Obama Health Care Law - Essay Example

Health sciences and Medicine 6 January Obama Health Care Law The health care bill was the most expansive social legislation enacted into law back in march 2010 for the benefit the American’s citizens. For quite a long duration, it had been a tussle between the Democrats and Republicans in the government, with the later group giving strong opposition before and after the health reforms were made. However, even after the republican’s attorneys sort a repeal of the law, the U.S. Supreme Court upheld the health care law signed by President Obama as constitutional in June 2012, ruling that the individual mandate portion of the law be maintained within congress’ power under the taxation clause (Smith, cnn.com). The ruling was as a result of several sections of the enacted law being challenged as unconstitutional by a combination of certain states, whose appeal had been defeated in the Washington D.C. court of appeal, before seeking for further legal hearing. The law is wide and covers numerous different components focusing on the consumer (patients), health care providers (medical practitioners), insurance companies, and extended private and public organizations (including drug manufactures and employers among others). According to Ebokudom, the patient protection and affordable care act addressed the following issues of reform; “quality, affordable health care for all Americans; the role of public programs of Medicare, Medicaid, and CHIP; improvements in the quality and efficiency of health care … community living assistance services and support; and revenue provisions ” (248). The law spans across different ages and social status to protect patients’ health and needs. It is surely no doubt that it will affect every individual come 2014, when each person in the United States is expected to have enrolled in a health plan. Of course there are still hardships in the implementation of the law so far, especially in the context that some individuals still do not understand how some parts of the law would be applicable. Nevertheless, the act comes with packages of some essential health benefits, even after costing the federal government huge investment of public resources. Pros: Application of the health care law on abortion is an improvement to women health services, which many people continue to reject. Women will be allowed to pay for abortion coverage for the special cases that involve risks to their health. The law offers better care and protection initiatives for seniors in Medicare programs, as will be discussed below. The insurance companies will now have to extend coverage to children, young adults and other people, even if they have preexisting conditions, removing discrimination in insurance companies. The Health care law is working hard to improve transparency in insurance companies, while protecting and informing the consumers of their rights, and cutting wasteful spending and fraud in health care. Medical practitioners will receive more incentives, and in return, they are expected to deliver quality services even to the door steps in communities, at least for the sake of the seniors and children health. The law eliminates annual limits on insurance coverage, enhances preventive services, avails information to consumers, offers discounts on drug prescription, and provides flexible insurance cover plans for individuals, households, and employers. Cons: The newly operating businesses (small and large) will have to plan for an extra cost of insurance cover for their employees come 2014, otherwise they will have to bear the harsh penalties. Insurance companies feel burdened for having to cover for high risk patients, which could adversely affect their profit margins in business. According to McCaughey, there are chances that decision making power would be transferred from doctors to the federal government, and hikes in tax as the law tries to cover for new entitlements who will be receiving taxpayer funded subsidies; institutions could reduce care for seniors as the law force cuts back on Medicare payments (2-7). Similarly, including more people in the coverage plan by cutting back on the Medicare in the next 10 years would trigger an imbalance between the resources available, and the population seeking health care services. Impact on small businesses: The law provides health insurance tax credits for the eligible small businesses, to be able to offer insurance benefits to their employees. These businesses will only need to provide the coverage they can afford to their workers, without being pushed. However, they are encouraged to provide the coverage, due to the benefits of the tax credits that will see most of the small businesses save quite a lot through the scheme. Most SMEs in the USA see the plan as a threat to their enterprises, but in the long run, the government will have exempted them from paying billions of dollars through taxes. According to the United States department of Health & Human services, the initial phase of this provision provides a credit worth up to 35 percent of the employer’s input to the health insurance of his/her employees’, and 25 % to small non profit organizations (healthcare.gov). There are numerous operating SMEs in the USA without insurance coverage for their employees; unlike large businesses who have put the measure and experienced