It has been two years since president Obama put a new health care reform into law, also named the affordable health care act plan (ACA). The reform obligates every individual to obtain health care insurance, or else penalized. The United States spends more on healthcare than any other industrialized nation. Even with Medicare and Medicaid; there are still almost 50 million people without healthcare coverage. By offering universal health care, the reform is a way to provide nearly 30 million new people with health insurance. The reform is needed now for its advantageous effects on some important aspects in health care and economy.
Democrats, who are the leading voice when it comes to ACA, argue that the reform does not violate any constitutional law, and that the reform comes to improve Medicare laws, quality of health care, and lower premiums down as well. It’s also going to boost the economy by reducing national deficits. To begin with, the “individual mandate “ portion of the ACA plan, which states that every person is required to have health insurance or else penalized, is purely constitutional, and those who disagree with that did not take a deep look at the constitutional provisions.
Under the constitutional provisions, Congress has the power to regulate interstate commerce (health insurance industry), “for the general welfare” among the several states (Wydra 2), to tax, and to enact “Necessary and Proper” clauses that are used to implement the previous powers. Due to the powers of Congress, the new health care law was enacted to regulate health insurance policies across the states, and under constitutional laws, Congress has the power to pose necessary and proper policies as well as regulate interstate commerce.
So, the part of law that forces people to buy health insurance is constitutional. According to Wydra, “health care reform falls squarely within Congress’s power to enact necessary and proper legislation to carry out its power to regulate commerce and tax and spend for the general welfare” (3). Overall, the ACA did not violate any of three constitutional provisions. Moreover, the part of law that penalizes people who chose to stay uninsured is constitutional.
The penalty here basically works as a tax, and if one looks deeply, it will be found that it is equal to the amount of money that would cost the uninsured to buy health insurance. This amount of money is used to cover the ACA plan expenses and subsidizes families who wish to purchase health insurance. So, “the provision really operates as a tax”, and under the constitutional laws, Congress has the power to tax (Metzger 633). Thus, the ACA plan is constitutional. Congress felt that changes in Medicare laws for seniors fell into their authority to pose necessary and proper policies.
The Affordable Care Act (ACA) plan reforms Medicare Part C (which offers Medicare Advantage) and Part D plans (which covers prescription drugs through private insurance companies). It cuts Medicare advantage of Part C that provides benefits to seniors through private health insurance companies. These changes also close the coverage gap under Part D, also known as the” doughnut hole”, which states that beneficiaries who reach a limit of $2,700 of drug cost would fall in the doughnut hole where they must pay the entire cost of their prescription drugs until they reach a limit of $6,145 of drug cost.
In fact, cutting Medicare Advantage does not mean cutting Medicare benefits. It would just direct the money towards increasing the quality of health care through more affordable preventive services. Besides, it would be pointless to waste a lot of money to cover benefits that are originally covered under the traditional Medicare plans (Parts A and Part B). As the article “Health Care Reform Does Not Cut Medicare Benefits” states, “starting in 2014, 85% of MA plans’ revenues must go towards benefits, not profits, or plans may be subject to sanction”.
Another pro of the ACA plan is that it works to help people exit from the doughnut hole, by giving those category of people a gradually increasing discounts on the cost of prescribed drugs, which starts at 50% and end at 25% in 2020. As Filipik and Anderson say, “now, Medicare enrollees will see that coverage [gap] disappear by 2020, and be replaced by 25% cost sharing across the board for both generic and brand drugs”.
Health care reform targets to decrease the waste of money and increase the quality of care (1). Additionally, the ACA improves the quality of health care in the long run, through encouraging physician-patient collaboration to establish a better effective delivery plan through standards founded by the Shared-decision Making Resource Center, as Cohen and Dougherty say, “the establishment of Shared-decision Making Resource Center will facilitate collaboration between patients and primary care providers” (11).
It also offers hospitals and doctors incentives if they perform better, as “Medicare Benefits and Changes” illustrates, “for the first time, Medicare will reward quality, not quantity; thus, bonus payments will be given to those doctors and hospitals that provide good quality care”(1). Benefits of the health care reform exceed improving quality of health care to include lowering premiums costs. Many people complain from the skyrocketing prices of premium insurance. Without the ACA plan, Americans would face rapidly rising cost of premiums.
The ACA plan forces health insurance companies to follow certain set of standards for premiums and its prices. “The affordable care act increases insurance company accountability by supporting states review of premium increases, setting standards for the amount of premiums spent on benefits versus overhead”, and “posting insurance price information for transparency” (healthcare. gov). Moreover, companies should spend 80% of premiums on care and quality, and if they did not follow the rule, they must rebate their customers.
As stated on healthcare. gov, “insurers must either meet the new minimum loss ratio requirements by spending at least 80 percent of premiums on care and quality improvement or offers customers rebates in 2012” (“health insurance premiums” 5) Also, it’s hard to ignore the competition in the individual market exchange (market where you can purchase health insurance at a low competitive price), would make premiums to lower down, and expand them over a wide number of people. These new choices complement the design of the exchanges, which will encourage new private health plans to develop and compete given that there will be a level playing field of competition based on price, quality and services offered” (“health insurance premiums” 7) . All in all, the health care reform works to lower premiums. The expansion of Health care Exchange Market, and make health insurance affordable would also have its beneficial effect on National debt.
According to reliable forecasts made by the Congressional Budget Office (CBO) in 2010, the ACA comes to reduce health costs and National debt. “The CBO estimates that the deficit will decline by $143 billion over its first 10 years” (Holahan 1). Fortunately, the estimation was proved by a recent study conducted by the University of California Irvine and the Virginia Commonwealth Health system on 26,000 uninsured people, allowing them to access primary care services in the same area in Virginia for three years till now.
The study results in lowering the annual health care costs per enrollee from $8,899 to $4,569 paid through Medicare. According to Ungar, ”the study reveals that, on average, the total annual health care costs per enrollee fall from $8,899 in year one, to a startling $4,569 in year three” (1). It was concluded that increasing annual checkups that can detect small illnesses, and treat them before they become complicated and expensive, can help cut costs.
Also, increasing primary care visits can lead to fewer emergency room visits and hospital admissions, which in turn reduce health care costs. Thus reduced health care costs, would follow lowering payments to hospitals, and consequently partake in lowering National debt. In brief, the affordable health care act is needed now more than ever for the general welfare of society. I think that a public option would not only provide healthcare for the uninsured, but help curtail the skyrocketing costs of healthcare, by reducing premiums and adjusting Medicare laws.
Moreover, incentives offered to doctors and hospitals would improve the quality of health care. Also the economy would receive a much needed boost, when reducing federal debt by reforming health care. It is also cleared that the health care Act is well within the authority of the Congress under the Commerce Clause, and it does not violate the principles of the constitution. For all the advantages mentioned above, the health care reform is important to solve a lot of problems with healthcare and economy in the U. S.