History of the Act
Commonly known as ObamaCare, was signed into law by President Obama on March 23rd, 2010 after its enacted by the 111th United States Congress ("History of the Affordable Care Act (ACA)," 2018). During the signing, the president stated the act’s core principle was to give everybody some basic security when it comes to health care. For 75 years, democratic presidents had pursued means of creating a nationwide insurance system with no success ("A short history of the Affordable Care Act – Obamacare drama," 2018). President Obama said, “this law had generations of Americans fighting for, marching for and longing to see.”
In his 2008 presidential campaigns, the president had promised to review the health care system about review laws relating to health insurance. After his election, House Democrats introduced a 1000 page plan on how to overhaul the healthcare system on July 14th, 2009 ("A short history of the Affordable Care Act – Obamacare drama," 2018). This resulted in a debate that raged through the summer and beyond. During his address to a joint session of the Congress on 9th September 2009, President Obama cited a letter sent to him by Senator Ted Kennedy who had battled the healthcare reforms throughout his life. Senator Kennedy had died a few weeks before this address. In this letter, the senator noted that healthcare reform was above all, a moral issue that served to address the fundamental principles of social Justice ("A short history of the Affordable Care Act – Obamacare drama," 2018). The president stated that the law would not protect the illegal immigrants, and this was displayed when the Senate health reform plan was tabled that prohibited the participation of those unlawfully present in the U.S.
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The bill was approved by the House on Nov 7, 2009, with a 220-21 vote while Senate approved its version in a 60-39 vote on December 24, 2009 ("A short history of the Affordable Care Act – Obamacare drama," 2018). The Senate bill was then to be amended and passed by the House in a 219-212 vote on 21st March 2010 (,"A short history of the Affordable Care Act – Obamacare drama," 2018). In this vote, all Republicans voted against the bill. After its enactment, the law was subjected to a lawsuit from 26 states and the National Federation of Independent Businesses. These groups challenged the mandate to carry insurance or pay penalties by individuals, and the expansion of Medicaid. Though the Supreme Court upheld most of the provisions of the act, it ruled that the states could not be forced into expanding Medicaid.
Key Features of the Law
The law meant to serve the following main purposes:
• Improving the quality and efficiency and lowering the healthcare costs ("Key Features of the Affordable Healthcare Act Law - MACMH," 2018). This includes providing support mechanisms for innovative medical care delivery methods that are generally designed to reduce the cost of healthcare ("Affordable Care Act (ACA) - HealthCare.gov Glossary," 2018).
• Improve access to healthcare by expanding the coverage across America ("Key Features of the Affordable Healthcare Act Law - MACMH," 2018). This includes making health insurance affordable and available to more people. The law gives subsidies in the form of premium tax credits to households whose incomes range between 100% and 400% of the federal poverty level ("Affordable Care Act (ACA) - HealthCare.gov Glossary", 2018). It also includes the expansion of Medicaid, which has not been by all states following the Supreme Court ruling.
• Consumer protection is another key feature of the Act ("Key Features of the Affordable Healthcare Act Law - MACMH", 2018). The Act protects individuals with a pre-existing condition through the Pre-Existing Condition Insurance Plan established by the Department of Health and Human Services ("Affordable Care Act (ACA) - HealthCare.gov Glossary", 2018). This plan was meant to provide a bridge to 2014 when prohibition of discrimination against pre-existing conditions by insurance companies was to be formalized. The Act also required all new insurance plans to essential health benefits and preventive services which will be covered without out-of-pocket costs.
Timelines for the Proposed Changes
The timelines for the implementation of the Affordable Care Act are discussed below. Some changes were supposed to take place within a period of 180 days since enactment, while others were to take place in 2011 through to 2014.
• 23rd September 2010. The coverage gap in Medicare Part D was supposed to be closed, and seniors were entitled to receive a $250 rebate to close the close the coverage gap ("History of the Affordable Care Act (ACA)", 2018). A government website was also supposed to be set up to provide consumers with information regarding health insurance ("History of the Affordable Care Act (ACA)", 2018). Insurance companies were also prohibited from excluding children from coverage over grounds of pre-existing conditions ("History of the Affordable Care Act (ACA)", 2018).
• By 2011, the law required insurance companies to allow their plan members to visit any doctor of their choice, allow parents to cover their dependents under their plan up to the age of 26 and cover all preventive care costs ("History of the Affordable Care Act (ACA)", 2018). Insurance companies were also prohibited from placing a lifetime limit on their coverage while prohibiting rescission on claims ("History of the Affordable Care Act (ACA)", 2018). Insurance companies were also required to set up an appeal process for any aggrieved member of their plan ("History of the Affordable Care Act (ACA)", 2018).
• 1st October 2013. Health insurance exchanges were opened for enrollment in 2014 ("History of the Affordable Care Act (ACA)", 2018). Writing of policies scheduled to take effect in January 2014 was to commence.
• January 2014. Subsidies for individuals buying insurance on their own was to begin to help them pay for their monthly premiums ("History of the Affordable Care Act (ACA)", 2018).
• January 2014. Tax credits for small businesses were supposed to be at 50% following operational insurance exchanges ("History of the Affordable Care Act (ACA)", 2018).
• January 2014. Discrimination against pre-existing conditions was prohibited beginning ("History of the Affordable Care Act (ACA)", 2018).
• January 2014. Private insurance companies were therefore prohibited from failure to provide coverage for any adult between the ages of 19 and 64 that have applied for coverage ("History of the Affordable Care Act (ACA)", 2018). It also marked the expiry of High-Risk Insurance Pools.
• January 2014. All Americans were required to buy health insurance or pay a fine to prevent people from buying insurance when they get sick ("History of the Affordable Care Act (ACA)", 2018). The penalty was to begin at $95 and increase each year until 2016 when it was to be replaced to either $695 or 2.5% of a person’s income, whichever is higher ("History of the Affordable Care Act (ACA)", 2018).
Effects of the Changes on the Employees
The Act had the following impact on the employees:
• Reduced the cost of healthcare by making certain services to be fees such as contraceptives and preventive screenings such as mammograms and colonoscopies.
• It allowed workers with pre-existing conditions to enjoy coverage from insurance companies.
• Employees are not allowed to purchase bare-bones policies, i.e., policies that have high deductibles, but few benefits and they say that the ObamaCare premiums are unaffordable.
• The employees can purchase insurance on their own if they are unhappy with the employer-provided insurance cover.
Effects of the Act on Employers
The Act has had the following impacts on the employers:
• Workers no longer have the ability to place a lifetime limit on the benefits enjoyed y their employees on their health insurance coverage plan.
• Due to an increase in the price of premiums, some employers have stopped offering health insurance for their workers.
• The law also requires employers with at least 50 employees to provide affordable insurance to their staff who work for more than 30 hours a week. This increases the employer costs.
References
Affordable Care Act (ACA) - HealthCare.gov Glossary. (2018). Retrieved from https://www.healthcare.gov/glossary/affordable-care-act/
A short history of the Affordable Care Act – Obamacare drama. (2018). Retrieved from http://affordablehealthca.com/history-affordable-care-act/
History of the Affordable Care Act (ACA). (2018). Retrieved from https://resources.ehealthinsurance.com/affordable-care-act/history-timeline-affordable-care-act-aca
Key Features of the Affordable Healthcare Act Law - MACMH. (2018). Retrieved from http://www.macmh.org/2012/08/key-features-of-the-affordable-healthcare-act-law/
