If doctors like Dr. Knowitall take control of America’s healthcare system, it would result in tens of thousands of people dying from being uninsured. In concerns to Dr. Knowitall’s views, President Donald Trump’s plan to repeal and replace the Affordable Care Act (ACA) are unreasonable. Repealing and replacing the ACA or “ObamaCare” was a promise to Americans as a rally for change. For many years, the United States struggled with rebuilding the U.S. health care system. The American Medical Association (AMA), for years, stood firmly on their position that legislators aren’t equipped to implement control on health care. They believed that achieving health care reform should be left to medical professionals. Since then, with the help of many Presidents’ America’s goals to achieve health care reform has grown considerably. With the goal to better the health for all people, many lawmakers still believe that health care should not be a right. Currently, the want to repeal and replace the ACA has been unsuccessful. Although Trump’s efforts to repeal and replace ObamaCare with the American Health Care Act (AHCA) has failed, the “disaster” system (the ACA) will remain effective. Until bipartisan leaders find better ways to improve America’s health care system, the ACA will not be replaced. Health care reflects our culture and values. If the United States can’t provide health care to their people, then how can America be made great again? I do not stand with repealing and replacing the Affordable Care Act. However, I do believe that improvements should be made to ensure better health care for all people.
Before we get into why the ACA was introduced and how it helped Americans in both negative and positive ways, we have to clarify one major issue Americans are trying to figure out. The Affordable Care Act and Obama Care are the same thing. Most of the American people who were in favor of Trump repealing and replacing the ACA simply did not understand what is was or what it was intended to do. Despite the ACA having its flaws, Obama’s new version of health care reform was introduced, in efforts, “to extend publicly funded health insurance coverage to millions of formerly uninsured adults whose income falls near or below the federal poverty level (FPL)” (Barr, 2016, pg. 1). Repealing and Replacing the ACA would have to result in making sure the number of Americans health care is providable for is impressively higher.
Let’s take a look at the history of the United States health care reform. Dr. Knowitall believes that before ObamaCare, everyone regardless of how poor they are could always get care when they needed it. However, what he doesn’t know is that for many decades people have fought to get a well-rounded health care reform system. For decades lobbyist influenced lawmakers to get their laws passed. Some have even traded sex for policies to get changed. The United States eventually went into war for more power because back then on the federal level, laws could not get passed. The Constitutional Convention which was a delegation that happened so the Constitution could be re-written, allowed the Federal Government to have more power. In which the Bill of Rights, the first ten amendments of the constitution, did not ensure healthcare for the people.
From the mid 1900s to early 2000s health care policies have been proposed but vetoed because of oppositions or monopoly greed. In 1912, Theodore Roosevelt tried to remodel the U.S. health care system after Germany’s system, but he didn’t win the presidential election. Decades later, Franklin Roosevelt proposed for Social Security in the 1930s. The Social Security Act in 1935 was passed, but it did not include health care. Roosevelt’s demand to a system of national health insurance was opposed because, according to the American Medical Association, they believed that “socialized medicine was an agitation” (Barr, 2016, pg. 9). In 1965 a victory towards healthcare was made with the Social Security Act establishing the Medicare and Medicaid programs. Medicare is a Federal Government administered single payer system. Parts A-D is referred to as “Medicare for all” covering elderly ages 65 and up, the blind and disabled. (Medicare.gov, 2018). Medicaid is a state-based program with federally set guidelines that provides insurance for those who can’t afford it. Adults, children 6 and under and pregnant women must be to 133% of the federal poverty line (FPL) and 6 to18 year olds must be to100% of the FPL. (Medicare.gov, 2018). Supplemental Security Income individuals are also eligible. Now, with congress passing the ACA in 2010 it provided an individual mandate, employer mandate, tax coverages, expansion of Medicaid, compromise of congress bills and closed the doughnut hole.
The Affordable Care Act is a law that addresses insurance coverage, patient care and cost. There are two parts to it: Patient Protection and Affordable Care Act. Healthcare.gov provides insights on the protections Americans have for this bill. “Insurance plans are required to cover Americans with pre-existing health conditions. Preexisting conditions can include; pregnancy, cancer, illnesses, obesity or asthma” (Healthcare.gov, 2018). The ACA gives you the right to choose an individual insurance plan rather than the one your employer offers you, employer retaliation, mental health and substance abuse rights. Is the ACA perfect? Of course not. There are many positives and negatives about the ACA and its plans for the future. The ACA insured millions of people who makes less than 138% of the FPL. The individual mandate was enacted for those who could possibly “afford” health care and chose not to buy into it. It is a penalty that individuals will receive around the time where taxes are filed and distributed. This penalty can range from $500 to over $1000 depending on your income level. However, there are exemptions for people such as those in financial hardship, 7 Day Adventist or Amish Religions. Insurance premiums for health care are at an all-time high. Since physicians are getting paid less to treat more Medicaid individuals, there has been a limit in physicians who accept Medicaid. Private sectors play a vast majority in the insurance market. The insurance market is the key to expansion of Medicaid and public-private sectors will be more competitive, open, and fair in access and cost. According to healthcare.gov, in 2019 “health insurance companies could end your coverage if you fall behind on your monthly premiums.” The barriers to the provider and supplier sector will result in more intensive competition and qualify individuals for a Market plan where they will pay a premium tax credit to reduce gap in medical care.
In 2013, the Kaiser Family Foundation estimated that more than 1 in 3 children are covered by the Children’s Health Insurance Program (CHIP). However, there is debate over whether or not America is spending too much on Medicare and Medicaid. These programs constituted to 14% of the federal’s health care budget annually and is expected to rise as we approach 2019. The Government typically spends over 265 billion dollars in providing “quality” health and is projected to spend over 4.4 trillion dollars in 2020. As Medicare and Medicaid expands, America will pay more and more to improve the system.
As America pays more to improve the health care system, it becomes expanded. Under the ACA, the expansion will provide better outcomes for the reform. Although studies were done where it proved that wait times in clinics were longer for those with Medicare, and the overall quality of care as decreased, I believe that expanding the ACA can benefit America in the future. With Trump and his administration, “The Congressional Budget Office analysis of the American Health Care Act found that 23 million more people would be without insurance in 2026 under the bill than the current baseline” (Bryan, 2017). Republics parties and Trump were in favor of repealing and replacing the ACA. The AHCA was a proposed health care revision that failed. With Trump’s new idea of “health care” the AHCA would ensure more tax credits, lower insurance premiums, public and private sectors enhancing the Medicaid program and a Cadillac tax plan push back. Republicans in favor believe that Trump’s version of health care reform will change significantly. Unlike the AHCA, the Medicaid expansion provides health insurance coverage and per capita block grant program. Within the next three years, these changes will be in full effect and should support ACA consumers. Overall, with the health care Medicaid expansion, insurance coverages and quality of medical services have already improved. 32 states have already expanded the Medicaid program. “If your expected yearly income increases so it’s between 100% and 400% of the federal poverty level, you become eligible for a Marketplace plan with the advance payments of premium tax credits” (healthcare.gov, 2018). These tax credits apply to those who were previously in a state that didn’t expand or if you qualify for tax credits and don’t have healthcare insurance. The expansion already ensured primary care in both rural and urban areas. Rural community health clinics that have been difficult for Medicaid users to get to. But, these clinics have been publicly funded by the Government to help serve the low-income community in rural areas. It shows that the government is trying all efforts to provide better quality for low income communities.