The affordable health care act, commonly referred to as Obamacare, brought a set of health care reforms aimed at making health consumers to be responsible for their health care. The act brought into law the patient's bill of rights, which gives Americans stability and flexibility in making informed health choices and decisions. Enacted by President Obama in 2010 as the Affordable Care Act, it aims in ensuring the insurance reforms in the country are comprehensive. This is achieved through providing discounts for seniors, protecting consumers against health care fraud, providing free preventive care, ensuring small businesses get tax credits, providing cover for pre-existing conditions, providing consumer assistance, and health insurance in the marketplace
The affordable care act also has other benefits for special groups such as women and youth. Women benefit from enjoying insurance options that provide them with preventive services thus lowering their cost of health care. Young adults benefit from being covered by the insurance scheme until they reach the age of 26 years. Overall, Obamacare or the affordable care act is aimed at holding insurance providers accountable because they are required to justify any increase in their premium that exceed
The third aspect is media coverage. The author states that media coverage is important in affecting the ability of states to learn and adapt towards Medicaid expansion. The author states that if journalists adopt a broader view and look at both what is working and what is not working, they can help the public make informed decisions about the ACA as well as implementation of improvement efforts in the future. The importance of this is because it will portray the real picture of Obamacare implementation to the public
Research questions and hypotheses
The Affordable Care Act has been in the spotlight with experts from different backgrounds, economics, insurance, business, and hospitals, discussing its impact. Different views have been presented regarding the effect of the ACA to the economy, African-American communities and African-American students. These are the focus of this paper. The research questions formed for this study are based on these three aspects:
1. What is the impact of the ACA on the U.S. economy?
2. What is the impact of the ACA to the African-American Community?
3. What is the impact of the ACA to African-American Students of the AHCA?
Several hypotheses have been formed that fit these three questions. First is that the Affordable Care Act will stimulate economic growth by reducing health inequalities that exist in the American population. The number of persons who are unable to access health care will reduce significantly since the act is aimed at reducing inefficiencies in insurance schemes and make them inclusive for all. This will increase the number of people present for the workforce and improve their contribution to the country's economic well-being. Additionally, out of pocket health care spending will reduce leading to increase in disposable income for families.
The second hypothesis is that the Affordable Care Act improves the lives of African-Americans because it allows them to access similar health services as the majority white population. Often, the African-American communities have been left out of health sector reforms, which focused majorly on the majority white group. The Affordable Care Act allows them to enjoy the same benefits as the majority group thus improving their quality of life considerably.
The last hypothesis is that the Affordable Care Act will bring positive changes to African-American students. As stated by Debra et al. (2011)
The affordable care act which was later amended by the Health and Education Reconciliation Act of 2010 is expected to be fully implemented by January 2014. At this point, individuals and employers are expected to fulfill their responsibilities as provided in the act with state health insurance exchanges going into operation, expansions to Medicaid taking effect and subsidies to individuals and small employers beginning to flow. Though the process seems easy, there are a series of events that must take place in succession to lead to the successful implementation of the act
As described by Rosenbaum S (2011)
The guide the analysis of the effects of the affordable care act, it is best to outline the background of the U.S. health care system and the key features and aims of the act in order to provide a basis for the analysis.
Background of the U.S. health care system
Health care expenditure in the United States constitutes roughly 17% of the country's gross domestic product (GDP)
. Expenditure on health care in the U.S. is higher than most countries in the world and with continued population growth, it is expected that by the 22nd century, spending on health care will be about 50% of the GDP. The high expenditure on health care does not reflect the fairness in the health care affordability and coverage in the country. A good example is seen in the infant mortality rate which stands at about half a percent for the majority white population and over 1.3 per cent for the African-American population
. Other disparities exist in the U.S. health care system and can be attributed to the lack of universal access in the country despite it being ranked as a developed country with one of the largest economies in the world
The elderly population also faces challenges in accessing health care since apart from the few covered by Medicare, majority do not have health insurance since employers are the primary providers of insurance in the U.S. Employer-sponsored insurance or ESI as they are commonly referred to only cover the majority of Americans who have not retired. They do not cover former employees after they retire. This is because the American system provides employers with tax breaks and subsidies for providing health insurance and they also receive lower costs of insurance by pooling risk in the workplace environment.
Christine et al. (2011) present this in detail and provides that the federal government foregoes about 250 billion U.S. dollars each year when they exclude compensation in the form of health insurance from taxation of payroll and gross income
. Employers are not encouraged to provide retired employees with health coverage because insurance for employees is purchased with pre-tax dollars because they are in the employment environment while that of retired or former employees is provided with post-tax dollars. Therefore, employers are greatly incentivized to provide insurance in the employment setting than for older employees
Further to this, the country only has two major sources of insurance coverage that is publicly provided and funded. These are Medicare and Medicaid. Medicare is a universal insurance provider for the elderly in the United States while Medicaid focuses on the poor and low income families. Therefore the majority of the uninsured in the country are the working poor which as Rosenbaum (2011) describes are those whose age and income makes them ineligible for public health insurance coverage and at the same time do not receive health insurance coverage from their employers
This presents the case for the non-group insurance market, which is a major focus for the Affordable Care Act. Majority of state insurance providers often discriminate individuals with pre-existing conditions. This is majorly because they are often a sure event in terms of having to spend on illnesses that the individuals already had at the time when they were insured
. Therefore, though they provide non-group insurance, they have clauses that limit inclusion of persons with pre-existing conditions thus reducing the number of persons covered by their schemes considerably. In market sense, they do not provide real health insurance protection because they have specific clauses that limit inclusion into the schemes
. Therefore, those persons unable to get access to employer insurance coverage schemes and public health insurance schemes face challenges in joining public or state health insurance schemes due to these limitations.
Outline of the Affordable Care Act
The Affordable Care Act provides a series of premium and cost-sharing subsidies for the health care system and establishes new rules for health insurance providers and create a new market for purchasing of health insurance
In the act, Medicaid will be expanded to include all citizens and legal residents in the U.S. whose family income is less than 133 per cent of the federal poverty level. As described by Rosenbaum (2011)
, the federal poverty level is described as a measure of modified adjusted gross income. This is expected to streamline Medicare enrolment even though the five-year waiting period for United States legal residents will continue to apply to those who have recently arrived into the country.
According to provisions in the act, the almost universal coverage will be the duty of individuals, employers, and insurers. Individuals have a duty to safeguard their right to universal coverage. All taxpayers in the U.S. have this duty and only those who are not legally present in the country are exempted from both the guarantee of universal coverage and their obligation to secure insurance…