It is a Presidential “first” that has begun, and will continue, to change the course of our nation for generations to come. It is critical, and beneficial to the entire United States’ population, to fully comprehend such an important piece of historical legislation; especially since this fairly new law affects every citizen and legal resident living in the United States regarding their personal health future.
However, understanding the Patient Protection and Affordable Care Act in its entirety is very trying; as the law is nearly 1,000 pages long, extensive amounts of time, thought and money have been put into developing this reform, and research of the long-term effects this law will generate will not be available until the unforeseeable future, understanding the law is difficult. In beginning to explain the Patient Protection and Affordable Care Act, the following text will first answer the question of why such legislation was developed and implemented.
Next, the text will briefly summarize the most important facts of this infantile law. This will include a description explaining the Patient Protection and Affordable Care Act in regards to the history and development of the reform, and the public reaction emphasizing contrasting political parties. After that, the Pros and Cons of implementing the Patient Protection and Affordable Care Act will be weighed in a bipartisan fashion based on historical research, future speculation and opinion from experts on the subject matter.
Finally, the text will conclude with the author’s personal opinion on the Patient Protection and Affordable Care Act. Reasons Behind Developing The Patient Protection and Affordable Care Act Before explaining what the Patient Protection and Affordable Care Act entails, the question of “why such a reform is necessary for the United States at all” needs to be answered. Historically, the public realization of a need for some type of national health insurance began nearly a century before the current law had been developed (Davidson 185).
Many Presidential Administrations throughout the 20th Century had suggested ideas of health reform; however, none of these reforms prevailed. This indicates that adjustments to health care on a national level were inevitable. Why make those adjustments now? There are many reasons as to why this health reform initiative was heavily, and successfully, pushed into law. The Institute of Medicine issued a report in 2002 suggesting six strategies on how to improve the current public health system (Majette 367).
Among these suggestions, the Institute of Medicine called on the federal government to develop a system of accountability assuring the quality and availability of public health service and strengthen the governmental public health infrastructure. Eight years later, the Institute of Medicine has suggested focusing on preventing disease and promoting health to improve the current health system. Since then, congress has been pushing health reform harder than ever to stay consistent in improving public health.
In addition to improving public health, the federal government became aware of the health/financial crisis of average United States citizens. According to a poll done in April 2009 by the Kaiser Family Foundation, 59 percent of the families taking the poll indicated that they put off preventative or necessary medical care; this is because of costs of private medical insurance and the actual medical care. Instead, these families try home remedies, postpone seeking health care until it is vital, skip filling or taking prescription drugs, or simply skip medical or dental checkups (The Henry J.
Kaiser Family Foundation Public Opinion). This is a problem that decreases an individual’s quality of life and threatens public health when there are sick people spreading diseases instead of getting well. Un-coincidentally, it is not just families struggling with health care spending; the cost of private insurance makes it very hard for businesses to provide insurance to their employees (Health Reform in the 21st Century: Expanding Coverage, Improving Quality and Controlling Costs 2). The Committee on Ways and Means reported in a March 2009 hearing that the current Healthcare spending is expected to consume 17. percent Gross Domestic Product in 2009 and is projected to rise to 20. 3 percent by 2018. Even though the U. S. spends a significant amount of money on Healthcare, the U. S. is not even close to being the global leader in health insurance coverage or medical quality. With inadequate or no coverage, citizens and legal residents of the United States have a lower life expectancy than all other equivalently developed nations. The same Committee reported in a June 2009 hearing, half of all bankruptcies in the U. S. re caused by medical debt (Health Reform in the 21st Century: Proposals to Reform the Health System 2). According to President Barack Obama, reforming Healthcare has become a moral and fiscal imperative (Health Care Reform in the 21st Century: A Conversation with Health and Human Services Secretary Kathleen Sebelius 2). Congressional committees stressed to the House of Representatives the need for comprehensive health reform that builds on the United States’ current policies that work while fixing the policies that do not work (Health Reform in the 21st Century: Proposals to Reform the Health System).
So, a century-long effort to reform the national health system, a push by the Institute of Medicine for improving public health, and a health/financial crisis of the United States population who are unable to obtain quality, affordable healthcare has ultimately led the Federal Government to develop and implement the Patient Protection and Affordable Care Act. Description/Development of The Patient Protection and Affordable Care Act/Public Reaction As previously stated, many Presidential Administrations have suggested national health reform policies throughout the past century.
