The Affordable Care Act

1/1/14

Overview

The Affordable Care Act is once again in the national spotlight.  Join Active Minds as we review the major elements of what has become known as “Obamacare” and take a look at how these changes will be implemented and their likely impact on individuals and businesses.

Key Lecture Points

  • The American Health Care system faces significant challenges.  At least 44 million Americans (about 15% of the population) live without health insurance.  Additionally, the US spends more per capita on health care than any other industrialized democracy in the world.  In 2013, the US is expected to spend $2.8 trillion on healthcare—18% of its GDP.
  • As health care costs continue to escalate, Americans are paying more out of pocket for their healthcare.  In a recovering economy, people are concerned about paying for their healthcare needs.  As Americans lose their jobs, they also lose their health care coverage.  In addition, the rising costs also affect the significant government health care programs, Medicare and Medicaid.
  • After his first inauguration, President Obama requested Congress pass health care reform legislation. With strong pressure from the White House, the Affordable Care Act (ACA) was approved in March 2010.  Its intent is to increase the quality, accessibility and affordability of health insurance while decreasing health costs.  Among other things, it requires Americans to have health insurance while providing new ways to buy coverage and giving subsidies and tax credits to help those who previously could not afford insurance to pay for coverage.
  • Widespread opposition to the ACA focused on the individual mandate as unconstitutional intrusion of government into individual lives.  The US Supreme Court, however, upheld the major provisions of the ACA, including the individual mandate.
  • Although some provisions of the Affordable Care Act started as early as 2010, such as allowing children to stay on their parents’ insurance until the age of 26, the major roll-out of the law begins in 2014.  In preparation for the individual mandate for health insurance on January 1, 2014, the health exchange marketplace (healthcare.gov) debuted on October 1, 2013 and immediately experienced massive technical problems and delays, much to the embarrassment of the Obama Administration.
  • Adding to the Administration’s frustrations, soon after, 4 million Americans received notice that their individual policies were canceled, mainly because they did not provide the benefits now required under the ACA.  These policy holders felt betrayed by the President because he had repeatedly promised the American people that if you had a policy you liked, you could keep it.  Pressured by even his Democratic supporters, Obama tried to dampen the outrage by announcing insurers will be allowed to renew these policies through 2014 and by allowing individuals whose policies were cancelled a “hardship waiver” for the individual mandate.

Exploration Questions

  • How do health care costs relate to the economy? 
  • What are the major provisions of the Affordable Care Act?

Reflective Questions

  • Do you recall a time when the cost of health care was burdensome to you?
  • What do you recall about the debates about Medicare and Medicaid in your lifetime?  How does that relate to the current debate on the Affordable Care Act?
  • Do you think the Affordable Care Act will succeed in decreasing healthcare costs?

More to Explore

Books for Further Reading

  • Starr, Paul. Remedy and Reaction: The Peculiar American Struggle Over Health Care Reform.  Yale University Press, 2013. 342 pages. This book tells the history of how and why the US health system is so different from the rest of the world and traces efforts at healthcare reform including the Affordable Care Act.
    Click here to order
  • Bredesen, Phil.  Fresh Medicine: How to Fix Reform and Build a Sustainable Health Care System. Grove Press, 2011. 288 pages. The author tells the story of healthcare in the US from the perspective of a businessman, a historian and a former governor of Tennessee.
    Click here to order