affordable health care for America act more often referred to as HR 3962 was a bill that crafted by the House of representatives in the year 2009. The Senate decided to pass a health care bill referred to as the Patient protection and affordable act on the year 2010. The Affordable Care Act referred to as the ACA was originally enacted with a goal of increasing affordability as well as the quality of the American health insurance. The ACA is intended to lower the uninsured rate in the ever expanding private and public insurance coverage, and also reducing dramatically health care for the government and individuals (Gruber 45).
The health care reform was necessary as more than 44 million are currently without any health insurance. A majority of these people do not have health insurance primarily because the quality of health insurance in the United States is very high. Therefore, the ACA can be said to have been passed into law in order to ensure that all Americans have the ability to access reliable and cheap quality health care. The ACA has profound effects on the State of New Jersey and this paper is going to look at some of these effects as well as the history of the Act.
The Affordable Care act began in the year 2010 and is a set of health insurance reforms that are intended to roll out in 2014 as well as beyond. However, before the act has reached where it is today, it has gone through several bumps along the way. It was on March 23 that President Obama signed the Affordable Care Act into law. However, there were several legal battles in and of the supreme court where several people wanted the law to be scraped off deeming it unconstitutional. In the year 2010 beginning the month of October the individual health insurance plans started to allow children to the age of 26 years to be covered as dependents.
In the year 2011, the long term care insurance program started. It reimbursed some costs to nursing homes. In the year 2012, the nonprofit insurance cooperatives were initiated and were intended to compete with the commercial insurers (Gruber 45). This was a plan whose final result was supposed to be lower premiums. In the year 2013, there was the creation of standardized insurance forms whose main aim was to reduce paperwork, the administrative costs as well as duplication costs. There was also the introduction of a new tax of 3.8% that was intended to ensure that the health reform program was running the way it was supposed to. In the year 2014, insurance companies will be warned and prohibited from denying coverage to the people with medical conditions. In the year 2018, a 40% tax will be imposed on the companies that will provide Cadillac health plans whose value is more than $10,200.
It is important to understand that the Affordable Health Care Act does not only affect the national level but also it affects States. The ACA can be said to be the largest restructuring of health care delivery and it is intended to dramatically reshape the structure of American health care in New Jersey with an emphasis on the universal coverage for all people and value based care (Gruber 45). Although it is layered deep inside the bill, the ACA dramatically changes the relationship that exists between the medical device industry and the United States government. There are several benefits that will accrue to the State as a result of the Affordable Health care Act.
The ACA has two ways in which it can be able to increase coverage, firstly there is the expansion of Medicaid eligibility, which will include person who are within the required 138% of the federal poverty level. This means that more people in the State of New Jersey will be able to access cheap healthcare. Secondly, it should create state based insurance exchanges where individuals can comfortably buy health insurance plans. This scheme should be for those individuals that have incomes between 100% and 400% of the federal level of poverty. This will directly affect the residents of New Jersey who will be able to afford health care despite being below the poverty line.
There are several negative effects that will come as a result of ACA. Firstly, individual clinics will have to invest more on technolocial advancement and this might mean some of them closing down or unable to afford the ACA services. It is important to understand that for the ACA to work, there is need for a technological framework from the federal government, the state government of New Jersey and the individual clinics that give services directly to the patient. It is imperative that New Jersey develops an IT system in order for them to facilitate securely the movement of personal information in real time to the consumers.
The information that will be transported must be protected securely as this information is very confidential. The medical details of a person are often very confidential and in fact, it goes against the doctor-patient relationship ethics for a doctor to expose a patient’s medical state without his or her consent. This is exactly the same case with the transportation of files that are medical (Gruber 45). It is imperative that the files reach the target area by any means possible, they should reach there in a secure way without any alterations with third parties.
The ACA has radically changed the way hospitals and clinics do their jobs in the State of New Jersey. Firstly, there is a need to improve the existing technology so that it is at par with what the Affordable Care Act requires and this has been done in most hospitals in the State. The ACA requires a high level vision for the IT system where information can be shared as quickly as possible with multiple sources. However, these channels must be secure so that the confidential information is not tampered with.
There is a need for the technology to have a navigating policy as well as technological integration, which will allow the exchange of information from the Medicaid of the state or the CHIP programs to the local server at the clinic or the hospital. It is imperative to understand that despite the various guidance and regulations that were provided by the ACA, some of the clinics in the State have had to to face significant changes in regards to how they exchange information from Medicaid, CHIP activities and others which are the heart of the reform that ACA was originally meant for.
I believe the impact will be immense in the State of New Jersey. Most person will be able to afford health care services and the state clinics will be technological advanced. As earlier dscussed, it is important to understand that in clinics there is a need for technological development which in turn must support the full implementation of the ACA through the sharing of information. It is also worth to note that even clinics that choose not to expand and are public will be required by the Federal and the state government to meet all the possible aspects of the Affordable Care Act.
This means that more clinics in the State of New Jersey will have to invest more in their clinics or close down. Therefore, there is a need for the clinic to have an SBE, modernized Medicaid as well as CHIP eligibility systems that will be capable of performing different functions as it is well illustrated in ACA (Gruber 45). The IT systems in the clinic are expected to support first class user experience, and this must be understood is regardless of the coverage type. This IT system should be facilitated by what can be described as seamless coordination among several stakeholders.
