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Robert Wright
Ms. Eaker
English 1102
March 29, 2014
People Most Concerned About the Affordable Care Act
Image you are on a family vacation a few hundred miles away from home. You go hiking
with the family and friends and you fall and break your arm. Your family provide first aid and
your friend runs to get help. An ambulance finally arrive and take you to the local hospital you
receive all the appropriate care, the doctor get an x-ray to confirm you broken are and then place
your arm in a cast. You finally make it back home and a week later your get a massive bill and a
letter from the insurance company stating you have to pay the bill in full, they will not take care
of the bill because you went to a hospital outside of your original hospital network. How would
you feel? You were on vacation, were you suppose to fly back home and wait to see a doctor in
your city? This is only one of many stories some individuals have about their insurance
company. The insurance company can find any reason to drop a person from their insurance
policy. The most common reason for individual being dropped from their insurance is
preexisting condition, which is when you have a health problem prior to signing up for
insurance. Now, a genetic disorder can also be seen as a preexisting condition, and if you
genuiny had no idea that you had a preexisting condition, your insurance could drop you from
your insurance leaving you to pay the hospital bill.
The Patient Protection and Affordability Care Act took effect March 23, 2010 after both
House of Representative and Senate passed the Bill.
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Before the implementation of the Patient Protection and Affordable Care Act (ACA) also
known as Obamacare many Americans went uninsured. In most cases due to the high prices
of insurance, unable to receive insurance because of a pre-existing conditions, and simply felt
that they didnt need insurance or it was cheaper to pay for their doctors visit out of pocket.
With healthcare cost on the rise, this issue left many hospitals, clinics, and Urgent Care
Units footing the bill for more than 47 million uninsured Americans. The healthcare system was
unregulated before 2010, which allowed insurance companies to deny coverage to Americans
that had a preexisting condition such as a genetic heart disease or cancer, insurance companies
would also charge women more for insurance than men or change the premium of a persons
health insurance with no notice. These factors combined count for why more than 44 million
Americans were uninsured.
Senator Obama became President Obama and put his Democratic ran House of
Representatives and Senate to work on a bill that would insure all Americans the opportunity to
be insured. The Bill set standards for basic health insurance coverage, expanded Medicaid
insurance for low income families, created a government healthcare marketplace. The market
place is where insurance companies compete with other insurance companies insuring the person
looking for insurance coverage get the best price. The bill also eliminated preexisting conditions
and terminated annual monetary caps on coverage and penalizing individuals that did not
purchase health insurance.
Healthcare was one of the biggest issues in the 2008 Democratic Presidential Primaries
and the 2009 U.S. Presidential Election. Senator Obama ran his campaign on the basis of his
promise to reform health care. Throughout the presidential campaign we start to hear the first and
most important voice of the uninsured American, the 2008 Census estimated 47 million people
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were found to be uninsured. Decreasing the number of uninsured is the goal of the Patient
Protection and Affordable Care Act. Before moving any further, we need to understand the one
aspect that determines who receives government assistance and who doesnt: The Federal
Poverty Level (FPL), this formula is based off of your gross income and the number of family
members. In order to be considered for benefits your FPL would have to be below 100%.
When the census most uninsured Americans states cost of premiums and out of pocket
cost such as co-payments as a reason for not having health care coverage.
The majority of uninsured Americans are families that have lower income and cant
afford to pay the out of pocket cost for health insurance. In an article Published by the Robert
Wood Johnson Foundation we see that cost is the most daunting concern among the uninsured.
In the article the researchers states that Medicaid fills gaps of many low income Americans, the
coverage is limited for adults that do not have children. Financial levels are set by states, and
most states economy very. This finical level set by the state may be very hard to meet and vary
state to state. Another large groups of people contributing to the number of uninsured
Americans are people who are new employees or employers did not offer insurance or the
insurance company refused to provided them coverage. The concern of this particular group of
people is the rising cost of health care and how much they will have to pay for health care
insurance when inflation and other living expenses get the better half of their paychecks. As
stated before, most uninsured families have low income so additional taxes, bills, or penalties
can be seen as adding to the hardship.