The first big health reform movement started with the Progress Party, Theodore Roosevelt was the presidential candidate, in 1912 (Davidson 185). In the beginning, the American Medical Association was on board with supporting a move towards national health insurance. However, as the years went by and the members of the AMA became more interested in finances and the economy in contradiction to health and science, the AMA opposed national health insurance.
They were actually opposed to any type of insurance because they were convinced people would only value medical care if they had to pay for it personally. They were also convinced Doctors needed to charge patients for the individual services they provided instead of earning a salary. This is similar to how modern day medical care works; hospitals and private practices charge the patient and insurance company by the individual services provided instead of a flat rate.
The problems with medical care costs occur because of the combination of significantly high insurance premiums, that many average citizens are unable to afford, and the extremely high costs of services charged by health care providers, which most of the U. S. population cannot afford either. Tack on the insurance issues of high out-of-pocket costs in addition to high premiums and removal by pre-existing conditions, age and life-time limits and you have a population full of people who are simply unable to afford preventative health care or treatment.
The federal government realized the issue and started taking steps towards a health system reform. This is where the Patient Protection and Affordable Care Act steps in. The Patient Protection and Affordable Care Act was developed during President Barack Obama’s Administration in 2009 by three Congressional Committees; the Committee of Ways and Means, the Committee or Energy and Commerce, and the Committee of Education and Labor. The first health reform hearing was held in the 111th Congress on March 11, 2009.
On July 14, 2009, the first comprehensive health care reform bill, originally titled America’s Affordable Health Choices Act of 2009, was introduced to Congress. By March 23, 2010, the bill had been revised and finally signed into law by President Obama. This marks the first health reform in United States history to be signed into law. (Majette) The Patient Protection and Affordable Care Act is basically an extensive health reform law applying to all citizens and legal residents of the U. S. nvolving regulation of private and public health insurance and health care with specific guidelines including, but not limited to, the following: individual mandates, employer requirements, expansion of public programs, premium and cost-sharing subsidies to individuals, tax changes, health insurance exchanges, benefit design, private insurance changes, the state role, cost containment, improving quality/health system performance, prevention/wellness, long-term care, financing, and other investments. The provisions made in this law have been and will continue to be implemented in stages until 2018 (The Henry J.
Kaiser Family Foundation Basics). Some of the most important examples of reform include, but are not limited to, the following: * Requirement of employers with 200 or more employees to automatically enroll employees into health insurance plans offered by the employer, or pay a tax, by 2014. * Requirement of all citizens and legal residents of the United States to have qualifying health insurance, or pay a tax, by 2014. * Allowing young adults to stay on their parent’s health insurance until they reach the age of 26, implemented in 2010. Prohibiting private insurance companies from imposing life-time limits and rescinding insurance coverage, implemented in 2010. * Restricting premiums to vary based on age, geographical area, tobacco use, and number of family members only, by 2014. * Requirement of insurance plans to cover certain preventative services with no cost-sharing, implemented in 2010. * Distribution of premium and cost-sharing subsidies to families depending on income levels, by 2014. * 100 percent of funding provided by the federal government for the costs of those who become newly eligible for Medicaid between the years 2014-2016. Expansion of Medicaid to families that fall within 138 percent of the federal poverty level, implemented in 2010 and will be increased to 133 percent in 2014. (Committee on Ways and Means, Committee on Energy and Commerce, Committee on Education and Labor) Obviously, with such an extensive piece of legislation that provokes changes in almost every aspect of the nation’s current health system, there are going to be very contrasting reactions between partisan voters. According to a March 2009 poll provided by the Kaiser Family Foundation, 77 percent of Liberal poll takers saw a need for reform.
This percentage is not too far ahead of the 57 percent of Conservative poll takers that saw a need for reform. With such close percentages coming from a nation where the population has immense partisan views, this data indicates the true health system crisis the majority of Americans faced in 2009. By March 2010, when President Obama signed the Patient Protection and Affordable Care Act into law, 75 percent of Liberal poll takers were in support of the new law and only 13 percent of Conservative poll takers were in support.