In addition to the sharing technology which will make ACA work better and more effectively there is also the technological advancement that will be needed in the clinic that exists in the New Jersey state as a result of the expanded clientele. This includes the increase of basic technological equipment as well as more specific technology equipment. This will be important in order for the Affordable Care Act to achieve its set objectives in the State of New Jersey.
Gruber, Jonathan, and H P. Newquist. Health Care Reform: What It Is, Why It's Necessary, How It Works. New York: Hill and Wang, 2011. Print.
The 2012 United States election was poised on the Affordable Care Act that was passed in the year 2010. The Presidential campaign efforts of President Obama was centred on the several key characteristics that he indicated that the health care reform would help to resolve. The first issue that the campaign focused on and argued that if Obama is re-elected, every American making less than 133 percent of the shortage line will be qualified to receive Medicaid. Further, Obama argued that every American that is making between 133 percent and 400 percent of the poverty line will get credits from tax in order to help them to buy private insurance.
Further, Obama in his campaign strategy argued that Americans that lose their jobs need not fear that their families will miss their health insurance. The discrimination based on the pre-existing conditions will be said to be a thing of the past and every state will have a fitness insurance transfer where insurers often compete for business and where the regulators can often help expel shoddy health plans. According to the strategy, the Medicare will continue its transition from a fee-for-service model towards a system of value-based payments where providers are compensated in order to maintain healthy patients.
For this reason, Obama’s strategy will help to see the first iteration of a unique American universal health-care system. The basic guarantee is that the state will provide health insurance and subsidies to purchase it and will likely to prove immutable. This strategy has been implemented partially, and it is currently still being rolled out in the United States. The Affordable Care Act is the centerpiece of Obama’s legacy, and he will be remembered as the president that finally provided almost each and every American with health insurance.
When Barack Obama campaigned for the presidency in the year 2007 and 2008, he promised one healthcare system where he would make health insurance universal. This means that he promised 100% of Americans health insurance. Most health care health professionals in the United States support Affordable Health Care Act with 61% of them approving the law.
They argue that it has made them treat more patients and consequently get more money and expand their mandate of affording health care to the millions of Americans that were previously uninsured. When it comes to small business, most of them support the law since most of them will be able to get the insurance premium lowly. When it comes to the low wage employees, 91% of them support the law and argue that it will help to acquire health insurance cheaply and consequently ensure that they can live a healthy lifestyle.
Public opinion indicates that the United States supports the healthcare reform. 61% of Americans support the law and currently believe that the ACA will grow more popular with time. This is the same with Medicare that was opposed first after its inception but with time it gained favour among the American Public.
Most people believe that the law has taken a lot of time for its effects to be taken into account and consequently this might be the reason as to why there has been low rating as expected in regards to the law. The polling average from different presses consequently shows that indeed there is approval for the Affordable health care act with 52.1% according to Real Clear Politics approving the Act in 2014.
3. Analyse the intentions of the Affordable Care Act as articulated by its proponents during 2012 presidential campaign with the feelings of the above groups of individuals.
The proponents of the Affordable Care Act articulated several intentions of the Act during 2012 presidential campaign. The first reform will be the guaranteed issue which will effectively prohibit insurers from denying coverage to individual because of pre-existing conditions and a partial community rating which will require the insurers to allow the same premium price to all the applicants of the same geographical location and same age without regard to pre-existing conditions and gender. There is also the creation of an individual mandate that will require all the individuals that are not covered by Medicaid, Medicare, employer-sponsored health plan or any other public insurance program to secure a private insurance policy or else pay a certain penalty.
However, it is important to understand that this only happens when the individual has a financial hardship or is a member of a religious sect that is exempted by the IRS. According to the Act, it will help persons with low income to comply with the mandate. Further, according to the Affordable Health Care Act, low-income individuals and families who have incomes that are between 100% and 400% in the federal poverty line will be eligible to obtain federal subsidies on a sliding measure if they obtain insurance via an exchange.
The Medicaid eligibility according to the Affordable Health Care Act will include individuals that have incomes up to 138% of the federal poverty levels and will further include people with disabilities and without dependent children. There will also be reforms to the Medicare payment system that will aim to encourage greater productivity in the healthcare delivery system by restructuring Medicare reimbursements. Businesses that also employ 50 or more people will be forced by the Act to offer health insurance to their full Time-employees or pay a tax penalty. This has been commonly referred to as the employer’s mandate.
4. As a result of this, do Americans appear to be in favour of the implementation of the Affordable Care Act or are the majority against it?
The Public Opinion shows that most United States citizens support healthcare reform. The polling statistics shows that there was a rejection in the first years, but this changed with most people starting to feel the effects of the law. About 30% of whites approve the law, this is compared to around 61% of Hispanics and 92% of African Americans.
It is important to understand that specific elements that are very popular in the political spectrum, with a striking exception when it comes to the mandate to purchase insurance. For this reason, sections of the law are loved because others are not liked by majority of the United States citizens.
Further, there is also the element of party affiliation with most Democrats support the law at 59%, while 19% of the Republicans and 27% of Independents support the law. When it comes to the reasons for opposition, most respondents standing at 62% argued that they thought that the Affordable Health Care Act will increase the amount of money that they spend on healthcare.
Further, there are those that argue that the bill gives the government too much involvement in health-care and a 19% of them said that their families would be able to better off without the legislation. There are other polls amongst the public that believed that the law would cost more than it was projected, and it would effectively not do enough to control the cost of healthcare that affected their families.
