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A1 Obamacare; The Affordable Care Act

A2 Introduction

        The Patient Protection and Affordable Care Act, much more commonly called "Obamacare," was designed to provide insurance to a large number of Americans who would otherwise be uninsured, but it has been fraught with problems since its creation. There was much resistance to it in the beginning, and not all of that resistance came from the Republican side of the aisle. Even some democrats were opposed to it. The same is basically true whether one is talking about Congress and the government, or whether one is talking about the general population – there is opposition to the law. That was the first hurdle that had to be gotten past. Once that was conquered, the work of creating the website to help people sign up and the information about what would be done regarding those who refused to sign up had to be addressed. There were many complaints when it was discovered  that there would be a penalty for those who did not sign up for insurance. It was argued that the government could not force people to buy insurance, but the penalty was ruled a "tax." Because it was classified that way, the government could legally collect it.

        For people who were happy about the law, there was a realization that they would soon be able to have health insurance, could not be rejected for pre-existing conditions, and would not have to struggle with medical bills if something catastrophic should happen. That was very important to them – but only if they could afford to have the insurance. Like many of the other insurance plans that came before Obamacare, such as Medicaid, there were gaps where people basically made too much to get affordable coverage but did not make enough to afford coverage of their own. That was a serious issue for those groups, and something that has still not completely been corrected. A3 However, Obamacare has vastly improved the opportunities for health care for many people in the US, despite its problems.

Creation of the Law

        The Law was signed into effect by President Obama in March of 2010, and was designed to take effect January 1st of 2014 (Barr, 27) A4 . It was a hard-fought battle to get Obamacare into US law, because of the strong resistance of most Republicans and a significant number of Democrats (Barr, 35). In the end, however, the law prevailed and Obama was able to sign the bill creating what many of his supporters believed was his greatest achievement as president. The law was a long time in coming, because presidents before Obama had also tried to create sweeping changes to health care A5 (Barr, 2011). Naturally, they were not successful. There are many speculative reasons for why Obama was successful where past presidents were not. However, it appears that the American people were simply ready for a change and felt that a move toward a more socialized system of medicine that would allow everyone to have health care coverage would be the best choice.

    There have been challenges to the law since its creation (Feldman, 241). In addition to challenging the requirement that people either buy insurance or pay a penalty, the entire law itself has been challenged as unconstitutional (Feldman, 244). That challenge was lost in court, but that does not mean that everyone in the country agrees that the ruling was the right one. There are still many people opposed to the law and its creation, and many who hope a new president during the next election cycle will mean a repeal of the law. Myths also surrounded the law and caused concern for citizens who believed them. For example, it was rumored that older people who were sickly would be denied life-saving treatment through so-called "death panels," and that people who did not buy insurance would be put in jail (CCH, 55). Those fears have generally been put to rest, although there are some people who still believe those things are accurate.

A6 More People Insured

        One of the points on which there really can be no argument is that more people will be insured under Obamacare. People who were previously not able to afford coverage will be able to get subsidies to make it easier for them to purchase a policy for a price they can handle (Barr, 135). Additionally, the Medicaid guidelines will be expanded, so more low-income people will qualify (Barr, 135). Medicaid is similar to Medicare in that it is a government-operated system of health care that is designed to help a specific group of people. While Medicare is for the elderly, Medicaid is for those who are low income and cannot afford any type of medical care for themselves or their families (CCH, 45). With the expansion of Medicaid in Obamacare, more people who fell through the cracks and did not qualify, but who also did not make enough money to have their own insurance, will be able to get Medicaid insurance that they will not have to pay for (CCH, 51).
That is very important for low income people who may not be able to pay any insurance premiums and who may also not even be able to pay the penalty if they do not purchase insurance (Barr, 57). It will protect them and their families in the event of a catastrophic medical issue, and will also help them get care at their doctors' offices more frequently. It is believed that will stop people from using the emergency room as their sole method of health care, which could help to lower ER wait times and cut the cost of medical care for everyone (Barr, 62). It remains to be seen if this will actually take place, however, because what will actually happen cannot be determined until the law takes effect and has been in place for some time. It is likely that adjustments to the law will need to be made over time, even though the basic premise of what is being offered to the American people seems to be sound. Studying the true effects of Obamacare will be necessary.

