Affordable Healthcare

The Affordable Care Act
Name
Institution affiliation

Abstract
When President Barrack Obama introduced the Affordable Care Act through the Obama Care initiative, the system was highly criticized. However, this ACA has completely reformed the lives of many low income and poor citizens who could not afford health care as they can now access care through private insurance as well as government-run schemes. Today, the vulnerable and previously discriminated upon groups seem to be the prime beneficiaries of this program as it stands. Take for instance, before the reforms; insurers declined to cover individuals with terminal ailments, a trend that the act reversed. Additionally, today, 75 percent of the Americans of the age between 16 and 64 (amounting to 138.8 million individuals) are now privately covered (Belad, Rocco& Wadan, 2016). Be that as may, many argue that it has alienated middle-income earners whom despite qualifying for the insurance, cannot afford the services. This segment hence discusses some of the negative results if the scheme on middle earners. It identifies the cost of healthcare, poor accessibility and lack of the coverage as the three grand challenges. It also touches on the alternative patient protection set by President Donald Trump’s administration. Later it does a cost-benefit analysis of both, where it establishes that the former is still more beneficial and that with few reforms it could efficiently represent all populations.
Keywords: Average, middle class, income, earners, Obamacare, Act, reforms, private, insurance, healthcare, cost, the poor, cover
Introduction
When asked about how she felt about the bill, Jennifer DeVoe, M.

