Hello all, this is my final semester paper for my English class. Any corrections or advice would be great. It is due at 3:00 pm today so the sooner the better. Thank you all for your help.
Health Care Reform: Is the Affordable Care Act a good idea?
Currently about 45 million Americans are uninsured and with health care premiums this number is on the rise (Pickert). It is estimated that by 2018 health care spending will equal 20% of the US gross domestic product (Pickert). These alarming issues have made health care reform the primary goal of the president. On March 23, 2010, Barack Obama signed into law the Affordable Care Act, also referred to as Obamacare, which plans to bring coverage to 32 million uninsured people by taxing those in higher income brackets (Clemmitt). This is not the first time universal health care has been implemented in the United States although it is the largest such attempt. In 2006 Massachusetts governor Mitt Romney signed the Massachusetts Health Care Reform Act into law. The law has proven wholly successful as Kenneth Rapoza of Forbes explains, "Every resident is required by law to have insurance, or pay a fine. To date, 99% of the state's residents have health insurance, up from around 90% before healthcare reform. That number changes drastically depending on which segment of society you look at. At least 24% of low income residents did not have health insurance prior to the 2006 law, according to the Urban Institute, a Washington DC non-partisan think tank. Today, just 8% of low income adults do not have healthcare coverage." The Affordable Care Act was modeled after this system and hopes to achieve similar results but on the national level (Rapoza). Although the bill was not passed without scrutiny, not one Republican member of congress voted for the bill to pass (Clemmitt). Conservatives often cite the cost of the health care plan and the constitutionality of the law. As Scott Gottlieb states, "Uncle Sam will spend $2.6 trillion on ObamaCare over the next 10 years" (Gottlieb). This steep cost has conservatives asking where the money will come from and for an entirely new approach to health care reform. The republican dominant House of Representatives has actually voted over 30 times to get rid of Obamacare which have all failed to make it through the democrat dominant Senate (Minyanville). So why are so many people and parties split on this new legislation? Well it comes down to three main points: money, personal well-being, and legality.
Supporters of the new law often say that the biggest benefit of the Affordable Care Act will be the cost benefit to the people and to the economy. The new legislation will bring health care coverage to these 32 million unemployed Americans by expanding Medicaid, providing subsidies to help low- and middle-income families buy insurance, creating markets for those without employee health care coverage can buy subsidized coverage, and by using the economic clout of Medicaid to cut health care costs (Clemmitt). These changes will in theory allow everyone to get health care coverage while also cutting costs through government subsidies for those that cannot afford or struggle to afford health care currently. In fact the average subsidy for those buying non-group insurance that are below 400% of the poverty line will be $2,672 (Klein). Also supporters will point to the $190 billion dollars that the law will save the federal government over the next 10 years according to an analysis done by the Center for American Progress (Volsky).
So if the bill helps people get coverage and saves them and the government money then what's the problem? Conservatives are arguing that the increase in taxes on the middle class and up to pay for the law will put too much of a burden on those groups to support the system. As Scott Gottlieb of the New York Post states, "The middle class is a clear loser: It gets squeezed, since these people earn too much to qualify for adequate subsidies, but too little to afford the needlessly pricey exchange coverage" (Gottlieb). These rising taxes on the middle class have many conservatives worried. "Families with incomes greater than $250,000 will pay a higher Medicare payroll tax - up to 2.35 percent, plus a new 3.8 percent tax on interest and dividend income. With this stroke, Democrats have managed to punish both work and the savings of American families," wrote Sally C. Pipes, chief executive officer of the free-market-oriented Pacific Research Institute in San Francisco (Clemmitt). These imposed increase in taxes will hurt the middle class which is responsible for the majority of small businesses in the US conservatives argue. Those who oppose the bill contest that because of this small business will suffer and have to decrease the number of employees they hire. The mandate also requires these small businesses to provide insurance to all employees if they have more than 50 employees or pay a fine (Surowiecki). Opponents then argue that these businesses will actively try to stay just under 50 employees to avoid having to pay for insurance which will again negatively affect the economy and the individual in the work place. Although supporters of the bill argue that over ninety percent of businesses with over 50 workers already provide insurance (Surowiecki).
As touched on earlier supporters of the Affordable Care Act emphasize the benefit of the law to the well-being of the American people. Simply put those who had no insurance will now be able to get insurance and cover themselves for future ailments. Currently many Americans are denied health care because of pre-existing illnesses or age; Obamacare will eliminate this and not allow insurers to deny coverage to these people (Clemmitt). As of February 1, 2011, about 12,500 people have enrolled in "high risk" pools which aids them in finding affordable health care coverage despite their pre-existing illness. This number is also expected to dramatically rise when more of the law goes into effect in 2014 when all insurers will be forced to accept all new comers regardless of preexisting illnesses (Clemmitt). The new legislation doesn't stop there though; it also will provide better health care coverage to those that have poor coverage. Millions of Americans have what they call Swiss cheese coverage. It is insurance but it doesn't actually insure anything or it appears to cover them but in actuality it will leave the individual with high costs if a medical issue arises. Many people have co-insurance or chronic disease insurance. Co-insurance will cover about 80% of the medical costs but leave the individual with the other 20% to pay themselves (Pickert). This type of insurance is common because it is much cheaper but in the event of a medical emergency can prove impossible for the person to pay because of large medical costs. Obamacare will effectively get rid of these policies and offer better coverage to those who had this type of health care. Also many people decide to get chronic disease insurance which will cover them for large surgeries or emergencies but has a very high deductible. This deductible makes routine hospital visits have to come out of the individual's pocket which can lead to many financial issues (Pickert). Obamacare would effectively eliminate this type of coverage as well.