The percentages in support of the new law declined to 66 percent of Liberals in support and 12 percent of Conservatives in support by March 2012. Only 47 percent of all poll takers want the Patient Protection Affordable Care Act to be maintained as is or expanded. Sadly, only 14 percent of all poll takers say they have personally benefited from the new implementations from 2010 including greater access to insurance, health care for low-income children, young adults staying on parents insurance longer, and preventative check-ups being covered 100 percent.
In contradiction, 21 percent of all poll takers say they have been negatively affected in ways including decreased insurance options for increased premiums, health services have been cut, and the fact that they might have to pay higher taxes in the future. (The Henry J. Kaiser Family Foundation Polls) Despite opposition of support from either political party side, the nation as a whole has replaced “the Patient Protection and Affordable Care Act” with the newly coined term, “Obamacare”; a name that will always be remembered both positively and negatively.
Pros and Cons of Implementing the Patient Protection and Affordable Care Act With the Patient Protection and Affordable Care Act having been a law for only two years, the population of the United States has not had time to experience all of the effects implementing this law might cause. Nevertheless, professional experts with experience and education in subjects relating to this law are reliable sources for predicting future outcomes.
These predictions and opinions are useful when trying to weigh the pros and cons of implementing the Patient Protection and Affordable Health Care Act. Pros * The honorable Kathleen Sebelius, Secretary, U. S. Department of Health and Human Services indicates in a May 2009 hearing how The Patient Protection and Affordable Care Act will extend health coverage to 32 million Americans who previously were unable to obtain insurance for reasons including: pre-existing conditions, insurance costs, and unavailability through employers. Health Care Reform in the 21st Century: A Conversation with Health and Human Services Secretary Kathleen Sebelius 8) * In a February 2011 hearing, Families USA, a national nonprofit, nonpartisan organization for healthcare consumers, issues a statement stressing how the Patient Protection and Affordable Care Act improves Medicare benefits by improving access to preventative service. This is done because there is no cost share where Medicare beneficiaries used to be liable to deductibles and co-pays. Health Care Law's Impact on the Medicare Program and its Beneficiaries 116-117) * During a January 2011 hearing, Chairman Austan Goolsbee for the Council of Economic Advisors explains how small businesses receiving tax credits to provide health insurance to their employees will help lever the playing field with large businesses. The small businesses will be able to provide the same premiums as large businesses. In addition, the tax credits will save the businesses money purchasing insurance, so they will be able to expand and create more jobs. The Health Care Law's Impact on Job, Employers, and the Economy 8-12) * A social issue that will be improved affects nursing mothers. In a statement at the January 2001 hearing, the National Partnership for Women & Families and the United States Breastfeeding Committee stress the importance of policies included in the Patient Protection and Affordable Care Act that support the needs of nursing mothers in the workplace. Women have protected rights in the workplace making it easier to start and/or continue nursing their child for longer periods of time after returning to work (than they previously could before this law).
This nurtures physical and mental health of the growing child. (The Health Care Law's Impact on Job, Employers, and the Economy 177-179) Cons * In the May 2009 hearing with Secretary Sebelius, Clark Newhall, M. D. , J. D. notifies congress about the possible saturation of formerly uninsured people who have insurance now competing with the rest of the population for scarce medical resources; for example, time with the doctor, cancer treatments, etc. Health Care Reform in the 21st Century: A Conversation with Health and Human Services Secretary Kathleen Sebelius 68) * A large group of economists express their concern at the January 2011 hearing about how the Patient Protection and Affordable Care Act might cause a barrier in job growth. They say the expensive mandates and penalties with cause employers to reduce employee numbers to avoid high penalty costs and high insurance premiums for all of their employees. The Health Care Law's Impact on Job, Employers, and the Economy 127-138) * In the same January 2011 hearing, Douglas Holtz-Eakin, President of American Action Forum, suggest the United States is “approaching a fiscal train wreck” (The Health Care Law's Impact on Job, Employers, and the Economy 54-59). He predicts the deficit will be 5. 6 percent of GDP by 2020, or about $1. 3 trillion. All due to the increased spending and timing of the Patient Protection and Affordable Care Act. * Chief Actuary Richard S. Foster, F. S. A. at the
Center for Medicare ; Medicaid Services implies, at the February 2011 hearing, that there would be a decline in the Standard of Living for a portion of American families. This would be because of increased taxes for families over the $250,000 income level to support the expansion of public health insurance. (Health Care Law's Impact on the Medicare Program and its Beneficiaries 73) Conclusion As proven above, the Patient Protection and Affordable Care Act is a very extensive piece of legislature; one that is very difficult to understand in its entirety and takes a tremendous amount of time and analysis.