The Penalties for Non-Compliance

        Non-compliance with Obamacare is an issue. Some people have openly said that they will refuse to pay for any government mandated health insurance, on principle. Others have said that they simply cannot afford the policies that are offered to them and will not be able to get insurance even if they wanted to (Barr, 74). It appears for some people, there is still a gap between who qualified for Medicaid and who is able to afford insurance on their own. For people who do not purchase insurance for any reason, there will be penalties that have to be paid (Barr, 75). These will come in the form of taxes, which is how they had to be worded in the law in order to be ruled legal for the government to require citizens to pay them (Barr, 75). The penalties will be added onto the tax paid to the IRS at the end of each tax year if the person filing the return did not sign up for Obamacare insurance (CCH, 254). The cost of penalties still may be more than some people can afford to pay, though, which could put them in tax trouble with the IRS.

     That is a serious concern for people who do not have much money, and it is understandable that they would be concerned. However, there are many options for people who are low income to get coverage through Medicaid or qualify for subsidies so they can get insurance and not have to pay a penalty (Feldman, 63). That is very important, because it eases the minds of people who were worried that they might not be able to pay for insurance or pay the penalty, and that they could end up in serious financial trouble with the IRS. Once a person runs afoul of the IRS, it can be difficult for that person to straighten out his or her financial life, so that is best avoided. There are still many worries about Obamacare, and the penalty is one of the more significant ones. However, the penalty is a low percentage of income and would be easily paid by most people who choose not to purchase insurance (Barr, 88).

The Website Glitches

        Another big concern for Obamacare is the difficulty with signing up. While the majority of the state-run exchange websites worked well, the main site – healthcare.gov – experienced serious glitches and issues from the day it went live. There are still problems with the website, although it has improved. People struggled to sign up. Many got partway through the process, only to have the site glitch and stop them from completing the process A7 (Dwyer). Others found that they were not able to even get started because the site was simply down and would not allow them to begin the process of getting insurance (Dwyer). Blame was placed throughout Washington, but in the end it was not about who was at fault. It was about getting the issue fixed so that people could go ahead and sign up for the insurance they wanted. Since the problems started, a great deal of work has been done to the site. The site's capacity has been doubled, and that will allow it to support its intended usage numbers, which is up to 50,000 people logged on at one time, and up to 800,000 people per day (Dwyer).

        In October, the Obamacare website was down nearly 60 percent of the time, frustrating the Administration and the people who were attempting to sign up (Dwyer). There were software bugs by the hundreds, and the hardware used to operate the site was not sufficient for what was attempting to be done with it. More than 400 fixes have been completed, with 300 of those taking place in the last three weeks of November (Dwyer). It is now believed that 80 percent of the people who want to sign up online will be able to do so without problems, but there are still issues with the site that have not been corrected (Dwyer). It is down five percent of the time even after the fixes, but this is a vast improvement over where it was a few weeks ago (Dwyer). It was clearly not designed to handle the level of people who tried to sign up when it originally went live.

Conclusion

        It is easy to see that there are good and bad points to Obamacare, when it comes to the insurance itself and also when it comes to the execution of the law through the website and other means. People who choose to sign up for insurance will be able to be covered in the event of a medical need. For many of those people, it will be the first time in their lives that they have had health insurance. That will allow them access to better medical care, and can also provide significant peace of mind, especially if they have a pre-existing condition and/or they have a family to support. Of course, there are still people who may fall through the cracks and who cannot qualify for Medicaid but cannot afford their own insurance. Obamacare is not perfect, and more will need to be done as the health care law is put into practice and problems with particular areas of it are discovered. Changes and adjustments will likely be ongoing once the insurance actually takes effect.

        Additionally, changes and adjustments will be ongoing on the technological side of the issue. The website is still clearly not up to the standards it should be, and it is leaving people frustrated and upset. However, the site is much better than it was even a few weeks ago, and changes continue to be made in order to ensure more people are able to sign up for the insurance they need. Overall, Obamacare is a good idea. People need insurance, and they need access to medical care. Not having a lot of money should not be a reason that people have to die or a reason they are turned away for care that could provide them with a much better quality of life. For many low income Americans, poverty is not something they chose. They cannot help their plight, but they still deserve medical treatment. A8 Obamacare may not be perfect, but it will allow people of all income levels to know that they can go to the doctor or the hospital when needed, and they will be treated and not bankrupted in the process.

A9 Works Cited

Barr, Donald A. Introduction to U.S. Health Policy: The Organization, Financing, and Delivery of Health Care in America. JHU Press. 2011. Print.

CCH. Law, Explanation and Analysis of the Patient Protection and Affordable Care Act: Including Reconciliation Act Impact. CCH Incorporated. 2010. Print.

Dwyer, Dennis. White House Declares Obamacare Website Fixed, but Problems Persist. ABC News. 2013. Web. B1

Feldman, Arthur M. Understanding Health Care Reform: Bridging the Gap Between Myth and Reality. CRC Press. 2011. Print.


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