It is important to realize that in the back and forth of politics, it is sometimes easy to forget why people fight so hard for progressive values each and every day. This is the same case with the Affordable Health Act. I believe that the first impact my family and I would have based on the affordable health care act is based on the effect on the insurance premiums. I do believe that the insurance premiums that my family pays will be effective, and consequently we will pay less.
Further, I believe that the insurance premiums will be more stable and transparent due to the regulations on insurance. Further, there will also be the provision of the law that will allow additional preventive care as well as screenings for women as specified in the Health Resources and Services Administration.
The employer mandate can be described as a penalty that is incurred by owners with more than 50 workers who do not give health insurance when it comes to their full-time workers. Currently, my family is covered through the employer and this, for this reason, means that even when I might change jobs and go to a company that has less than 50 employees my family will still get insurance.
It is important to understand that during as well as after the debate that surrounded the Affordable Health Care Act, Obama stated if one likes his or her health care plan, one will be able to keep it. This, for this reason, means that since the insurance that my family and I currently have was in effect before the law was established will not change. This is because the current plan satisfies the current criteria, and it complies with the current requirements and insurance standards.
There are several provisions that exist that will take effect between the year 2010 and the year 2020. Some of the titles will affect my family because others will not change anything. The first is that my family will be able to enjoy cheaper and quality health care. This is because there will be minimum standards for health insurance policies that were established, and it requires the same premium price to all the applicants of the same age as well as geographical location.
For this reason, this means that the pre-existing conditions will not be a factor in my family and, therefore, we will experience better health insurance policy. Low-income individuals and families that have incomes between 100% and 400% of the federal poverty level will be able to receive federal subsidies.
My family does not fall into this category and, therefore, this aspect of the Affordable Health Care Act does not apply to family. Further, the aspect of Medicaid, where eligibility expanded to include the individuals and families with incomes up to 133% of the national poverty level, which include adults that have disabilities and even those without dependent children. Again, this section of the Medicare does not apply to my family and consequently, it will not affect us.
Another section is the fact that the State children’s Health insurance has also been simplified. This, therefore, means that it will be easier for them to be enrolled into the process. Lastly, the reforms to Medicare payment system means that there will greater efficiency into the healthcare delivery system. This will affect the family, as under the new payment system, a single payment will be paid to hospital and physician group for a defined episode of care as compared to the individual service providers.
I believe that these changes will be positive for my family. The first title will help to increase cheaper, and quality health care for my family and this will be extremely important. Further, in terms of children enrolment in the Medicare system, it will be easier, and this will be important to my family. Otherwise, there will be no major changes as currently my family has a reliable health care insurance system.
Prior to the implementation of this Affordable Health Care Act, I believe I will choose the best health insurance program in order to understand the best and cheapest program. This will give my family the best insurance policy in terms of quality and cost. Further, I will also ensure that my children are eligible for Medicaid in the case of loss of employment and, therefore, for this reason, it is important to understand the different dynamics of the Affordable Care Act.
There are several changes that have occurred, firstly, I have experienced cheaper premiums since the introduction of the Affordable Care Health Act. This is because there have been uniform premiums in my geographical region and, the people in my geographical region tend to have lower premiums.
This, in fact, has been the biggest change after the implementation of the Affordable Health Care Act. I am ready to face the impact in several fields such as the implementation of the Children insurance program. Further, I do understand that in old age, I will be able to receive adequate health care since of the affordable health Care Act.
I believe that there has been a positive impact so far when it comes to the Affordable Health Care Act. The positive impact has been especially felt when it comes to the health insurance exchanges where individuals and small business in every state can be able to compare policies and buy insurance. It is important to understand that this has allowed persons like me to be able to get better insurance policies that have lower premiums. Further, another positive effect is when it comes to the lower-income individuals and families that have incomes between 100%, and 400% will be able to receive federal subsidies.
This, therefore, means medical insurance will be accessible to persons that are poor in the United States. Further, Medicaid eligibility under the law has expanded and includes individuals and families that have incomes up to 133% of the governmental poverty line. There have also been reforms to the Medicare payment system that has been extremely positive.
This greater efficiency has led to restructured Medicare reimbursements from fee-for-service to the bundled payments. It is important to understand that under this new payment system, a single payment is often paid to a hospital and physician group for a defined episode of care (for example, a hip replacement) this is as compared to the individual payment services that were there before.
In conclusion, the Affordable Health Care Act has been able to make most people in the United States to have universal health insurance. The method is currently up and running and in the United States and it has provided to my family several benefits such as reduced expenditure.
The provision of the best healthcare services is one of the main goals of any government. Healthcare refers to prevention, management and treatment of illness and the preservation of both mental and physical health. This is done be ensuring the provision of the best medical services to all the citizens of a nation. In almost all the nations of the world, the governments strive to provide the best medical services to all citizens (Gruber, 2011). The policies enforced are aimed at ensuring that the public is kept safe from all the avoidable and unavoidable illnesses. At times, this proves to be a challenge especially in the third world nations with a larger population, languishing in poverty.
The main reason why governments all over the world strive to provide the best healthcare policies is because; the progress of a nation will proceed much faster if the larger part of the population is health. There are a couple of things that healthcare reforms try to achieve. The first being the decrease in the cost of health care to the citizens. Second, the improvement of services and quality of health care and offer more care to the citizens. The third reason is the improvement of access to healthcare by citizens. Another reason is the increase of healthcare providers that gives the citizens have a wide range of variety for selection.
