Health policy, politics and perspectives

Running head: POLITICS IN HEALTHCARE 1

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Politics in Healthcare

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Politics in Healthcare

Since it was enacted, “Affordable Care Act” has attracted divergent views from Americans –among them politicians as well as other key stakeholder groups within the healthcare industry. Upon its enactment, the law was expected to positively change the landscape of the U.S. healthcare sector by expanding access to healthcare, enhancing the affordability of medical coverage, as well as minimizing the uninsured people. Notably, ACA has been able to achieve its key goals since “an estimated 20 million people have become newly insured and approximately 24 million people have gained access to subsidized or free care through marketplace tax credits and Medicaid expansion” (Eibner, 2019). Despite achieving its key goals, ACA continues to face “strong political spectrum headwinds”.

Consequently, two political alliances –one consisting of Republicans and the other one comprising of Democrats –have emerged. The Republicans have constantly undermined ACA while at the same time opposing all the proposals of Medicare-for-all. On the other hand, Democrats wholly support ACA advocating for the its maintenance with minimal or zero changes. However, the Republicans have maintained that Affordable Care Act should be repealed and replaced it with “proposed healthcare reforms” by President Donald Trump. Republicans further argue that ACA is going to worsen the government’s final position –leading to federal deficits amounting to $530 billion by the year 2021 (Amadeo, 2019). The Republicans have projected a scenario whereby healthcare spending might exceed the country’s income. The argument by Republicans is meant to “avoid worsening of federal deficits and increasing federal health care financing commitments.” Hence, repealing and replacing ACA with AHCA would improve the government’s fiscal outlook.

According to a report released by KFF in November 2017, 50 percent of the Americans supported ACA while 46 percent opposed it. In terms of partisan politics, 80% of the Democrats braced the legislation while 81% of Republicans strongly opposed it (Rovner, 2017). While Medicare-for-all option fronted by Democrats calls for a single-payer healthcare whereby all Americans are covered by a single government-run insurer, Republicans were advocating for AHCA which allows people to either choose a public or private insurance plan (KFF, 2017). Basically, the reforms pushed by Republicans gives Americans more options compared to ACA. In other words, Medicare-for-all is limited and strict hence denying people the option to choose.

According to Republicans, Affordable Care Act fronted major financial constraints to the federal government –subjecting the country to a substantial risk of deficits. Basically, the government was expected to spend over $1.15 trillion by 2021. ACA has also raised income tax rate for people earning above $200,000 to 2.35%. Moreover, Americans earning above $200,000 were expected to pay an extra “3.8 percent Medicare tax on investment income” (Amadeo, 2019) Moreover, ACA became a burden to pharmaceutical companies and medical equipment manufacturers due to 2.3 percent excise tax imposed on them. Moreover, people who did not purchase the cover were also taxed. Generally, ACA had a lot of financial constraints both to the government, key players in health industry, as well as Americans. In a nutshell, Republicans have downplayed ACA and all the proposals of Medicare-for-all due to its weaknesses –especially financial arguments discussed above. This saw the introduction of AHCA that fronted a public option to allow Americans choose “from Medicare and other private insurers” (Boxer & Herzlinger, 2019).

References

Amadeo, K. (2019). Obamacare Pros and Cons. Retrieved from: https://www.thebalance.com/obamacare-pros-and-cons-3306059.

Boxer, R & Herzlinger, R. (2019). The Case for the Public Option Over Medicare for All. Retrieved from: https://hbr.org/2019/10/the-case-for-the-public-option-over-medicare-for-all.

Eibner, C (2019). The Future of U.S. Health Care: Replace or Revise the Affordable Care Act?. Retrieved from: https://www.rand.org/health-care/key-topics/health-policy/in-depth.html.

KFF. (2017). Side-by-Side Comparison of Medicare-for-all and Public Plan Proposals Introduced in the 116th Congress. Retrieved from: http://files.kff.org/attachment/Table-Side-by-Side-Comparison-Medicare-for-all-Public-Plan-Proposals-116th-Congress.

Rovner, J. (2017). Why Do People Hate Obamacare, Anyway?. Retrieved from: https://khn.org/news/why-do-people-hate-obamacare-anyway/.