The Patient Protection and Affordable Care Act (ACA) is one of the significant health care laws in the history of the United States. The Act has elicited heated debates with proponents and opponents endeavoring to prove or disprove its usefulness in the contemporary evolving health care arena. However, this paper explores two fundamental issues that the law addresses.
One of the issues that the ACA sought to address is providing health coverage for the millions of uninsured Americans by expanding Medicaid. Before the Act, it was estimated that almost 15% of adults in the American population were uninsured (Adepoju, Preston, & Gonzales, 2015). Historically, this program catered for children from low-income backgrounds, elderly people, expectant mothers, and disabled individuals. However, it excluded adults from poor backgrounds (Bauchner, 2016). The ACA fills the coverage gap and now the majority of Americans can enjoy health insurance through Medicaid, employer coverage, or private plans. The cost of insurance plans and health care has been increasing annually and the burden was becoming unbearable for most individuals.
Given the financial crisis of 2008 that left many people jobless, there was a growing need for the federal government to come up with a strategy for ensuring a healthy nation. However, the 2012 Supreme Court ruling meant that states could choose whether to expand Medicaid or not (Glied & Jackson, 2017). Therefore, the Act has only achieved the objective of insuring the uncovered in states that have adopted Medicaid expansion. Therefore, in states where this expansion has not taken place, the majority of adults from low-income backgrounds are not insured (Nix, 2015). Unfortunately, such individuals are in the age bracket where health complications start to develop and given that they cannot access quality care, it means that the nation will have a sizeable proportion of unhealthy citizens. Therefore, it suffices to conclude that the act is efficient in solving the problem of the uninsured in states that have Medicaid expansion programs. On the other hand, the law is ineffective in states that have not embraced the necessary programs.
The ACA also sought to reform the private insurance market. Initially, companies in this market segment would not cover pre-existing conditions (Silvers, 2013). Alternatively, the companies would review premiums based on one’s health condition. However, the ACA requires insurance firms to offer coverage to all individuals regardless of one’s health status (Manchikanti, Helm, Benyamin, & Hirsch, 2017). This assertion means that people who could not get health coverage due to pre-existing conditions or other variables like age can now enjoy such services under the Act. However, this requirement has created the problem of rising insurance premiums. Nevertheless, this issue is being addressed through subsidies under Medicaid. Therefore, one can conclude that the ACA is effective in addressing the problem of discrimination based on different variables like age and health status when an individual is seeking insurance coverage.
The ACA sought to expand health covers to the uninsured and eliminate the discrimination that people face when signing up for private insurance coverage among other issues. The law has addressed these objectives efficiently. The number of uninsured adult Americans has dropped by almost 50 per cent since 2014 when the Act started being implemented which is an outstanding achievement (Manchikanti et al., 2017). However, the law has failed in states that are yet to adopt Medicaid expansion. On the other hand, ailing individuals can get insurance coverage and access quality health care services.
Adepoju, E., Preston, M., & Gonzales, G. (2015). Health care disparities in the post–Affordable Care Act era. American Journal of Public Health, 105(5), 665–667.
Bauchner, H. (2016). The Affordable Care Act and the future of US health care. The Journal of the American Medical Association, 316(5), 492 – 493.
Glied, S., & Jackson, A. (2017). The future of the Affordable Care Act and insurance Coverage. American Journal of Public Health, 107(4), 538–540.
Manchikanti, L., Helm, S., Benyamin, R., & Hirsch, J. (2017). A critical analysis of Obamacare: Affordable Care or insurance for many and coverage for few? Pain Physician, 20(3), 111-138.
Nix, M. (2015). Reforming health care through Medicaid expansion: An update. The American Journal of Nursing, 115(5), 14-15.
Silvers, J. B. (2013). The Affordable Care Act: Objectives and likely results in an imperfect world. Annals of Family Medicine, 11(5), 402- 405.