The Affordable Care Act is a health care reform being proposed into law in America. It consists of the Affordable Health Care for America Act, the Patient Protection Act, and also some sections of the Health Care and Education Reconciliation Act and the Student Aid and Fiscal Responsibility Act (The Washington Post, 2010). Other factors that have been featured here include amendments to other acts such as the Food, Drug and Cosmetics Act.
Provisions of the Affordable Care Act
With the Affordable Care Act, the health insurers lose the power to deny individuals insurance coverage basing on their previous or present health status (The Washington Post, 2010). Thus, individuals who were previously not eligible will be able to obtain their insurance. The Act also ensures that health related policies can meet certain minimum coverage standards as stipulated in the Essential Health Benefits (EHB). Additionally, a child can remain under its parents coverage up until they attain the age of 26 (The Washington Post, 2010). Once this policy is passed and accepted, each individual will be expected to purchase a health insurance plan or pay a penalty for not complying with this rule. Only those who are exempted will be free from this penalty (The Washington Post, 2010).
The provision of health insurance exchanges is also present in the sense that insurance must not only be obtained from an employer or government, it can also be purchased through the applicants state exchange, the federal exchange, or even through what is commonly referred to as Other (The Washington Post, 2010). This act promises maximum eligibility as it fills gaps which have existed especially for the poor Americans. It plans to do so by providing minimum Medicaid income eligibility level for all citizens. Once accepted, this act will ensure coverage for all newly eligible adults as the financing will be catered for by the federal governments for their first three years (The Washington Post, 2010).
The information technology systems and data will be used to ensure that Medicaid systems will be in place prior to the launch, once it has been accepted into law. It will also ensure an effective expansion of the eligibility of this Act. Lastly, there will be payment reforms, as the Affordable Care Act will be paid in bundles. The Medicare payment system features a fee-for-service approach which is expensive for applicants (The Washington Post, 2010).
For over 70 years, democratic presidents have been trying unsuccessfully to create an insurance system that will be applicable nationwide despite the social and financial status of an individual. For this reason, the idea used in the Affordable Care Act is not an entirely new concept. Its formation was not entirely smooth, some individuals were for the change while others were not.
In July 2009, the Speaker of the House and a group of other Democrats expressed their plan to overhaul the health-care system (The Washington Post, 2010). The following months was faced by mixed reactions from citizens, as some embraced the expected changes while others became frightened. In November 2009, the House approved its healthcare reform version. In December 2009, the senate also approved its overhaul version. In January 2010, Obama reassured the public that the health overhaul will indeed protect all Americans from the discriminative practices of the insurance industry (The Washington Post, 2010). Sen. Scott Brown who was a republican, won the special election to see through the remaining terms of the deceased U.S Sen. Ted Kennedy. Unfortunately, he puts all efforts in putting an end to the Affordable Care Act (The Washington Post, 2010).
In February 2010, the members of the Anthem Blue Cross of California are informed of the increased premium rates. This move ends up galvanizing democrats on the health care issue. All this time, the act is developing and changing in terms of the people to be covered and the conditions of the coverage.
Critical Analysis of the Political and Policy Context
There are several factors which will lead to the success of the Affordable Care Act. First, it is clear that commitment to this act will make all the difference. Obama made a decision to pursue this action and did not give up even when his plan was in jeopardy in 2010 (The Washington Post, 2010). Further, when many democrats were giving up, Nancy Pelosi showed determination to finish legislation. Also, Harry Reid was so committed towards ensuring that he mobilized the sixty members who play an important role in passing legislation.
Second, this act is not the first of many. This is an advantage as there is the opportunity of learning from previous mistakes. There is the option of comparing the previous reforms and trying to identify where they went wrong before ensuring that a similar mistake is not repeated.
Third, the government only proposed increased taxes for wealthier Americans (The Washington Post, 2010). These are the same people who are comfortable with their present insurance coverage. Thus, the government is not affecting the group of democrats who are looking forward to enjoying the new Act.
The Affordable Care Act may not be successfully passed into law due to a number of barriers. First, there is the issue of Partisan pressures. The congressional environment has always been challenging. It is difficult to secure the support of the majority when all groups have their own beliefs (The Washington Post, 2010). For instance, not all democrats can support the health reforms that are to be introduced by this act. A good example is the anti-abortion democrat who would find it difficult to support an act that will legalize this procedure instead of abolish it.
Second, there is the issue of deficits and distrust. Reformers are constantly facing a federal budget deficit which never seems to get fixed. This is majorly attributed to the negative turn of the economy which occurred as a result of the Great Depression and the bailouts that followed shortly after (The Washington Post, 2010). Additionally, the fact that majority of the American citizens already have little faith in their government will make it difficult to get them to support the Act. The already insured Americans are comfortable and happy with their present coverage, thus it will be difficult to get them to change their mind and support the Affordable Care Act.
Health care professionals and insurance companies are the key stakeholders for this Act. Both stakeholders support the new law as it will bring benefits to their course. Health care professionals see this as an opportunity of ensuring that all individuals get an equal access to health care. Insurance companies, on the other hand, view this as security just in case they run out of business with private companies and employers.
Considering the analysis above, it is clear that the Act should be passed. It is clear that its provisions are meant to bring about change to how health care is provided. It offers protection to all applicants as it renders the health insurers powerless when it comes to determining eligibility of applicants (The Washington Post, 2010). It also offers extra years of coverage for children, especially since not all get employed immediately they turn 18 years of age. Majority will still need their parents to step in and help with crucial bills such as their health care expenses.
Passing this Act into law will benefit majority of Americans, including those who are exceedingly poor and unable to get employed. Through this Act, coverage can also be purchased through the applicants state exchange, the federal exchange, or even through other means (The Washington Post, 2010). Offering coverage alone is not enough as the poor will not be able to pay for it. This is why the Act should be passed to ensure that many enjoy the free first three years, which will be catered for by the federal government. The changes introduced in this Act should also be considered as they try to bring more benefits to the applicant, such as making payments in bundles.
Rich people will finally be equal to the poor in terms of their financial status when it comes to health care. This is why the Act should be passed. It ensures that people from all social classes have equal access to affordable health care.
The Washington Post (2010). Landmark: The inside story of Americans new health-care law-The Affordable Care Act-and what it means for us all. New York: PublicAffairs. ISBN-13: 978-1586489342 ISBN-10: 1586489348
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