the benefits, the small businesses too need to rethink on the strategy, and ensure their businesses and workforce are well protected. The benefit of the law will be experienced through the general premium reduction, considering that in the past, small businesses have been paying close to 18 % more, compared to large businesses for a similar health insurance policy (“Q: Will be required,” whitehouse.gov). Additionally, the small enterprises will be protected from such incidences of arbitrary rate hikes, due to employees’ unexpected health illnesses. The first phase of the tax credit mentioned earlier is just but the beginning, because come 2014, enrolled small businesses will enjoy more tax credits of up to 50%, with 35% for non profit (“Obama care small,” obamacarefacts.com). At the same period, it is expected that the businesses will have a further option of selecting a qualified health plan, through the shop exchange program that will be available for the small businesses to best suit the budgets. The plan generally increases chances of quality health through affordable means at the exposure of the small businesses. The disadvantage arises from the bitter truth of being penalized for not providing employees with a minimum coverage. Small businesses that fail to cover their employees will be penalized $2000 per worker, and $3000 if they buy the health insurance via exchange program with premium credits (“Obama care small,” obamacarefacts.com). This will equate to an expensive insurance cover, different from the minimum standards set by the Obama care. However, the Obama care has resulted to the working hours of a number of employees being cut, hence affecting the small businesses operations. Impact on Sole Proprietor: The impact of the health care to this group or any other category that has no employees will be similar to that of an individual. There is quite a huge difference from the small businesses, since the group is not entitled for tax credits, but is rather expected to fulfill the individual mandate. Therefore, all sole proprietors are expected to have health coverage as they are viewed by the government as individuals in the health insurance market place. In the future (2014), the sole proprietors will have to purchase insurance cover through their state’s benefit exchange programs; failure to comply with the law would result to a penalty of $695 or 2.5 percent of their income (“HSAs, HRAs,” hsafinder.com). However, the law does consider few exceptions depending on religious backgrounds and individuals’ income. The self employed or individuals who are uninsured, but with incomes within 133 and 400 percent of poverty level, would purchase insurance with available subsidies (Jackson and Nolen, cbsnews.com). The advantage of this is that it puts the sole proprietors at an equal platform with others. No one has to escape the health insurance plan, since it was meant for all the Americans. The only disadvantage it puts across is that it will force the sole proprietors to purchase the insurance, rather than invest the money in expanding or sustaining their businesses. To them, the resources they struggle to acquire seem to be channeled in the wrong direction, which is not their will, but now that it is law, they have an obligation to fulfill. Impact on senior citizens: For a long period the older Americans have been using more health services compared to any other age group, and for a fact the population is aging day by day, hence increasing the number of senior citizens. The health care reform proposed to cut $555 billion from Medicare in a span of the next 10 years, hoping to use some of the resources to include more people in the government health care plan. The law has placed their measures to strengthen Medicare, while intending to offer more illegible seniors a wide scope of preventive services without cost sharing in the first 12 months of part B coverage, and provide discounts on drugs once the seniors are in the coverage gap (Donut hole) (U.S. Department of Health & Human Services healthcare.gov). Some of these preventive benefit services are yearly wellness visits, no cost screenings, and tobacco use cessation counseling. The seniors (65 or older) are at a more prone age of being attacked by various diseases, and such services would cater for their health needs. The Medicare drug price discount seals the gap in drug coverage leading to a 50% lay off in cost of covered brand name drugs, and 86% for generic drugs. The discounts in insurance coverage are enjoyed by any individual who exists in the gap all the way to 2020 at its closure. The high risk Medicare beneficiaries, who may need to be readmitted every now and then due to repetitive illnesses, could benefit from the community care transition program that is intended to coordinate care, while connecting patients to services in their communities (US department of Health & Human services, healthcare.gov). Apart from the community service, seniors who hit the donut hole by 2010 would be entitled to receive $250 rebate. At the same time, those transiting into the senior age and have no employer sponsored coverage have an assurance of acquiring an insurance policy despite their conditions. However, those opposing the law argue that as more numbers of people are added in the health care plan, the number of doctors offering the services has