Yet many opponents argue that this law will not help the well-being of the individual in the health care market. Opponents state that the government is cancelling plans that the people were happy with and forcing them to take on the new Obamacare plans which could be more expensive. These new Obamacare plans also can heavily restrict the person's choice of doctor. Many plans restrict the choice in doctor to region or even as small as your county (Gottlieb). In some Florida county there are as little as 7 pediatricians for roughly 250,000 children, and if one goes outside of these narrow network of doctors then all of the costs could come out of pocket. These restrictions make the new plans under the Affordable Care Act impractical and actually a hindrance to the well-being of the individual in the health care market according to those in opposition to the law (Gottlieb). The Affordable Care Act has also received scrutiny for being very unfair to young people. As Rituparna Basu of Forbes magazine explains, "Preventing health insurers from fully accounting for age will not change the reality that, in general, the older you are, the greater your medical expenses (six times greater, when you compare 64-year-olds to 18-year-olds). These are costs that someone has to pay. If insurers can't charge those older according to their risk, they have to overcharge those younger to make up the cost." She goes on to state that non-smoking men under the age of 25 in California can expect their rates to at least double once Obamacare takes full affect (Basu). The new law has thus garnered many opponents who argue that the law will not actually benefit the well-being of the individual in the United States.
The main sticking point for many opponents of the law is simply that it goes against the constitution. "At least 20 state attorneys general and several private groups are suing to stop the law" (Clemmitt). Many fear that the law reaches too far into the liberties of everyone as an American citizen. As Senator Orrin Hatch of Utah stated, "I came to the conclusion ... that this would be the first time in history that the federal government requires you to buy something you don't want," he said. "If we allow the federal government to tell us what we can or can't buy, then our liberties are gone" (Clemmitt). Many conservatives share this regard and question that if we allows this law what else could the government mandate us to do in the future. Besides mandating that everyone have insurance the law will also require, "many businesses to provide access to contraceptives, sterilization, and drugs and devices that cause abortions, regardless of their religious objections" (Rienzi). This has many people demanding that the bill be appealed because it violates the first amendment which states freedom of religion. Many opponents also argue that the law oversteps the states' rights. They state that Obamacare goes against the tenth amendment which states all powers not granted to the federal government or denied to the states is left to the states or the people. Conservatives are arguing that health care would be one of the powers that would fall to the states thus making the federal mandate unconstitutional (Clemmitt). However as of now the attempts to repeal the bill have not been successful.
Liberals and other proponents of the law testify that the law is constitutional and there is a long stating precedent for laws of this type. "There is a long line of [Supreme Court] cases holding that Congress has broad power to enact laws that substantially affect prices, marketplaces and commercial transactions," including cases decided by the current conservative-dominated court, wrote Ian Millhiser, a policy analyst at the liberal Center for American Progress. "A law requiring all Americans to hold health insurance does all of these things," so its constitutionality is not in question," he said (Clemmitt). This sentiment was further confirmed when the Supreme Court voted 5 to 4 that the law was, in fact, constitution (Minyanville). As Erza Klein writer for the Washington Post explains, "Health insurance isn't like other forms of insurance. It's not protection against the unlikely; it's insulation against the inevitable." Almost everyone will need medical services at some point in their life, so the law is constitutional because it does not force anymore into the health care market since they will eventually have to join regardless (Klein). Also most Americans are not affected by the new law. Only Liberals also argue that the federal government has full rights to impose taxes under the constitution and the Affordable Care Act is simply an imposed federal tax. Regardless the law is here to stay with the backing of the Supreme Court, Barack Obama, and the Senate.
No matter which way you look at it the Affordable Care Act is not going away any time soon. But is it the right way to go about health care reform? The right side will argue that it is not and will be a colossal failure to our economy and individuals of the nation. Opponents to the law such as Grace-Maria Turner, President of Galen Institute, have argued that the law sorely underestimates the costs. She stated, "The Congressional Budget Office (CBO) recently said the law will cost $115 billion more than originally estimated, pushing the total cost above $1 trillion. But this underestimates the true costs by hundreds of billions - if not trillions of dollars - due to the law's deception and budget gimmicks." However those in favor of the bill such as Paul N. Van de Water, senior fellow at the Center on Budget and Policy Priorities, praises the law for its economic frugality. Water stated that, "The Congressional Budget Office (CBO) estimates that the new health reform law will reduce deficits by $143 billion over the first decade (2010-2019) and by about one-half of 1 percent of gross domestic product, or about $1.3 trillion, over the second decade (2020-2029)" (Clemmitt). These conflicting reports from each side of the argument often lead to confusion and cherry picked statistics to back their side. So which side is right? Well no one exactly knows yet. The law goes into full effect on January 1, 2014, at which point we can begin to understand how the cost and benefits of the law will pan out, but we really won't know the full effects of the law good or bad for many years to come.