The Affordable Healthcare Act (ACA) revolutionized the health care industry in the United States. The Act, known as Obamacare, is the most comprehensive reform in the healthcare industry since the enactment of Medicaid in the 1960s. The Act experienced several hurdles in the form of court cases with several contradicting rulings until the case reached the supreme court of the United States in 2012. The lawsuits raised concerns about the constitutionality of the Act, and that formed the main question that the supreme court was to rule. The Supreme Court had to give a ruling on whether every American needed to have a form of health insurance cover failure to which the Internal Revenue Authority would impose a tax penalty for non-compliance (Emanuel, 2014) . Besides mandatory insurance, the court was to rule on the legality of the provision of federal funding to states to increase eligibility to 133 percent of the existing poverty levels.
The Act provided that a state that would not expand eligibility would stand to lose federal funding on Medicaid. The Supreme court's decision was delivered in June 2012 and ruled that ACA was constitutional since it was passed by the Congress, who exercised their legitimate power to tax. The Supreme court ruled the second application as unconstitutional, arguing that the states could not be coerced into expanding its requirements for Medicaid, and it cannot lose federal funding based on decisions made on growing or not expanding Medicaid offerings.
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I agree with the court's decision on making healthcare insurance mandatory insurance for all Americans based on that healthcare is needed at some point in the life of every individual. The court's decision paved the way for affordable health care since the insurance companies had to provide products for the various income levels in the population in sharp contrast from the past when health insurance would be afforded by few who would afford the expensive premiums.
The Supreme Court's ruling was a landmark ruling paving the way for improved access to healthcare for more Americans. However, some aspects of the verdict I do not fully agree with is the tax imposed for failure to purchase some form of health insurance. It makes me question the original intention of the House of Representatives when they drafted the Act. If a tax is mandatory, the effects of non-compliance are not another tax but a penalty. Also, if the penalty for not having healthcare insurance is lower than the cheapest product in the market, then some individuals would be better of paying the penalty instead of the insurance (Emanuel, 2014) . That would negate the milestones and progress the ACA meant to accomplish.
I support the decision of the court to declare the section of the Medicaid expansion unconstitutional since it amounted to imposing conditions on states for receiving funding from the federal government. Politicians could misuse this clause in the future. The decision to expand or not expand a State's Medicaid should be entirely on the state's discretion, and there should have been no price to pay for failing to comply. For that reason, I applaud the court for its decision.
A vital benefit of the ACA is the increased access to healthcare insurance by millions of Americans who were locked out of healthcare insurance due to cost. Within the first five years, more than sixteen million Americans, mostly youth, had health care insurance. The Act opened the door for Americans with preexisting conditions to access healthcare insurance since the Act provided that no one could be denied access to insurance due to a preexisting condition (Emanuel, 2014) . Other ground-shaking impacts include improving access to quality and affordable healthcare for screening and preventative health services with minimal deductibles or co-pay. Also, prescription drugs cost is reasonable, and the list of the medications covered by ACA is growing, which is a great incentive to the aged segment of the American population.
References
Emanuel, E., 2014. Reinventing American Health Care . 1st ed. New York: PublicAfairs™,
pp. Chapter 7, Pages 188 - 202.