In trying to grasp the concept of this law, it is important to know why the law was developed, the history behind developing this law, the most important policy provisions included in the law, and what the possible outcomes might come about by implementing this law. These steps are crucial before forming a personal opinion on whether to support the Patient Protection and Affordable Care Act or not. As the author of this report, I have done enough research to feel comfortable forming an intelligent opinion on the Patient Protection and Affordable Care Act.
I support many of the provisions in the legislature including expansion of public health insurance, policies protecting the rights of nursing mothers in the workplace, the focus on preventative care, the requirement of employers providing insurance to employees, the age extension for young adults to stay on their parents insurance, and many more. I do worry about over spending the federal budget, but the welfare of my fellow citizens is more important to me. We need affordable, quality care available to everyone if we are to achieve an improved public health and standard of living.
Something that is just as important to me, regardless of the outcomes the Patient Protection and Affordable Care Act might bring to our nation, President Barack Obama has engraved this law’s name into American history. Support the law or not, it is a very impressive accomplishment. Bibliography Committee on Ways and Means, Committee on Energy and Commerce, Committee on Education and Labor. "Compilation of Patient Protection and Affordable Care Act: as Amended Through November 1, 2010. " Washington D. C. : U. S. Government Printing Office, 1 November 2010.
Printed Legislation. 27 November 2012. Davidson, Stephen M. Still Broken: Understanding the U. S. Health Care System. Standford: Standford University Press, 2010. 27 November 2012. Donald A. Barr, M. D. , Ph. D. Introduction to U. S. Health Policy: The Organization, Financing, and Delivery of Health Care in America. Baltimore: The John Hopkins University Press, 2011. 27 November 2012. Health Care Law's Impact on the Medicare Program and its Beneficiaries. No. Serial No. 112-05. Committee on Ways and Means U. S. House of Representatives 112th Congress.
U. S. Government Printing Office Washington D. C. : 10 February 2011. Printed Hearing Record. 27 November 2012. Health Care Reform in the 21st Century: A Conversation with Health and Human Services Secretary Kathleen Sebelius. No. Serial No. 111-18. Committee on Ways and Means U. S. House of Representatives 111th Congress. U. S. Government Printing Office Washington D. C. : 6 May 2009. Printed Hearing Record. 27 November 2012. Health Reform in the 21st Century: Expanding Coverage, Improving Quality and Controlling Costs. No. Serial No. 111-5.
Committee on Ways and Means U. S. House of Representatives 111th Congress. U. S. Government Printing Office Washington D. C. : 11 March 2009. Printed Hearing Record. 27 November 2012. Health Reform in the 21st Century: Proposals to Reform the Health System. No. Serial No. 111-26. Committee on Ways and Means U. S. House of Representatives 111th Congress. U. S. Government Printing Office Washington D. C. : 24 June 2009. Printed Hearing Record. 27 November 2012. Health Reform in the 21st Century: Reforming the Health Care Delivery System. No. Serial No. 111-13.
Committee on Ways and Means U. S. House of Representatives 111th Congress. U. S. Government Printing Office Washington D. C. : 1 April 2009. Printed Hearing Record. 27 November 2012. Majette, Gwendolyn Roberts. "PPACA and Public Health: Creating a Framework to Focus on Prevention and Wellness and Improve the Public's Health. " Journal of Law, Medicine ; Ethics 39. 3 (2011): 366-379. 27 November 2012. Private Health Insurance: Data on Application and Coverage Denials. Data Report to the Secretary of Health and Human Services and the Secretary of Labor.
United States Government. Washington D. C. , 2011. Printed Report. 27 November 2012. The Health Care Law's Impact on Job, Employers, and the Economy. No. Serial No. 112-03. Committee on Ways and Means U. S. House of Representatives 112th Congress. U. S. Government Printing Office Washington D. C. : 26 January 2011. Printed Hearing Record. 27 November 2012. The Henry J. Kaiser Family Foundation. Multiple Pages. 2012. Information Source. 27 November 2012.