not been added; meaning that the government is putting too much obligations ahead, yet the resources (doctors and finances) have remained few for each Medicare beneficiary. Impact on age group 18 to 25: In the insurance reforms, insuring companies have been banned from denying coverage to any individuals with preexisting conditions. Come 2014, the companies will have no choice, but to cover the approaching youths with such conditions. As much as it applies to any age group, the young adults too seem to benefit from this. However, the core benefit to this group is that it will continue to stay on their parents’ coverage, until they reach 26 years of age (US department of Health & Human services, healthcare.gov). The extension of the coverage for the youth will provide them with more time to clear colleges and get employed. The law does not overrule American colleges and universities Student Health Programs (SHP), but brings some changes to remedy their health insurance coverage, so that it meets all the requirements under the affordable care act. Impact on corporations: The numerous companies affected range from pharmaceuticals, drug manufacturers, insurance companies, hospitals, and other related profit and non profit organizations. The insurance companies have heavily been affected by the law, which holds them accountable for plans to lower the health care premiums. According to the law, for all the premiums gathered by insurance companies, a minimum of 85% for large employing companies and 80% for small/individual employers should be channeled to health care services, and their quality improvement (US department of Health & Human services, healthcare.gov). The companies have felt strained in making their profits, but at the same time, the law requires that if the companies fail to comply, then consumers are entitled to refunds. The insurance companies will also have to justify their premium hikes, so that the consumers are protected from exploitation and fraud in service delivery. Again, insurance corporations will have no choice, but to cover for the health care of different age groups (including children and old age), even if they have pre existing conditions. On the other hand pharmaceuticals, manufacturers, and other life science companies could experience accounting issues, arising from their reduction in net revenues because of the discounts, penalties, rebates, and taxes policies. However, the benefits for all these corporations would be high in the long run, since the number of patients visiting the hospitals (public and private) will increase, more people will have to purchase the insurance cover, increase in pharmaceuticals customers and stock, and lead to more drug manufacturing meaning more distribution and consumption. The expansion in heath care plans would effectively lead to increase in revenue for most of these corporations in the long run. Does it apply to all Businesses? The health care law affects all businesses within the United States. Through its different sections, both profit and non profit organizations are affected by taxations and insurance policies. Entrepreneurs, sole proprietors, SMEs, and large businesses have to also comply with the law, failure to which they will pay fines. Business have been the pillar for economic development in USA, and they employ huge numbers of workers who need quality health care services, among other related needs in social life. Therefore, any employers as organizations or businesses have to support the welfare of their employees’ to a particular level, to ease the burden of health care cost among Americans. Even the individual businesses within the poverty level have to apply for insurance coverage with minimal subsidies. However, in the application of law, certain exemptions are granted to businesses for a specific period of time, before resuming to full compliance. For example, there can be waivers for annual benefits, such as those granted to the 1168 businesses and unions (Week Staff, week.com). The law is a complex structure touching on learning institutions, households, private and public businesses, and spanning across economic and social domains. Works Cited “HSAs, HRAs More Likely for Individuals, Companies as Obama Care Passes Supreme Court.” hsafinder.com. 2013. Web. 6 February, 2013. Jackson, J., and Nolen, J. “Health Care Reform Bill Summary: A Look at what’s in the Bill.” cbsnews.com. 21 March, 2010. Web. 6 February, 2013. McCaughey, B. Obama Health Law: What It Says and How to Overturn It. Encounter Books: New York, 2010. Print. “Obama Care Small Business Facts.” obamacarefacts.com. n.d. Web. 6 February, 2013. “Q: Will I be required to Provide Coverage that I Can’t Afford.” whitehouse.gov. n.d. Web. 6 February, 2013. Smith, E. “Timeline of the Health care Law.” cnn.com. 28 June, 2012. Web. 6 February, 2013. Ubokudom, S. E. United States Health Care Policymaking: Ideological, Social and Cultural Differences and Major Influences. Springer: New York, 2012. Print. U.S. Department of Health & Human Services. “Key Features of the Affordable Care Act, By Year.” healthcare.gov n.d. Web. 6 February, 2013. U.S. Department of Health & Human Services. “65 or Older.” healthcare.gov. n.d. Web. 6 February, 2013. Week Staff. “Waiving Health Care Reform: Is Obama Playing favorites?” theweek.com. 5 April, 2011. Web, 6 February, 2013. Read More