Improving the Affordable Care Act

Insuring the Uninsured

The author of this report has been charged with offering solutions for the millions of Americans that are uninsured or under-insured. Some people that are under-insured or uninsured are in that situation through little to no fault of their own. However, others are able to afford insurance but simply choose not to enroll in coverage. However, everyone should be insured because accidents and illnesses do happen to everyone at some point and the cost needs to be spread evenly among everyone. Certainly, the expense should be subsidized or fully covered for those that cannot afford coverage but the need to cover everyone still remains. While some of the opinions in this report are not going to be popular with some people, the author of this report sticks by them without question.

Analysis

One major provision of the Patient Protection and Affordable Care Act (PPACA) was that people who can enroll in health coverage but do not do so are subject to a penalty in terms of taxes and fees. Per the Healthcare.gov website, the penalty is the higher amount between two percent of annual household income and a flat fee of $325 per person per year (or $162.50 for children under 18). For those that can afford to be covered but do not get covered, that penalty is not nearly strong enough. Given that a quick visit to the emergency room can cost thousands of dollars, the penalty needs to "hurt" a lot more than that. The author of this report would make sure that the penalty imposed is the cost of basic coverage under an applicable plan (Healthcare.gov, 2015).

Another major issue that needs to be address is also one that is one of the major reasons that costs are so high and why so many healthcare bills go unpaid. There are millions of undocumented immigrants in this country. Some of them cross illegally while others simply do not leave when their visa expires. Either way, it is not uncommon for care received by these individuals to go unpaid for. Given that their mere presence in the United States is a crime, then that is something that obviously needs to be fixed. Obviously, deporting twelve million illegal immigrants is not logistically possible. However, the legal status of those people needs to be clarified, the borders need to be secured and any person that is a financial or criminal scofflaw in the United States and is not a citizen should be deported for contributing to the mess that is the current healthcare system. Using civil/criminal actions against those folks does little good so simply expelling them and keeping the borders locked tight should suffice (Somashekhar, 2015).

Finally, there should be a progression from the current normal state of affairs of getting health coverage. Indeed, most people get health coverage through their private or public employer or because they are a spouse or dependent of someone that gets the same. The healthcare exchanges that exist with the PPACA are a good start but it should become the norm and not the exception. Obviously, there should not be a detachment between the cost and the value, but being anchored to an employer for insurance reasons only creates headaches in a lot of cases. More competition through multiple (and well-regulated) exchanges should make healthcare more accessible, more convenient and the prices should probably drop if overall coverage of people rises. However, depending on how it happens, it could hurt employees (Tracer, 2015).