The last reason for the healthcare reforms is to improve the access of the citizens to a healthcare specialist. This is very important when it comes to illnesses that can only be handled by specialists. The types of healthcare reforms differ from one nation to the other, and certain factors are put into consideration before the methods can be put in place. The most important factor is the population of a nation. For a nation with a smaller nation, it might be easier to contain the healthcare situation compared to a nation that has a very large population. The assessment of the poverty level is also very essential to the government. It aides come up with a rough figure of those who can cater for their own healthcare needs. Also, for those that struggle in poverty and need the assistance of the government. Healthcare insurance is the most common and preferred method of healthcare reforms in most nations.
The case is the same in the United States healthcare history. Healthcare reforms have been the cause of political debate in the United States ever since the 19th century. In the United States, the main issues under the healthcare reforms include; access to healthcare, right to healthcare, sustainability and equality of the healthcare system and the cost or spending of the government in healthcare. United States public-private healthcare system tops the list of expensive private healthcare systems in the world. The amount that is spent on healthcare per person is relatively expensive, and no other country matches up to these standards (United States, 2012).
Except for East Timor, the US spends a larger portion of its Gross Domestic Product on healthcare compared to all other member countries of the United Nations. Despite the spending on healthcare in the United States being higher than all other members of the United Nations, the Commonwealth Fund Report of 2008 reported that the nation ranks among the last countries in the provision of healthcare services. The report was done in comparison to the fellow developed nations.
This leaves behind two very crucial questions; How come the United States spends so much in its healthcare and still lags behind in the provision of healthcare services? What should be done to enhance that the public has access to the best healthcare services since the government is already spending too much? Truth is that the United States compared to other developed countries lags behind when it comes to infant mortality rates and life expectancy (Vivar, 2011). A large part of the population is underinsured, with the number amounting to about a quarter of the population.
Another issue is that, those insured have to incur about a quarter of their annual paychecks paying up the insurance, due to the high deductible policies. This has prompted the introduction of new reforms in the healthcare system to try and counter the poor results. In 2010, President Barrack Obama passed healthcare reform system that is popularly known as the ObamaCare. ObamaCare is the unofficial name given to the Patent Protection and Affordable Care Act that was signed on March 23, 2010. On June 28, 2010; the act was approved by the Supreme Court. Seven days later, the President also signed the Health Care and Education Reconciliation Act of 2010 on March 30.
The two acts can be termed as the progress of endless efforts of the 11th Democratic Congress in conjunction with the Obama government. The implementation of these two acts came at a time that the healthcare system in the United States was under too much pressure. The government had to come up with reforms that will transform the healthcare system (Tate, 2013). The reforms being aimed at achieving the trust of the public and retain the international image that the healthcare system had lost. This paper will focus on the Patent Protection and Affordable Care Act and the possible implications of the law.
The history of the emergence of the ObamaCare, however, is traceable to the 2008 national elections. The president put healthcare support as one of the issues he would take care f once he got into power. His plan was to provide subsidies and at the same time rejected the use of the individual mandate. After his election, President Obama in February 2009 made his intention of working with the congress to formulate a healthcare plan for the public. The formulation of the bill took about thirty one meetings before the members could agree. The main democrats behind the implementation of the act convinced the president to have the inclusion of the individual mandate.
Most people, however, do not understand the real terms behind the Obama Care and what the Act approves and condemns. The Obama Care in a much general explanation is a healthcare reform that is aimed at; reducing healthcare spending in the United States and offer all Americans access to quality and affordable healthcare services. Most people go wrong by assuming that the healthcare system is aimed at replacing the already in place private medical insurance systems like Medicare and Medicaid (Pratt, 2012). This, however, is one of the many misconceptions associated with the Affordable Care Act. The act is aims at offering affordable healthcare to all the American citizens just like its name.
The implementation of the Affordable Care Act is a significant milestone in the provision of healthcare systems. This is the largest law ever passed since the approval of Medicaid and Medicare in 1965. The Affordable Care Act includes ten titles that spread over a thousand pages, with most of the key provisions being included in the first title. The first title contains a total page count of about 140 pages. The law is divided into several parts depending on the implementation of the provisions (Turner, 2011). Some provisions became effective immediately after the act was passed into law, ninety days after the enactment, and six months after enactment. The enactments roles up in phases up to 2020, which by then all the provisions are supposed to have been implemented.
There are some main clauses that if one understands, it would be very easy for one to understand the Affordable care Act. The first is the individual mandate; under this mandate, each citizen as an individual has a part to play in ensuring the change of the healthcare system. Every individual must, therefore, find an insurance plan before 2014 or be eligible for a penalty. The employer mandate demands that employers find an insurance cover for their permanent employees by 2015. The Affordable Care Act also creates marketplaces in states for the purchase of insurance plans. These market places are an option of those that do not want to be included in the Medicare expansion.
Before people start criticizing the Affordable Care Act, people need to understand the law first. The act includes several provisions that are set to take place between the periods of 2010 to 2020. The policies that were already issued before 2010 remain in place and are protected by a grandfather clause, but this only last until 2015 (Pipes, 2010). This ensures the insurance standards are exempted from most of the reforms though there are some that touch them. There are significant reforms that are supposed to take effect as of January 1, 2014. These provisions are the main important ones in the Affordable Care Act, and that is why they are at the top list of preference.
