The Affordable Care Act (ACA), or more commonly known as Obamacare, is a law that is enacted to ensure that all Americans have access to an affordable health care insurance, hence the name “affordable care.” This administration aimed to aid most Americans without insurance. However, to really understand what Obamacare truly is, one must first grasp the concept of insurance.
Insurance is a contract between a person and their insurance company. In the contract it is stated that the insurance provider will pay for a chunk of the policyholders loss, as long as the person follows all the stipulations within said contract. The policyholder then pays a premium, which is essentially the amount of money the insurer charges the insured for the coverage that is set forth in the contract. If the policyholder experiences a loss, they will pay the deductible and then the insurance covers the rest.
However, many Americans lacked insurance for a variety of reasons, including the monetary costs or denial because of preexisting conditions. As was mentioned previously, the Affordable Care Act was made to assist those who viewed insurance as unattainable.This health care act consisted of 3 main features. The first feature included the creation of a new “marketplace” insurance exchange where people could buy health insurance. Not only that, but the ACA placed regulations on insurance companies that in the past, would deny benefits to customers for a multitude of reasons including preexisting conditions, making this no longer allowed. This legislation made insurers also cover preventive medicines in full, with a few exceptions. Moreover, the second feature, which is known as the “individual mandate,” requires all individuals who can afford insurance, and yet refuse to buy it, to be penalized. Those penalized are subjected to pay a fine of 1% of yearly household income or $95 per adult and $47.
50 per child, whichever is larger, and yet, this price will rise over time until said individual purchases insurance. However, there are a few exceptions concerning the individual mandate including: people who are incarcerated, undocumented immigrants, people with religions that forbid them from having any health insurance, and families whose income is so low they do not have to file a tax return. Those not exempt need to be covered by a company that meets the federal definition of “essential care.” Furthermore, the third, and final major provision of the Affordable Care Act was a set of subsidies (“a grant or contribution of money”) to aid those who are uninsured along with small business owners in purchasing insurance as well as an expansion to programs such as Medicaid and the State Children’s Health Insurance Program (SCHIP). The expansion on Medicaid made more people eligible by simply opening the program up to people with incomes up to $27,724. In addition, the reform also allowed those without dependent children that were of working-age to qualify for the first time.
However, even after this act was passed it still remained controversial. Many conservative Republicans declared that it was an “unwanted intrusion into the affairs of private businesses and individuals.” (BBC News, 2017) However, the reform faced more challenges than just from the public opinion. In fact, twenty-one state attorneys general filed lawsuits against the ACA on the grounds that the provision forcing individual mandate expanded the commerce clause beyond the limit of its constitutionality. The states also fought against the expansion of Medicaid programs covering the poor.
Unfortunately for them, in 2012, the Supreme Court ruled that these acts were indeed constitutional. Even Chief Justice Roberts, who was considered to be a conservative, declared the individual mandate to be constitutional, much to the surprise of the public. Roberts argued that the mandate could not be justified under the commerce clause, for the commerce clause regulates economic activity, while the mandate recognized economic inactivity. Instead, he ruled that it was legal under Congress’s taxing power. In addition, the Affordable Care Act underwent another major challenge in 2015 when conservative opponents sued on the grounds that the law prohibited the federal government from providing subsidies to the beneficiaries who rely on the federal health insurance exchange.
At the time only 16 states had set up their own individual exchange program, therefore, the people from the other states relied on federal exchange, meaning 6.4 million people would have lost their subsidies to purchase insurance. Obama’s administration defended the law, saying that the language of the law was nothing more than an error in the drafting of the legislation. They intended to make subsidies available to all who qualified , regardless of the kind of health insurance they used to purchase insurance. The Supreme Court sided with Obama’s administration, agreeing that if Congress intended to make subsidies available then no harm had been done.
In conclusion, the Affordable Care Act was essentially made to help out American citizens. While there may be both pros and cons to the reform, the main goal is to make affordable health care accessible, and with the help of the people making it more efficient we might just get there.