Question

Discuss the cultural underpinnings supporting pros and cons of health care reform and the Affordable Care Act in the United States.

Answer 1

Ans) The Affordable Care Act (ACA), also known as Obamacare, has garnered a lot of debate since its implementation in 2010. Although it has created a minimum level of coverage for many insured Americans’ healthcare benefits, it has also created some costly tax penalties for those who don’t participate. Even you may have a pros and cons list from your experience with the Affordable Care Act.

- As the healthcare reform debate continues, the market continues to change. Initially, many health insurance companies—lacking the information they need to ensure their financial stability—left the ACA’s marketplaces. As the marketplace stabilizes, some companies are returning, and other are expanding their health insurance offerings.

- So, in order to weigh both sides of the ongoing debate, we have jotted down a few of the more widespread Affordable Care Act pros and cons.

Affordable Care Act Pros and Cons:
• Pros:
The introduction of subsidies
Subsidies make purchasing health insurance less expensive for those who qualify. Also, the implementation of the 80/20 rule means 80% of your premium dollars is spent on healthcare instead of administrative costs.

- Free preventive care:
All qualified health insurance plans must provide 10 essential health benefits, including free preventive and wellness visits. No copay. No deductible. No coinsurance.

No surprise cancellations or pre-existing denials
Insurance companies can’t cancel your policy because of a mistake on an application. Insurance companies also cannot deny coverage for a pre-existing condition (unless your plan is grandfathered).

Medicaid is more inclusive for many
For states that have chosen to expand their program, Medicaid coverage now includes uninsured Americans under 138% of the poverty level.

Dependents stay under parents’ plan longer
You can continue to have your children insured under your health plan until they are 26.

No more unreasonable limits:
Limits on lifetime benefits have been completely banned and annual limits phased out. (This does not include grandfathered plans).

Cons:
The cost has not decreased for everyone
Those who do not qualify for subsidies may find health insurance plans sold on the marketplace unaffordable. Customers may end up paying more for a plan that includes benefits, such as maternity care, that they may not need.

Loss of company-sponsored health plans
Some businesses may find it more cost-effective to pay the penalty and let their employees purchase their own insurance on the exchanges rather than provide employer-sponsored coverage.

Tax penalties
Prior to 2019, you could face large tax penalties if you were uninsured. The national penalty no longer exists, but some states are now enacting health insurance mandates of their own.

Shrinking networks
Many insurance companies made their provider networks smaller in an effort to cut costs while implementing ACA requirements. This left customers with fewer providers that are “in-network.”

Shopping for coverage can be complicated
With the confusion surrounding the rollout of the ACA and the marketplace, limited enrollment periods, difficulties with the websites and more options to choose from, shopping for coverage can be more complicated.

Marketplace uncertainty can raise costs
While the marketplace appears to be stabilizing, many counties still have only one insurance option because of insurance cancellations, decreasing competition, and increasing costs.