The first provision aims at the prohibition of insurers from denying citizens insurance cover due to pre-existing conditions (CCH Incorporated, 2010). This is under the terms of guaranteed issue; therefore, an individual can sue the insurance company that denies him/her the right to insurance due to their condition. Insurers are also supposed to provide the same rates or premium price to those who may apply from the same geographical location and age. Gender or pre-existing conditions should not be used to determine the premium rates. However, there is an exclusion which allows the use of only tobacco as a pre-existing condition that can be used to determine the rates.
The Affordable Care Act requires the establishment of the minimum standards for the health insurance policies. The new standards include the ban on the power of insurance companies to let go of policy holders in case they get sick. There is also a ban on the discrimination when it comes to premium rates on factors like gender and pre-existing conditions. The new insurance policies also give children the benefit of depending on their parent’s insurance cover until they are twenty six years of age. After attaining this age, they are supposed to create their own insurance plans since at this age one is not a child anymore.
Under this rule provision, Kathleen Sebelius, the Secretary of Health came up with essential health benefits that all insurance companies have to provide. The insurance companies were, however, prohibited from issuing lifetime or annual charges on the defined essential health benefits. The defined essential health benefits include; emergency services, maternity and newborn care, hospitalization, behavioral health treatment, laboratory services, mental and substance abuse treatment, prescription drugs, chronic disease management, oral and vision care and pediatric care (Gruber, 2011). However, there are a set of the essential benefits that are meant to be covered through an insurance plan’s premium. They include; immunizations and vaccinations for children and adults, medical screening and preventive care.
There are four insurance plans; bronze, silver, gold and platinum. The four plans aim at ensuring there is an insurance plan for everybody; from those earning the lowest amount to those at the high class taking hefty salaries home. The bronze plan offers the lowest premiums while the platinum plan offers the highest premium rates. The insurance companies are expected to spend about 80%-85% of the premium amount on healthcare rather than administrative costs and profits.
Under the Affordable Care Act, every individual is expected by the government to be under an insurance plan. Therefore, if one is not covered by Medicaid, Medicare, a healthcare sponsored by the employer or public insurance system; the government makes it mandatory for individuals to look for an appropriate private insurance cover. If one does not adhere to the law, it makes them eligible to pay a penalty. The only exceptions to the penalty are that if one, they can prove that they are experiencing financial hardships and, therefore, cannot afford an insurance plan (Pratt, 2012). The other exception is if one belongs to a religious group that is exempted from this provision by the Internal Revenue Service.
If the least expensive premium rates would exceed eight percent of an individual’s income, then they are exempted from the penalties. The other group that can also be exempted are individuals who US citizens who also qualify as citizens of other nations. This would be under the provision known as the foreign earned income exclusion rule provided by the Internal Revenue Service. For those that experience financial hardships, the government can offer them subsidies that will help them find a working and suitable insurance health plan. Those who fail to pay the penalty cannot be arrested because it is not considered as a federal felony. However, the Internal Revenue Service has the power to withhold their future tax refunds.
The exchanges or marketplaces for health insurances exchanges provide the public with an open forum to view the various insurance policies, comparing the various premium rates. After selection, an individual can purchase an insurance policy with a government subsidy if this is allowed at the exchange. Every state has its own places where the marketplaces for purchase of insurance policies are held. The first exchange runs should have started on October 1, 2013 to March 31, 2014 and those that will have successfully purchased their insurance plans by December 15 can start using them by January 1, 2014. In the years that follow, the exchange rate will always open on October 15 and end on December 7.
The advantage of these exchanges is that those individuals or families that have low income have a chance to own an insurance plan. The government avails itself to offer subsidies to individuals or families that are living between 100% and 400% of the federal poverty level. However, they are only eligible for the subsidies if they purchase the insurance plan via the exchange forum (United States, 2012). For individuals or families who happen to be in the range of 133% to 150% of the poverty level, their premium costs will only consume an average of 3% to 4% of their income. Small businesses are also eligible for subsidies but under different terms.
The law also expands the eligibility of individuals and families to Medicaid; that is up to 133% of the federal poverty level and adults without dependent children or disabilities. There provision includes a five percent termed as an income disregard percentage. This rises to eligibility to Medicaid to 138% of the federal poverty level. In this provision, the enrollment to the State Children’s Health Insurance Program is simplified. This program is an affiliate of the United States Department of Health and Human Services (Washington Post Company, 2012). Its main aim is the provision of insurance cover to families with children; especially the uninsured children who belong to families that earn a modest income that does not, however, qualify for Medicaid.
The reforms in the Affordable Care Act aim at changing the method of payment involved when an individual is paying for the health services they receive. The medical reimbursements aim at encouraging the payment services in one bundle rather than individual payments paid to the individual service providers. For example, if one gets their hand fixed, the provision prefers the payment of all the services that have been offered to the patient as one bill. Rather than separately paying the physician, the nurses and then the hospital last.
For businesses that have an employee capacity exceeding fifty, there is the need of the offering of health insurance to their full time employees (Vivar, 2011). Failure to do so will lead to a business having to pay a tax penalty especially if the government has already subsidized the employees healthcare through deductions. This is referred to as the employer mandate and the provision in July 2013, was delayed for one year by President Obama. If a business has about twenty five permanent employees, the employer is eligible to tax breaks and tax credits that will ensure the employees receive health insurance. Obama Care also exempts individuals that make less than 200,000 dollars and 250,000 dollars annually for a family or a small business, from the tax levies under the law.