D., a medicine professor at the Michigan university said that “The current system of health insurance for some coupled with a fragile safety net for others is not working for many families’ Cooper (2013, p.1). ACA also known as Obamacare has been on the receiving end of such unparalleled criticism and controversy as it has been the greatest overhaul of America’s healthcare system since 1960.Barack Obama established this law with the aim of providing affordable and equitable healthcare for all while cutting on healthcare spending. This was to be achieved through expending coverage to the poor 15 percent who previously lacked it. It also mandated that all organizations harboring fifty employees and above cover them. More excitingly, it offers people younger than 26 years to stay under the umbrella of their parents cover thus creating chances for coverage of those with conditions. However impressive this sounds, the idea of it being fair seems so farfetched as Americans have refuted it for disregarding the middle-income earners outrightly. This ACA, although offered income-based covers, suffers from great controversy regarding its exact role in the life of middle income. Many have argued that it has pushed out the individuals who do not fit in its speculations rendering them unable to acquire health care. According to Elliot (2018, p.1), ‘almost 5 million Americans lost access to health care benefits because the health insurers did not comply with the ACA standards’. Additionally, private organs have brushed it off for its uncalled for intrusion in private businesses. Most people were positive that Obamacare would be the panacea to the then high cost of care but as opposed, it only favored the low-income earners while leaving out the middle class who could not qualify for the additional cost, therefore, for the plan to work for all, it requires technical modifications which ensures that everyone accesses insurance affordably.
Discussion
The middle class can no longer afford healthcare
The current plan focused on creating affordable medical insurance to the deprived families. However, the middle class seemed to suffer. The introduction saw to the coverage of most low-income people. The act stipulated that all insurers comply with the program stipulated. These changes in return prompted company employers to alter the previous systems in an attempt to cover more for less. As a result, a staggering number of these previously employed and insured were left in a worse situation. These could not cater for the monthly premiums that were by now three times higher than their net earnings. The families that had more than four children faced deductibles of a whopping $ 1000 annual fee, which was quite unrealistic, going by their salaries. According to Goozner (2017, p.1),‘more than 6 million Americans in the middle class lost access to affordable health’. At this time, they lacked insurance and could not afford the incredibly expensive healthcare. Some opted to secure marketplace insurance that turned out to be even more exorbitant. People have argued that acquiring insurance after the segment is unhelpful to the people who had jobs because now the deductibles, coinsurances and co-pays are outrageously expensive.
It affected small businesses
The plan was monumentally costly for small businesses with average operating capital. It required any business with over 50 employees instill an insurance practice for all the employees. It required them to ensure that the employers acquire essential coverage, offered it affordable, and the cover was of a minimum value. According to Cooper, (2013), although these companies received some credit to help with the costs, this was still a huge blow to them. This rude invasion on personal businesses truly affected the bodies, as they had to spend more than they even generated annually. To mitigate the extra costs, the employers opted to lay off some workers. A loss of human capital was another hit seeing as, without enough human resources, the output also reduced significantly. Letting go of employees would see the organization registering for an insurance scheme for the so said 50 employees. Even then, things were not looking out for the employer. In fact, some employers felt that the compliance to the scheme would just cripple their operation completely and opted for the $ 3000 annual fine for each employer who purchases the marketplace package (Berger, 2011). The payment, also known as ‘pay or play penalty’ was imposed on successful and charity organizations like churches that apparently could not generate that amount. Worse enough, the taxes rose by $ 260 each year. For instance, if an employer with 300 employees fails to cover 20 of the low-income earners, the penalty would be $ 3100 in 2015, $ 3300 in 2016, and $ 3560 in 2017.
Penalization
Obamacare created tax penalties for Americans that chose not to purchase health insurance. For instance, any American with a yearly income of $15,000.00 per year suffered a fine of $695.00 for not purchasing health care (Collica-Cox, 2015). Also, everyone with a yearly salary less than $65,000.00 per year incurred $1,366.00 for not buying healthcare insurance. This was one of the most outrageous policies that accompanied the act. Previously, Medicaid only exempted the Americans adults without children. However, the introduction of this act expanded Medicaid borders to cover those making 13 percent of the federal poverty line. That means that any employer earning an annual $ 15,000 was now covered but with extra premiums. To be fair, the program took the initiative to offer people tax credits on the premiums. This, in essence, was still costly as people were caught in the dilemma of expensive healthcare and expensive premiums. Additionally, purchasing of healthcare for individuals should at least be free, and employers must have a right to spend their income in the way that they deem best. Thus, the system had sprung out of control. Children were forced to stay under cover of their parents, and that was disadvantageous to them. In one classical case, a mother could not secure medication to her 14 years old owing to her suspended cover.
Counterargument:
Many are concerned that the repeal of ACA could result in millions of U.S citizens lacking access to affordable medical care. This Senate bill poses a potential cut of healthcare rendered to the vulnerable groups and lowest income earners. The controversial segment termed as repeal-and-replace, introduced under the Better Care Reconciliation Act would harm those with preexisting conditions, the elderly and those living below the federal poverty line previously covered by Medicaid. According to Edward, Elliot, and Miller (2017, p.1), ‘the bill would deprive 4.1 million middle-income adults their coverage, increasing the uninsured rate for adults with incomes above 200 percent of the poverty level by about 60 percent’.
Rebuttal:
This plan aims at modifying the former as opposed to substituting it. Many are concerned that the idea of creating cut-rate healthcare will cease, following the president’s signing of the Tax cuts and Job act (Mendoza, 2017). However, his initiative only zeroes in on mending some of the faults that the ACA provided. For instance, the latter has made the costs of insurance incredibly high as firms have to adjust to the requirements provided. With the repeal, the cost of living will be normalized, as the government will not need to transfer any charges to the taxpayer.
The scheme also does not offer direct and hefty fines on those who are uninsured but rather raises the cost of repurchase of insurance. It eases the fines taxed on short-term purchases in the sense that those with unexciting coverage who enter the marketplace would only be charged a higher premium for the first year before these could drop to the normal rate. This structure encourages people to choose what is best for them without the unwarranted coercion. On the other hand, as regards the costly patients, the bill sets aside $ 115 billion for the high-risk pool that will cater for them comfortably (Amadeo, 2018). The bill also encourages the sale of insurance across state lines. This concept creates more competition thus encouraging a cost of the prices. Third, the system allows employers to use the pretax income for Health reimbursement.
Conclusion
Who knew that the creation of the promising ACA initiative would raise such controversy, just a few years after its initiation? While many would agree that the creations of the Healthcare Act, also known as Obamacare was off to a great start, the initiative still leaves a lot to desire. Millions of Americans today are torn between the rising cost of care, the unavailability of coverage, and its inaccessibility. The much-decorated initiative took its charity options too far by ensuring that the vulnerable and the poor are adequately covered under the expanded Medicaid program. However, it failed to consider how its framework affected the currently insured, the employers and employees. With organizations forced to acquire a coverage program, came the unscrupulous non-compliance charges that coasted the companies a great deal. As if that was not enough, employees who could not comply with the schemes suffer fines as well as lack of insurance because the new policies’ premiums are too costly. That concludes that millions of Americans are still without affordable care and that we must continue to rework the potentially beneficial Act Obamacare until we create an all-inclusive option. While many have refuted Trump’s American Health Care Act as inconsiderate of the vulnerable in the society, it could be time to consider it as it rights the wrongs of the former. Concisely, it gets rid of the taxes and penalties charged on private companies as well as employees who do not comply with taxes. It also makes insurance competitive and in return, hindering the process. With the rising price of healthcare, everyone agrees that there is an urgent need for remedial strategies. While both the AHC and the AHCA do not necessarily agree, their policies can synchronize well towards upholding the perfect healthcare package for all American regardless of their social class. The Sebelius/Manuel plan might just be that answer as it increases the subsidies to insurance markets to prevent increases in premiums. Overall, the modified Obamacare would consider the fate of the middle class as well as employers thus ensuring equitable, accessible, and affordable health.

References
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Berger, Dustin D. (2011). The Management of Health Care Costs: Independent Medical Review after ‘Obamacare.’
Cooper K. (2013, August 29) The Obamacare dilemma: institutions grapple with the costs of providing health insurance to adjunct faculty under the Affordable Care Act. Diverse Issues In Higher Education [serial online]. 2013;(15):14. Available from: Academic One File, Ipswich, MA. Accessed February 12, 2018.
Collica-Cox, K. (2015). The Criminalization of Health Care. Society, 52(4), 309-315. doi:10.1007/s12115-015-9906-2
Elliott, P., Edwards, H. S., & Miller, Z. J. (2017). RIP, Repeal and Replace? The GOP Faces a New Crossroads. Time, 190(5), 13-15.
Goozner M. The Many Consequences of Repealing Obamacare. Challenge (05775132) [serial online]. March 2017;60(2):122-140. Available from: Business Source Elite, Ipswich, MA. Accessed February 5, 2018.
Mendoza, R. L. (2017). Information Asymmetries and Risk Management in Healthcare Markets: The U.S. Affordable Care Act in Retrospect. Journal of Economic Issues (Taylor & Francis Ltd), 51(2), 520-540. doi:10.1080/00213624.2017.1321451