PAD 510 INTEREST GROUP PRESENTATION
2
Position Paper
Position Paper
PAD 510
Strayer University
Dr. Smith
02/21/2022
Policy: Affordable Care Act
Healthcare is a critical component in our society since its availability and affordability determines all other spheres of human life. One of the main healthcare policies in American history is the Affordable Care Act (ACA). Affordable Care Act is a comprehensive care reform policy enacted into law in 2010 by president Obama. Purposely, the ACA was put in place to increase the affordability of health insurance among the American people, expand the Medicaid Program and promote innovative health care programs meant to lower the costs of healthcare generally (Sewell, 1). This policy is among the best things to happen in the country’s healthcare system since it has made healthcare more accessible and reduced healthcare costs among low income earners.
Evidence Argument for Affordable Healthcare
According to the department of Human Health Services (HHS), ACA has led to an increase in the number of insured residents who could not previously afford health insurance. The department of Human Health Services reports that the number of uninsured nonelderly citizens declined from 48.2 million in 2010 to 28.2 million in 2016 (Centers for Medicare and Medicaid Services, 2). Such a figure represents a 41 percent decline in the number of citizens without health insurance. Currently, 31 million citizens have a health insurance cover under ACA. Such figures underscore the importance of ACA in promoting healthcare access and affordability across the country.
The affordable Healthcare Act has also had a significant impact among small businesses and their ability to cover their employees. According to Sewell (1), the affordable care act made it possible for small businesses to cover their employees by providing them with tax credits. Under ACA, small businesses with up to 25 employees receive tax credits up to 35 percent of the cost of coverage. Since 2014, tax credits covered up to 50 percent of the cost of coverage. Additionally, in 2011 alone, 360,000 small employers utilized the Small Business Healthcare Tax Credit to offer healthcare coverage to 2 million employees (Centers for Medicare and Medicaid Services, 2). From these figures, it is evident that ACA is a very critical policy in America’s healthcare system and therefore, its importance cannot be overstated. Additionally, ACA was a major relief to women and other disadvantaged groups. For instance, it prohibited insurance companies from dropping or penalizing women when they became sick or pregnant. Since 2014, women were no longer treated as a special group with an existing condition. Previously, women used to pay higher insurance premiums due to pre-existing conditions such as pregnancy, breast cancer, C-section delivery or having been a victim of domestic violence. The ACA is so useful in healthcare provision since it eliminated all barriers that made healthcare inaccessible (Centers for Medicare and Medicaid Services, 2).
Normative Argument for Affordable Healthcare Act
From an ethical point of view, enacting the ACA was the right thing to do for Congress and president Obama’s administration. Before the act, proper medical care was a preserve of the rich, who could afford to pay for private health insurance coverage. Such a situation violates general principles of equality and just society. Morally, it is wrong to make healthcare, a basic human need, so expensive that only a few can afford. In my view, the affordable healthcare act saved so many citizens from exorbitant medical bills that threatened their general wellbeing. Individually, I believe in a fair and just society, where all citizens have equal opportunities in all spheres of life, including healthcare. Besides, ACA helped increase healthcare access and insurance coverage among minorities such as Black Americans hence reducing the disparities that exist between them and their white counterparts.
Argument Against Affordable Care Act
Evidence-Based Arguments
The Affordable Care Act has not lived to its expectations. Initially, ACA sought to increase in the number of people under health coverage, expand Medicaid program to include all adults whose income was 138 percent less than Federal Poverty Level, and support innovative medical care delivery techniques that would lower the cost of healthcare. On the contrary, ACA made healthcare more expensive and hard to acquire among citizens. For instance, the passage of ACA meant that insurance firms could cover a wider range of benefits and even people with pre-existing conditions. Such a policy led a rise in insurance premiums, making it harder for low-income earners to acquire healthcare insurance coverage.
The ACA turned out as a punitive tool designed to punish citizens not willing to acquire healthcare insurance. Before 2019, any person not under ACA coverage had to pay a fine, which deprived citizens their right to choice (Reisman, 3). The policy would have been beneficial if it was made voluntary. Additionally, the ACA policy increased inequality across the American society instead of solving it. For instance, additional taxes on pharmaceutical sales and medical equipment were imposed to help finance ACA. Such taxes were an extra burden to the American population. Besides the economic burden on citizens, ACA entrenched unfairness in the American society. The wealthy were subjected to greater taxes to subsidize healthcare coverage for low income earners. Such a move sought to punish the rich for their effort while rewarding the poor.
Affordable Care Act became an incentive for small businesses to lay-off some of its workers. According to the policy, only businesses with 50 or more fulltime employees were under obligation to make insurance contributions on behalf of their employees (Manchikanti,4). Such a policy encouraged small firms to reduce their workforce to less than 50 employees with an aim to evade paying for their insurance subscriptions. The same employers also sought to reduce working hours of their staff to less than 30 hours per week so that their staff do not qualify as full-time employees. Generally, under this situation, ACA reduced the rates of healthcare insurance among the population instead of increasing.
Normative Argument Against ACA
Under the values of equity and fairness, ACA was a poor policy that brought more harm to the health sector than good. For instance, under the policy, being female would no longer be treated as a pre-existing condition yet women need some special services such as C-section deliveries, breast cancer and care arising from domestic-related violence. In a fair and just society, women would be made to pay for the extra services they receive under ACA. Also, low income earners were granted exceptions and discounts based on their incomes relative to the Federal Poverty Level. Favoring low-income earners at the expense of the rich amounts to punishing the rich due to their hard work. In the principles of fairness and justice, I believe all people should be treated equally regardless of the situations.
In 2017, the Tax Cuts and Jobs Act removed penalties levied on employees who did not subscribe to ACA. Such a move made it voluntary for people to choose whether to acquire health insurance or not (Reisman,3). Making health insurance voluntary is burdensome to those with insurance since they have to bear some costs on behalf of those without insurance. Therefore, ACA did not promote fairness or equity in the health industry, hence it was a poor policy.
Sources
1. Sewell, Terri. 2022. Benefits of the affordable care act. Congresswoman, Alabama’s 7th District. https://sewell.house.gov/aca-you/benefits-affordable-care-act
2. Centers for Medicare and Medicaid Services. 2017. Nearly 12 million people with Medicare have saved over $26 billion on prescription drugs since 2010. https://www.cms.gov/newsroom/press-releases/nearly-12-million-people-medicare-have-saved-over-26-billion-prescription-drugs-2010
3. Riesman, Miriam. 2015. The affordable care act, five years later: Policies, progress, and politics, 40(9); 575-578. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4571845/
4. Manchikanti, Laxmaiah, et al. 2017. A critical analysis of Obamacare: Affordable care or insurance for many and coverage for few? National Library of Medicine. https://pubmed.ncbi.nlm.nih.gov/28339427/