Affordable Care Act Argumentative Analysis

The current issue that the government will have to face is what to do with the Affordable Care Act (ACA) given the recent presidential election outcome. The answer is not simple regarding whether the ACA should be replaced or repealed. The new president and congress will also have to focus on the costs of health care, driven by new drugs and treatments, an aging population, and how to preserve the Medicare program, whose current funding cannot be forever sustained. The ACA created subsidies and increased federal spending for healthcare for the purchase of health insurance and Medicaid expansion. At the same time, it reduced spending for Medicare and introduced reforms likely to make health care delivery more efficient (Rivlin & Reischauer,
2016).
Background
a) One of the reasons for the president’s plan to repeal of the ACA was that it was passed by Democrats without any support from the Republicans. Republican congressional leadership, opposed it from the beginning, in an effort to discredit Obama. In the 2016 campaign, Republican candidates demonized “Obamacare” as the federal government forcing people to buy health insurance even if they did not want it, punishing small businesses with mandatory costs, and raising premiums for everyone.
b) From the beginning, Obamacare had delays in the system.
Also, the government website Healthcare.gov was inundated with technical problems after its initiation on October 1, 2013.The mandated insurance from companies was deferred until 2015. Then, Obama announced that insurance companies were allowed to keep customers on their existing plans without changes. Many were angered at Obama’s ‘broken promise’. Then, companies began paying for their employees health insurance by cutting down their workforce (under the 50 limit), leaving many without jobs, and therefore, having no means to pay for insurance. Congress budgets in 2014 predicted that Obamacare would cut the US workforce by around 2.3 million workers by 2021 (Budgetary and Economic Effects of Repealing the Affordable Care Act, 2015). Obamacare has also been considered an intrusion into private lives, which launched a legal challenge. This effort was blocked when the Supreme Court declared the law constitutional. The controlling Republicans in the House of Representatives have also been working to have the law repealed. Obamacare has been criticized for being overly-complicated with its many types of insurance policies – bronze, silver, gold and platinum, plus, the co-pays, deductibles and co-insurance
levels.
c) The Congressional Budget Office has estimated that Medicare’s direct spending would increase $802 billion over the 2016–25 periods if the ACA were repealed (Rivlin & Reischauer). The Trust Fund, out of which Medicare pays hospital claims, is projected to be depleted in 2028, even with all of the ACA’s Medicare savings (Rivlin & Reischauer). Repealing the ACA would accelerate the date of Trust Fund depletion, as spending would increase when payment reductions for institutional providers and other cost-reducing measures disappear (Rivlin & Reischauer). The increase in payroll taxes on those with high earnings required by the ACA will be terminated, thereby reducing the Trust Fund’s revenue. Taxpayers will most likely sustain the brunt of the expense.
d) This issue is currently on the table, due to the election of a new president who is currently acting to repeal the ACA.
Advantages
Businesses could afford to hire more employees. There would be less intrusion by the government. Americans would have the right to choose their own insurance provider, or not be insured at all, without the threat of being penalized, and would avoid suffering through the long delays.
Disadvantages
If the ACA was repealed, fewer Americans would be insured. Americans would not be able to insure their children up to age 26 to their health insurance. Insurance companies could drop people based on their illness, or put limitations on its use. Coverage could be denied based on pre-existing conditions. There would be a co-pay for wellness and pregnancy exams. Insurance companies could raise their premiums without an agreement from the government. Insurance companies would no longer have to spend 80% of their money on medical services, and could spend the money on advertising, and executive salaries (Budgetary and Economic Effects of Repealing the Affordable Care Act).
Opposing Stakeholders Many consumers, who are currently on ACA insurance, are happy with their coverage, and are worried about what will happen if the ACA is repealed. The states will incur a loss of federal funds for the expansion and improvements of state Medicaid programs. Insurance providers have seen an overall increase in profit.
Supporting Stakeholders People who are against government intrusion, and don’t want to be forced to purchase health insurance. There are some people who think insurance is an indulgence, when they can barely afford the necessities. Physician’s reimbursement rates have decreased since the ACA, thus, making doctors more reluctant to see these patients.
Recommendation
I stand in opposition of repealing the ACA. I would keep the ACA, due to its many benefits, but I would also make some changes as well. I would give government vouchers so that insurance could be purchased privately or through the exchange, and primary care providers would be unaware of who received the vouchers. This would eliminate discrimination against patients. I would raise the age of Medicare recipients to age 70, giving them the maximum benefit at that time. I would also raise Medicare taxes, increase part B and D deductibles, and decrease the cost of expensive pharmaceuticals through negotiations with drug manufacturers, while easing restrictions on drug imports.