Through the provisions above, the law looks at accomplishing its main goal; reforming the healthcare sector and ensuring the government funds are spent in the right forum. For a very long time, the healthcare system in the United States has been a profit industry for insurance companies at the expense of the system. The system has been biased, and only those that can afford expensive insurance plans are able to access quality healthcare. Those who do not have the financial capability have no option, but to run to Medicare or Medicaid policies. This, however, has a restriction and patients can only get cover during emergency situations; not any other normal checkups. The Obama Care aims at expanding the coverage of healthcare to the bigger United States population, and providing quality medical care services (Tate, 2013).
There are various misconceptions that the public has about the Affordable Care Act. First being that every individual has to shop for a health insurance policy using the marketplace even if one has a job that has benefits. However, this is not the case because most employees have insurance cover at their place of work. This means that such employees do not need to purchase an insurance policy at the new marketplace. However, if one is not covered under the employer’s insurance policy, there are two options. One is to purchase an insurance policy at the market place, one that goes along with an individual’s income. The second is to be incorporated in the insurance policy being offered by the employer. This is a provision that is provided for by the Affordable Care Act (Pipes, 2010).
The second misconception is that if one purchases an insurance policy at the marketplace they end up paying the full amount. An average of abut forty eight million United States citizens will need to purchase insurance policies or enroll at Medicaid. Almost 40% of the uninsured people will qualify for federal subsidies. The federal subsidies will reduce the amount payable for the purchase of an insurance policy. The expansion of Medicaid will also ensure that those uninsured qualify for the benefits under the policy. The Medicaid expansion is, however, only accessible to individual who earn less than $15,900 and families of four earning less than $32,500.
The best part of those getting the opportunity to the expansion of the Medicaid is that; for the first three years, the government will cater for the full enrollment cost. Anyone who does not have an insurance plan already in place at this time of the year is at risk. As of 2014, anyone who does not have an insurance plan will pay a penalty. The penalty is ninety five dollars or one percent of an individual’s income which will amount to a larger amount. So if an individual takes home an average of $75,000 annually, the amount they should be ready to part with $750.
There is, however, a group of people that will remain uninsured even after the passing of the penalty next year. The first group is the over eight million illegal immigrants living in the United States. This group is ineligible to subsidies and Medicaid and also exempted from the health insurance mandate. The immigrants are, however, eligible for emergency services in case of emergency situations (Turner, 2011). The other group is citizens who decide not to be enrolled to Medicaid despite being eligible for enrollment. There is also the larger percentage of single and young Americans, who prefer paying the annual penalty rather than signing up for an insurance policy. The last group who will remain uninsured are the citizens who live in states; that have taken up the decision not to engage in the Medicaid expansion.
The impact of the Obama Care in the healthcare system, in the United States, can be termed as tremendous ever since the Act was enacted into law. The biggest impact has been felt by the insurance companies that have had their activities monitored and regulated. This is done to ensure the public receive what they deserve. This has seen the creation of provisions that ensure that even those living below the federal poverty level are able to have an insurance policy at hand. This is despite the common trend that has been there in the past. The insurance policies have only been available to those who can pay expensive premiums in the past.
The other groups of people that will also suffer under the Obama Care are the seniors. The seniors have for a long time had an upper advantage and enjoyed the Medicare advantage. Medicare is the most common private healthcare options that are preferred by the rich and well off. Obama Care seeks to end this and the law comes along with very expensive charges to the program (CCH Incorporated, 2010). The tax increases affect the high earners and larger businesses compared to the low income earners. There are also tax credits aimed at subsidizing the cost of low income earners and small businesses to purchase an insurance claim. The increased cost of taxes for the high earners is used to cater for the tax credits used on the low income earners. This leaves behind the question whether the Affordable Care Act is out to burden the high income earners.
Another group that will gravely be affected by the Affordable Care Act is the drug companies. This is due to the creation of new taxes that will affect the drug companies and medical device makers. The new taxes for drug companies amounting to 27 billion dollars while the medical device makers having to cough 20 million dollars in tax. Physicians have not also been spared, and there are new reporting requirements and regulations imposed on them. This will make healthcare services expensive and difficult to access especially for seniors. This makes it seem like the law was aimed at favoring the low income earners at the expense of putting oppressive tendencies to the high income earners.
The increase in taxes brought about by the Affordable Care Act also affects the taxpayers in a very significant way. In the period of 2010 to 2019, the estimated cost that taxpayers ought to incur is 503 billion US dollars. The tax hikes in the law will, in fact, increase raise the taxes payable by the middle income earners. This will end up being a violation of something that the President’s Obama government had sworn not to violate. The delays by the President and the congress have shown that there is reluctance in the government to pass these taxes. This goes a big way to prove that the fear that the taxes might force the nation into increasing the deficit. This again will be a break of another promise that the President’s government had made (Coulter, 2012).
These tax hikes will end up reducing employment, suppressing the wages and slow economic growth. The loss in employment is projected to affect mainly the middle and low income earners. This is because their small incomes cannot sustain their needs and also pay up the increased tax rates. This puts into jeopardy the effectiveness of the Affordable Care Act. Calculations show that, in the long run, the law may end up causing more problems than benefits. There are some negative implications already being felt by various sectors in the economy. There is also the fear that the law may not be in existence for the time it was stipulated.
Since the amendment of the Affordable Care Act, several companies have already or are projecting to incur higher tax costs as of next year. An example is the Delta Air Lines, which projects that its healthcare costs will rise to about 100 million US dollars from next year. In the first year of the passing of the Obama Care, the Caterpillar Incorporation also projected a similar increase in 100 million dollars of its healthcare costs (Turner, 2011). The SeaWorld Company used to have most of their part time employees work up to 32 hours per week. However, the company has been forced to reduce this to 28 hours per week.
