Controversial Issues in Health Insurance
The main reason forhaving a health insurance policy is to cover the insured against incurringexpensive medical costs.Individuals without a medical insurance cover expose themselves to huge medical bills when injured or become ill. The current debate on health insurance coverage has continued to be on the forefront of American politics. Following these debates, several issues have been raised with regard to health care.Oneparticular issue of controversy is whether to make the health insurance policy optional or mandatory for everyone.However, because a huge number of Americans are uninsured, making health insurance cover mandatory would be a favorable choice for everyone.Making insurance cover mandatory has the potential of reducing costs of insurance not just for individuals, but also for people with families.While it is important for every individual to havea health care insurance cover, most Americansremain uninsured. However, the affordable care act offers a better to ensure all Americans get insurance health cover.
In the recent past, the rising cost of health care coupled with a large number of Americans living without health care insuranceprompted leaders to find reforms to the health care sector. In 2010, the Affordable Care Act (ACA), otherwiseknown as the Obama care,was implemented Bradley (41).The ACA had an immediateimpact on the health insurance market, as it introduced wide range of changes.Oneof the most significant changes was theindividuals mandate policy, which not only allowed Americans to purchase health insurance coverage, but also to purchase other additional services such as Medicaidexpansion andpolicy benefits. This policy also enabled the implementation of marketplaces or exchanges and health insurers mandate which stipulated that minimum medical loss ratio requirement should be met by health insurance providers.As such, the ACA will undoubtedly have long-term effects in the health insurance market on not just insurance providers andparticipants and but also regulators as well.
The introduction of the ACA in America changed the way individuals and companies conduct their daily businesses. Clemans-Cope, Kenney et.al. (921) argued that the ACA introduced new extensive insurance coverage provisions that were carried through three major initiatives; it expanded medical eligibility by up to one hundred and thirty eight per cent for Americans living below the federal poverty level; it introduced twelve new health insurance exchanges for small-employer and individuals living below the federal poverty line with new subsidies of private coverage; and a general requirement that American citizens as well as legal residents to have a health coverage or face a tax penalty.
The ACA penalty for failing to comply with the health insurance coverage was heavy per individual and even greater for those with families. However, for undocumented immigrantsearning low income and those whose income does not meet the minimum tax filing threshold were exempted from penalties. Moreover, under that ACA, undocumented immigrants were not allowed to purchase insurance coverage through exchanges or to enrollin Medicaid and the Children’s Health Insurance Program (CHIP), but rather,the localities or State funded for the immigrants, documented and the undocumented individuals.
The rise in the cost of health care services has impacted negatively in the American’s standard of living, especially among middle income earners. However, with the enactment of the ACA into law, significant changes, particularly lowering of health care prices, has been effected in the field of insurance. While the ACA was intended to cut down on the cost of insurance and improve the living standards, it was harshly opposed by the republicans and some section of the conservatives. The republicans cited that the ACA was inappropriate government interference into the booming health insurance industry.They also claimed that the ACA would end up killing millions of jobs once it was passed into law because it will not only impose heavy taxes on businesses, but also introducemany other costs of running businesses.
The ACA also faced intense rejection not just from the Congress, but also from insurance consumers. Insurance buyers complained that they will lose their health insurance private insurance companies cancels their individual policies. According to Nickitas (265),private insurance companies have their own set of rules, most of which were not in compliance with ACA’s new law and requirements. Many insurance companies were affected with this new law, which in turn affected the individual policies of consumers holding those policies and resulted in cancellation of their insurance policies. However, in order to be compliant with the new law, insurance companies were required to disclose to policy holders all the consumer protection that their policies currently lack and also make them aware of any better policies that were available for purchase in the marketplace. This particular option only applied to those individuals whose insurance policies were cancelled, and will not be available for individuals who plan to purchase the same insurance plan.
The ACA was also an infamous policy among Americans. According to Long and Peter et.al., (67), the ACA has had a negative impact on household budgets. Some individuals experienced sizeable new costs while procuring household items as a result of contributions and taxes towards their health insurance cover. In contrast, other householdswith higher wages realized huge benefits and enjoyed subsidies for purchasing insurance through the exchange. Additionally, people who were previously uninsured would get cheap medical costs through subsidies and also become eligible for Medicaid. Also, individuals who got insurance cover through their employers or shopped insurance on their own would also pay less for insurance as a result of government subsidies. However, employees whose employers reduced their contribution towards coverage would end up paying more premiums.
