Obama Care

Introduction

Healthcare improvements or reforms remain a pressing concern for any government in the world, which would explain why it presents itself as a major talking point in any political party’s manifesto. The major concern has always been how to improve the affordability and quality of healthcare provision in the Country. In USA, the Affordable Care Act (ACA) or Obama care as it has come to be popularly known is one those healthcare reforms adopted by the Democrats during Obama’s Tenure. ACA faced a test of time especially owing to the fact that it came during a period where the country was still coming into terms with the effects of the 2007/2008 global financial crisis. Owing to the hard economic times the country was still undergoing, many critics were skeptical of having to take such ambitious risks of undertaking expansions on the health insurance coverage and establishing new guidelines for health benefits provision by employers. The fear was that such bold moves would worsen the unemployment situation in the country and hinder economic recovery. In light of these predicted risks, this paper will review the impacts of Obama care on the US health system and then offer an opinion on the expected outcomes of the repealed health legislation recently conducted by the Republican congress. 

One of the perceived benefits of ACA was increased health coverage to all including the low income households in the country. While deliberating on this point, one would completely ignore the impact it has have had on the people in the health care industry itself. The care givers who fall under the health workers category have benefited from the expansion of the health insurance scheme to all. Research conducted by (Frauenholtz, 2014) reveal that about 500,000 care givers in the country were able to access insurance between the years 2010 and 2014. In the past, most of these workers were not able to afford health insurance mainly because of their low incomes. The introduction of the Medicaid program increased federal subsidies under the Obama care helped minimize their troubles and the result was massive subscription to health insurance by this group of health workers. 

One of the principles of ACA was improving the quality and efficiency of healthcare delivery in the US health systems. One strategy of achieving this mission was through the establishment of the Accountable Care Organizations (ACOs). The working behind this strategy is that the ACOs are entitled to bonuses, but only if they are able to lower the costs of providing health care while at the same time meeting the high standards of quality set each year by the Centers for Medicare & Medicaid Services (Kessell et al, 2015). Before the ACA came into place, in efficiencies existed in the health care system. Individuals that were not provided insurance by their employees had to subscribe on their own. The resulting effect was many individuals not taking up health insurance and the subscribers being charged heavily for insurance with the cost even eclipsing higher if the individual has a pre-existing condition. Some of the providers would even go to the extent of excluding cover for the pre-existing conditions in individuals, which left many either underinsured or uninsured at all. Research conducted by Commonwealth Fund in 2015 revealed to this trend with enrollment for health insurance increasing to about 23 million people either through the Medicaid program or through their employers (Commonwealthfund.org, 2015). The federal tax subsidies made it affordable for individuals paying their own premiums because the subsidies almost help match the rate to that of employers. The result was a decrease in the number of uninsured non elderly adults decreased from about 22.3% in 2010 to about 13% in 2015.  The rate of uninsured children below the age of 18 years decreased from 7.8% in 2010 to about 4.6% in 2015 (Uberoi, Finegold & Gee, 2016). To further increase efficiency, ACA through the private insurance reforms further directed that the insurance companies to offer additional benefits for the individuals with pre-existing conditions, which is seen as a major boost for individuals within the low and middle income bracket (Cohen & Martinez, 2015).

A closer analysis of the current proposed legislation by the Republican Congress reveals that the Medicaid program is one of the programs that will be negatively affected by the new legislation. This implies once again the greatest impact will be felt by the low and middle income households in the country. This is because the law proposes the introducing cuts on the Medicaid program while at the same time giving the States the power to evaluate whether to support certain benefits earlier offered in the ACA such as maternity care, mental health treatment and emergency services. The proposal on the Medicaid program is that federal spending on the program would be reduced with the federal government instead opting to send lump sum grants to the States or pay the States a given amount per individual who has enrolled under the Medicaid program (Pear & Kaplan, 2017). The legislation further eliminates the idea of the law requiring that individual’s take up health insurance; instead the Insurance companies have been offered power to charge higher rates for those individuals that allow their coverage expire (Willison & Singer, 2017). These are some of the moves that have led to most critics of the new legislation predicting that in years to come most low and middle income Americans will have lost their health insurances. 

Conclusion

The aim of this paper was to discuss the impacts of Obama care on the US health system and then offer an opinion on the expected outcomes of the repealed health legislation recently conducted by the Republican congress. The discussion has revealed some of the notable impacts of the Obama care. The impacts discussed include the improvement of healthcare quality and effectiveness in delivery, the increased health insurance coverage for the care givers and other middle and low income households and the decreased costs of health care provision in the country. On the issue of the new legislation, the paper has identified that the subsequent killing of the Medicaid program will in the end result to the decrease in the number of health insurance subscription especially for the middle and low income families. 

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