This is because the Obama Care only allows the company to offer insurance cover if the threshold does not exceed 30 hours. This has greatly affected the company considering that about 80% of the company employees are either part time or seasonal. The Smith and Nephew, a British Company, informed its workers in Massachusetts and Tennessee that they would be laid off. The nearly 100 workers would be laid off in an aim of containing the costs that the company has to take up due to the tax on medical devices. Hospitals have not also been spared by the negative effects that have resulted due to the implementation of the Obama Care.
The Cleveland Clinic in Ohio happens to be one of the world’s best known hospitals. In September, the hospital management made a press statement that it was considering reducing the number of employees in the facility. It would also reduce its annual six percent of its annual six billion budget. This is to have the ability to pay up the cost that associated with the Obama Care. The Clinic is the largest in Ohio and also a very large employer attaining the second position with forty four thousand employees. The Orlando Health Hospital also announced the cutting down of about four hundred jobs. The areas of those said to lose their jobs ranges from the administrative sector to the children’s sector.
The different state government and institutions have also not been spared. In the township of Middleton, New Jersey, the working hours of twenty five part-time employees, have been cut down (Pipes, 2010). In its defense, the authority of the town claims that if they do not reduce the working hours, the expensive cost of insurance will be passed to the public. In the state of Virginia, the general Assemble accepted the Governor’s, Bob McDonnell, decision to cut down the working hours of the part-time workers to 29 hours per week. The director of Brevard County, Florida, announced that the larger group of over 300 part time employees would have their working hours slashed. The part-time employees would now have to work for less than 30 hours to avoid the about 10,000 US Dollars expected to be paid per employee in the health insurance policies.
There are already numerous complaints from the public against the implementation of the Affordable Care Act. This is especially from the middle and low class society who fear the implications of the law. President Obama had made a promise that the implementation of the Obama Care would not affect those earning below 250,000 US Dollars. This might end up not to be the case, however, since the increase in taxes may end up affecting the middle and low class. This might not be direct, but the effect will surely be passed on them eventually breaking a promise the president’s government promised not to break. The effect of the law is even being felt by the government institutions and state government which raises very many questions about the future of the Obama Care.
The Obama Care does not seem like it will sustain the test of time after President Obama’s term ends. This is because of the negative impacts that have associated the act ever since its enactment. Though the act is a transformation of the healthcare system, there are various negative aspects that have come with the law that the government had not anticipated. The government might be forced to change some few aspects of the law to enable gain the approval of the public (Ross, 2013). The earlier the government can do this, the better before it becomes too late. The changes should try and reverse the measures that have been taken by the state and other institutions in the reduction of working hours for the temporary workers.
The new imposed taxes are another issue that should be considered for change and amendment. This is especially the increase in taxes in the drug companies and medical care services providers. An increase in taxes to the two groups is being shifted to the public and, therefore, an increase in taxes that the public has to pay. A change in these tax increases would save the American economy of sinking into a great deficit. This would also save the public the amount of 503 billion US dollars expected to be incurred in taxes by the year 2020. The low and middle class will also be saved from unemployment in the move. This seems as the only way the government can regain the public approval when it comes to the Affordable Care Act.
The law might end up losing the trust of the public and risk being vetted out if no change is done. President Barrack Obama should be keen to make sure the changes in the law keep the promises that he made to the public who elected. Otherwise, he will end up leaving a very bad legacy when his term expires. That of a president who could not keep his promises like other past presidents. The history books will obviously portray a picture of him as a failed leader. Therefore, the Affordable Care Act should have some of its provisions changed. This is to ensure the law brings out the best of the healthcare system to all the American citizens without discrimination and oppression of some (Pipes, 2013).
The Affordable Care Act has faced a lot of political disapproval since the first stages of the formulation of the law. This is because of the century old rivalry known to be between the two major political parties in the United States; the Democrats and the Republicans. The republicans were against the implementation of the individual mandate in the bill. The republican senators who had actively been included in the formulation of the bill started claiming it as unconstitutional due to the inclusion of the individual mandate. This is because, in his campaigns president, Obama had promised not to include the individual mandate in the bill. To the republicans, the view that every American must purchase an insurance policy was conservative thinking.
The Affordable Care Act also faced a lot of oppositions from various lobby groups in its stages of creation and implementation. These are the same groups that led boycotts against the healthcare reforms proposed back in 1993. They were now backed by the advocates who also viewed the Obama Care as unconstitutional. Over the August 2009 summer recess, several movements held organized debates and demonstrations. In the debates, the members were asked their consideration about the Obama Care and the bigger percentage of them were against the bill. The movements even went a step ahead to threaten members of the congress who were advocating the Affordable Care Act. On November 7, 2009, the House of Representatives passed the Affordable Care Act on a vote of 220-215, and it was, therefore, passed to the senate.
In the senate, the case was not different, and the bill erupted many debates. The senate was, however, a little more effective, and it changed and modified some of the clauses that were under the bill. The struggle to keep the bill was, however, replication of what had happened in the House of Representatives. The battle between the Democrats and the Republicans was far from over with every side trying to pull as much as they could. The Democrats, however, emerged successful after a vote count of 60-39 on December 24, 2009. This, however, did not prove to be the end of the battle between those advocating the law and those against it (Pipes, 2010).