The government should make healthcare insurance cover mandatory and available to everyone, but also affordable. To achieve this, the government should cut down the cost of acquiring insurance subsidize the price of acquiring insurance policiesfrom health insurance companies. Furthermore, it is hard to conceptualize the nature of how long-termcare type of insurance coverage would be feasible with the current Medicaid program. According to Saltzman, Evan and Eibner (6), the optional insurance cover suggests that insurers should continue to offer non-Affordable Care Act-compliant services to the currently insured individuals. In this regard, thehealth insurance companies should thus continue offering insurance cover to the existing insured individuals who were enrolled by the end of 2013, unless the insurance company cancels all the plans offered in the individual market. Meanwhile, in the optional health insurance cover, insurers are free to extend non-Affordable Care Actthe any pre-existing enrollees.
In recent years, the American Congress and the Senate were tasked with reforming and amending the legislation. According to Barr(3), the senate came up with different approaches and policies that wouldensure health insurance coveredall Americans. In the first approach, the senate proposed that insurance coverage should take place through the individual mandate, whereby individualswere required to finance for their own health coverage. The second approach, termed as the employer mandate, required that all companies offer their employees with health insurance cover. Barr (3) further noted that making insurance cover mandatory would also require a centralized place that will connect companies offering insurance covers andemployers or individualsseekingthe cover.
The healthcare policyin America needs to be litigated especially on the coverage of individuals with low income. The ACA policy had a requirement that all the states needed to expand their Medicaid programs in order to cover every American under the age of sixty five with low incomes below the federal poverty income line. The actalso required states to provide essential health benefits to all Medicaid recipientsto a level that will satisfy the insured.Any state that did not comply with the ACAexpansion coverage plans risked losing the federal Medicaid funding. However, the Supreme Courts had barred federal government from expanding health care access to low income Americans. Ilene (89) argued that the Supreme Courtad to defend its decision citing that the ACA’s medical expansion plans had exceeded the threshold of the Congress’s authority under the spending clause. If the Supreme Court had allowed ACA’s law to pass,it would have compelled the federal government to forceStates to enact a federal regulatory program against their wishes.
In summation, even asthe affordable care act attempts to expand insurance medical coverage to every individual in America, it still faces widespread opposition from groups such as the conservatives, who view it as an unnecessary government intrusion into private businesses. Also,a large percentage of the American population still regardthe ACA negatively. Private business owners, for example, have opposed it because it imposeshuge taxes and other needless costs in running their companies, costs that would have otherwise been avoided. Despite the Supreme Court’s approval of the ACA, it still faces challenges of convincing the American population of its good intentions. In conclusion, it will be a mistake to overlook the existing benefits of the ACA and its potential to improve and transform the health care sector. Even though the future of ACA looks bleak, it is a vital step going forward.
Saltzman, Evan, and Christine Eibner. Evaluating the “keep Your Health Plan Fix”: Implications for the Affordable Care Act Compared to Legislative Alternatives. Santa Monica, Calif: Rand Corporation, 2014. Internet resource.
Barr, Donald A. Introduction to Us Health Policy: The Organization, Financing and Delivery of Health Care in America. Baltimore (Md.: Johns Hopkins university press, 2016. Print.
Karl, J. B. (2014). A discussion of private health insurance markets in 10 OECD countries. Journal of Insurance Regulation, 33, 41-66. Retrieved from https://search.proquest.com/docview/1665508105?accountid=45049
Clemans-Cope, L., Kenney, G. M., Buettgens, M., Carroll, C., ; Blavin, F. (2012). The affordable care act’s coverage expansions will reduce differences in uninsurance rates by race and ethnicity. Health Affairs, 31(5), 920-30. Retrieved from https://search.proquest.com/docview/1015200909?accountid=45049
Long, P., & Gruber, J. (2011). Projecting the impact of the affordable care act on california. Health Affairs, 30(1), 63-70. Retrieved from https://search.proquest.com/docview/847269449?accountid=45049
Goldberg, I. (2015). The affordable care act: Triumphs and tribulations. International Journal of Law and Management, 57(2), 87-97. doi:http://dx.doi.org/10.1108/IJLMA-07-2013-0030
Nickitas, Donna M, PhD, RN, NEA-BC,C.N.E., F.A.A.N. (2013). The politics of health care: Congress vs. consumers. Nursing Economics, 31(6), 265. Retrieved from https://search.proquest.com/docview/1477880086?accountid=45049