Another voice that we have heard in the news and political advertisements are the small
business owners. Small businesses before werent required provided health insurance if they had
less than 100 fulltime employees, now small companies are mandated by law to provide health
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insurance to their employees. The Affordable care Act now require small businesses with 50 full-
time employees or more to provide health care insurance to their employees. The recession of
2008 made it very difficult for small businesses to prosper. After 4 years the economy is finally
showing signs of recovery and small business are now staying afloat and competing with bigger
companies. Small business owners now feel like they have to jump through another hurdle and
are weary of what this means for the future of their business. Most small business owners find
the ACA confusing to understand and are not sure how the new law will affect them.
Republicans have been the front runner in the media and have spoken the loudest on the
issue of ACA. Republican politicians, particularly the House of Representatives republicans have
voted 50 time to repeal the ACA. Many republicans wanted to defund Obamacare based on
speculations that it will kill millions of job and the bumpy rollout of the massive law is proof it
will fail. In addition to killing jobs and the bumpy roll out. The politicians have argued daily
about the U.S. Budget and deficit. The most recent government shutdown was because of the
ACA; opposition leaders like Ted Cruz, Texas Republican Representative and Michelle
Bachman, Minnesota Republican Representative and other Tea Party members tied delaying or
defunding ACA to the Budget for Fiscal year 2014 (October 1, 2013-September 31,2014). The
Senate and President whom are Democratic would not negotiate with the Republican House of
Representatives and other Tea Party members on a bill that was already in place and funded from
the Budget for Fiscal year 2013. Days before the government shutdown, Ted Cruz relied on
public fear, to get the citizens to tell their elected officials to repeal Obamacare. In an interview
he stated If you go to the 1940s, Nazi Germany, Look, we saw in Britain, Neville Chamberlain,
who told the British people, Accept the Nazis. Yes, theyll dominate the continent of Europe but
thats not our problem. Lets appease them. Why? Because it cant be done. We cant possibly
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stand against them. The gridlock lead to a 16 day government shut down. The Budget was
finally approved and ACA still remained operational.
Another issue politicians discuss when asked about ACA is Medicaid and Medicare, the
government assisted health care for low income and elderly (65 or older). ACA expanded
Medicaid to the 133% FPL and pay 100% of medical bills for 2014, 2015, and 2016; 95% in
2017, 94% in 2018, and 93% in 2019 and 90% 2020. Some politicians believe Medicaid is
unsustainable. The government spend an estimated $211 Billion on Medicare and State
childrens Health Insurance Program (SCHIP). In other words the government will continue to
pay for a large portion of the medical care expensive for the need based population, but will shift
a small portion of the cost onto the patient every year, decreasing the amount the government
will spend until the amount reach 90% of the healthcare bill and the patient will pay 10% of the
health care bill.
The media cover the Affordable Care Act daily; many stories about it whether they are
true or false have been about cost as the underlying factor of a problem with healthcare reform.
The importance of cost present challenges in a different ways on an individual, business, and
government level. My reasoning for selecting ACA was inspired by a late night television show.
While watching Jimmy Kimmel Live it became apparent to me that I should stick Affordable
Care Act as my Line of Inquiry. Jimmy Kimmel sent his staff in the streets of Los Angeles to ask
Citizens about the ACA. Most of the people that were asked about the ACA has no idea it was
called Obamacare and was asked which one was better. No one could give a clear explanation of
why there were against the ACA. The majority also regurgitated words or reasoning from the
news media. The population depend on the media to rely factual information. With ACA being a
hot topic in the media it is very hard to get a clear understanding of what ACA is because the
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majority of news coverage only talk about the ACA from a political standpoint. The Affordable
Care Act protect patients from big insurance companies from raising premiums without notice, it
also require insurance companies to provide a quality coverage and include vaccinations and
preventative health care at no additional charge. Most importantly the Affordable Care Act
expand Medicaid to millions of people who cannot afford insurance.