Even after the implementation of the Affordable Care Act, there have been several groups that are still trying to bring the law down. The act has even eluded an international outcry from International Activists Groups and the media. Most condemning the Obama government for passing a law that does not fulfill what it promises. The main concern being that the low and middle income earners that the Obama Care seems to have their interests will end up suffering more (Torinus, 2013). The President’s government is under too much pressure not only from the international community but also from within the government. The congress has to figure out ways to contain these complaints from all over or face the consequences which might be severe.
In the government, there have also been various attempts to bring the law down since its implementation. This shows that the leaders who vetted for the law in the first place do not approve of it just a few years later. This raises the credibility of the success of the Affordable Care Act when it is completely implemented. The fall out points out the fear of the failure of the Obama Care, and the possible consequences that the Americans will have to bear. Such measures go along to show that this law is not here to stay. If at all, its existence is being jeopardized by the same people who created it, this means that, in the near future, the law will be completely faced out and forgotten (Ross, 2013).
The Affordable Care Act has had to face several unsuccessful repeal efforts by the Republicans. The 111th, 112th and 113th congress houses have all come down very strongly when it comes to the Affordable Care Act. In 2011, the republicans passed a repeal motion against the Affordable Care Act which they won on a vote count of 254-189. A Supreme Court ruling last year, however, proved the Affordable Care Act as constitutional. After the court ruling, the Republicans held another vote to repeal the law on July. The House of Representatives had 239 votes of the Republicans which included five votes from the Democrats. This was the 31st repeal attempt by the republicans, but their efforts deemed useless after the re-election of Obama in 2012 with the larger Democrats consisting the majority of the senate.
In conclusion, the Obama Care is a very good idea and a major milestone in the American Healthcare reforms history. The genesis of the act being the provision of better health care services even to those who earn middle or low incomes. The act also aims at the abolition of some bad practices that the insurance companies have including; dropping off their members when they fall ill due to pre-existing conditions and the discrimination due to gender (Gruber, 2011). The law, however, in its full implementation might cause some unexpected results. These results include; increase in the national deficit, increase in tax rates, loss of employment and wages and a lag in the development of the American Economy (Pipes, 2013). Therefore, the government needs to jump swiftly in action and change the clauses that will bring the negative effects. Though, it is proven to be impossible to come up with a perfect bill, the act should have many benefits and few unavoidable bad outcomes (Torinus, 2013).
CCH Incorporated., & Wolters Kluwer (Firm). (2010). Law, explanation and analysis of the Patient Protection and Affordable Care Act: Including Reconciliation Act impact. Chicago, IL: Wolters Kluwer Law & Business.
Coulter, A. (2012). Mugged: Racial Demagoguery from the Seventies to Obama. S.l.: Penguin Group US.
Gruber, J., & Newquist, H. P. (2011). Health care reform: What it is, why it's necessary, how it works. New York: Hill and Wang.
Pipes, S. (2013). The cure for Obamacare. New York: Encounter Books.
Pipes, S. (2010). The truth about Obamacare. Washington, DC: Regnery Pub.
Pratt, L. L. (2012). Let's fix medicare, replace medicaid, and repealthe affordable care act: Here is why and how. Bloomington, Ind: AuthorHouse.
Ross, B. M. C., & Ross, B. M. C. (2013). Beating Obamacare: Your handbook for surviving the new health care law. Washington, D.C: Regnery Pub.
Tate, N. J. (2013). Obamacare survival guide.
Torinus, J. (2013). Opt Out on Obamacare, Opt Into the Private Health Care Revolution. New York: BenBella Books, Inc.
Turner, G.-M. (2011). Why Obamacare is wrong for America: How the new health care law drives up costs, puts government in charge of your decisions, and threatens your constitutional rights. New York: Broadside.
United States. (2012). Examining the impact of Obamacare on job creators and the economy: Hearing before the Committee on Oversight and Government Reform, House of Representatives, One Hundred Twelfth Congress, second session, July 10, 2012. Washington: U.S. G.P.O.
Vivar, L. M. (2011). Obama's health care reform 2010: From change to concession?. S.l.: GRIN Verlag.
Washington Post Company. (2010). Landmark: The inside story of America's new health-care law and what it means for us all. New York: PublicAffairs
The article by Michael F. Hopkins titled Continuing Debate and New Approaches in Cold War History published in the year 2007 by Cambridge University Press. This source is extremely credible as it has been peer reviewed and published in the Historical Journal. His writing can be described as a historiography.
The MMBC should not introduce the light beer. This is because the pros are weightier than the cons. The first advantage is that the light beer will appeal to the ever-growing young crowd. The young crowd prefer light beer and consequently by MMBC introducing light beer, the company will be able to reinvent itself and appeal to this vast market.
The events of the ninth of September, 2001 are a gruesome memory that will remain in the American history, now and for centuries to come. The damage caused in the American soil on that day caused shock not only to the American soil but also the whole world.
Fight club is a club in which men have the opportunity to meet and fight, as a form of alleviating stress and troubles of life. The fact that these men, who are part of the fight club, meet secretly in order to fight, shows the great desire for a thrill that these men have
Trafficking in human beings is not a new phenomenon, especially that of girls and women. Historically, sex trafficking has taken many forms
Diabetes type II is one of the fastest growing chronic diseases in many countries and large scale prevention measures have been proposed to control the rising health menace (Codario, 2005). Diabetes mellitus is a serious complication with other associated health effects such as heart diseases, stroke, limb amputation and kidney failure
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