The Affordable Care Act: Obamacare


The Affordable Care Act

The Affordable Care Act
The Affordable Care Act or what gains reference as Obamacare refers to a federal statue in the U.S that came into play to provide low income members of the U.S with health care insurance. The statute serves as the most significant regulatory change in the U.S health care system signed into law on 23rd March 2010. Enactment of ACA focused at increasing quality as well as affordability of health insurance, lowering the uninsured rates achieved by an expansion of both private and public coverage as well as reducing healthcare costs for both the government and individuals (Musumeci, 2014). The statute led to introduction of mechanisms that comprise of mandates, insurance exchanges as well as subsidies. All insurance companies are required by the law to cover any willing applicant based on the provided minimum requirements and also offer similar rates irrespective of pre-existing conditions. Despite the Supreme Court of the U.S upholding ACA’s constitutionality on 28th June 2012, the statute is not the best health care option for the overall U.S society.
Thesis-The Affordable Care Act is not the best healthcare option for the United States because of financial requirements and targeted populations.
The Federal Poverty Level (FPL) serves as a policy guideline that the U.S federal government and states governments use in determining the level of cost assistance among the citizens. As such, eligibility to ACA healthcare program is based on specified financial requirements an indication that not everyone benefits from the statute (Fitzgerald et al., 2015). CHIP together with Medicaid provide health insurance coverage to almost sixty American citizens that comprise of parents, people with disabilities, children as well as seniors. It is a mandatory requirement by the federal government that all states cover specific groups while equally enjoying flexibility of covering other groups within the society (Medicaid, 2015). Most states currently run on expanded coverage especially for children and people with disabilities. As of 2015, the FPL was at $27,724 for a family of three with Medicaid as well as CHIP eligibility expanded to individuals making 138% less than the FPL. However, it is important to note that the Medicaid benefits are eligible to persons from states that expanded Medicaid.
It is indicative that individuals without the income brackets presented by the FPL and the respective percentages of annual income earnings are ineligible for the ACA programs. In states that failed to expand the Medicaid, beneficiaries of ACA earn less than 133% of FPL while in those that expanded the program earn less than 138% of the FPL (Obamacare Facts, 2015). Therefore, U.S citizens above the low income brackets put by the federal government are excluded from the health care benefits. Considering that the U.S is a developed economy, majority of the citizens are above the provided poverty levels. As such, taxpayers’ money of U.S citizens is used in benefiting part of the society as opposed to the whole. Both private and employer insurance coverage benefit from the ACA program, but on some conditions for employer provided coverage. Families that access coverage through their employer qualify for Medicaid or CHIP based on their income, family size, children age and whether their state expanded Medicaid.
Targeted populations
The ACA program targets both the young and adults in health care insurance coverage. However, statistics reveal that the young or in other words children benefit more than adults. Furthermore, as a child matures into an adult, there is an increased risk of losing the benefits. According to Garfield and Damico (2016), states no longer expand their programs that as a result lead to a limitation of medical eligibility within states that fail to expand their programs. Garfield and Damico (2016) revealed that as at 2016, the median income limit among parents in a family of three in poverty stands at only 44%. Furthermore, as a result of failure by states in expanding Medicaid eligibility, adults without children remain ineligible. Again, since the basis of ACA relates low-income families, people below poverty fail to receive financial assistance for other coverage options. Consequently, adults in states where there is no Medicaid expansion experience a ‘coverage gap’ because of possessing incomes above the eligibility of Medicaid while also with limits lower than the tax credits of market premium.
While the ACA targeted benefiting the low-income earners families in the U.S, studies reveal that the goal is yet to be achieved. The minority groups of Latinos, African Americans and Hispanics form the largest group of low-income earners within the American society. Since the majority whites form the high and medium income earners group, if the program achieved its goals, they should become the least beneficiaries. Studies conducted to measure the impact of the statute reveal that the majority whites fewer benefits from the program with the minority groups benefiting more despite most of them falling under coverage gap. According to Sneed (2015) a study examining the benefits of the ACA statute revealed that around seven million and four hundred thousand white majority received coverage under the program. During the same period, the number of Hispanics that benefited from the program amounted to four million with the black Americans gaining coverage in the same period amounting to 2.6 million. As a result of the changes in health insurance criteria, the number of uninsured whites dropped by 6% from an initial figure of 14.3% to 8.3% (Sneed, 2015). The minority group rates of uninsured dropped significantly while compared to that of the white majority. The Hispanics registered a drop in uninsured with a net decrease of 11.5% to reach 30.3% from the initial figure of 41.8%. The uninsured rate of African Americans on the other hand recorded a drop of 103% to arrive at 12.1 percent from the initial figure of 22.4%.
The health insurance provisions and reforms presented by ACA equally comprises of tax provisions. The provisions affects all the parties involved in the insurance process that comprise of individuals, insurance organizations, business and government organizations together with tax-exempt entities. The tax concept provided in the statute offers a description of the crucial changes that comprise of information regarding the procedures of families and persons in filing their taxes (Obamacare Facts, 2015). The statute further provides the benefits for other employers and organizations. However, it is the content of tax credit provision that portrays another weakness of the law. The law requires individuals and their dependents to possess health payment, a tax exemption of the manner of making a payment with the tax return. Individuals that make purchases of health care insurance policies from the market place, they possess an eligibility of premium tax credit. The tax credit premiums allowed to individuals serve in reducing states revenue and the overall federal government revenue collected from taxes.
With the U.S already facing a budget deficit prior to the introduction of the ACA law, the situation has even worsened after the implementation of the law. As such, the budget deficit faced by the U.S has continued to widen with more gaps expected in the future. Estimates of net costs of the ACA insurance related provisions stood at $1.207 trillion as at March 2015 (Obamacare Facts, 2015). The presented budget deficit depicts a figure down from the ensuing year’s projections with the evidence of the deficit resulting from the fact that more people continue to get subsidies. As such, it is evident that with time, as more individuals continue to get subsidies while at the same time a rise in health care costs is recorded, the total health care spending will outpace revenue.
Addressing the problem of attainment of health care services that faced by the U.S citizens will require adoption of a more inclusive approach as opposed to the ACA law. The inappropriateness of the ACA law results from the ensuing financial costs of the program as well as the target population. While it is the task of every government to address the issues affecting the minority members of the society, the same government has a task of addressing the health concerns of every citizen. Irrespective of existing evidence that the ACA program benefits the minority members within the U.S, most still fall into coverage gap as a result of states failure in expanding the Medicaid programs. Adults still face high risks of failure of receiving covers while compared to children. Furthermore, the tax subsidies provided by the law serves as a significant factor that influences and adds to the U.S budget deficit.

FITZGERALD, M. P., BIAS, T. K., & GURLEY-CALVEZ, T. (2015). The Affordable Care Act and Consumer Well-Being: Knowns and Unknowns. J Consum Aff, n/a-n/a. doi:10.1111/joca.12059
Garfield, R., & Damico, A. (2016, January 21). The Coverage Gap: Uninsured Poor Adults in States that Do Not Expand Medicaid – An Update | The Henry J. Kaiser Family Foundation. Retrieved from
Medicaid. (2015). Eligibility | Retrieved from
Musumeci, B. (2014, April 8). The Affordable Care Act’s Impact on Medicaid Eligibility, Enrollment, and Benefits for People with Disabilities | The Henry J. Kaiser Family Foundation. Retrieved from
Obamacare Facts. (2015, July). ObamaCare Deficit and Debt – Obamacare Facts. Retrieved from
Sneed, T. (2015, September 22). More Whites Gain Obamacare Coverage Than Blacks And Latinos Combined. Retrieved from

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