The 2010 Affordable Care Act

The 2010 Affordable Care Act

Introduction

            The Affordable Care Act is a legislation that was enacted on 23 March 2010 when President Barrack Obama signed it into law. It comprises of various reforms of healthcare security among American citizens. The reforms include better access to healthcare, consumer rights and protections, stronger Medicare and more affordable coverage. The Affordable Act stipulates that every American be entitled to affordable healthcare coverage with protection from improper insurance practices. Therefore, the aim of the law is to improve the lives of vulnerable people in the American society through quality health care and reduced costs. “The Affordable Care Act (ACA) has been hailed as the most important set of changes to American health insurance since the 1965 enactment of Medicare and Medicaid and, overtime, this hugely complex law could effectively reorder most aspects of the healthcare system (Teitelbaum et al, preface x).”The Supreme Court and other lower appellate courts had a role of reviewing the validity of the 2010 healthcare reform law before its endorsement. The review was done through the evaluation of several cases that had individual mandate and the Medicaid expansion as their central focus. Therefore, the constitutionality of the Affordable Care Act’s provisions was observed, by the Supreme Court, to evaluate Congress’s power to allow the provisions. The court later upheld the legislation that promotes a healthcare system that is equitable and accessible to every American citizen.

Discussion

Presidency

            The Healthcare legislation was necessary to President Barrack Obama because he believed that the health reform needed urgency of action according to the problems the vulnerable communities faced, in relation to their insurance coverage. His speech showed his determination to ensure equality among all social classes in America. Despite the difficulty he experienced together with the proponents in the beginning, President Obama went further to form a committee of experts to give the health policy enough impetuses. The healthcare reform was part of the president’s legislative initiatives during his campaign in 2007 and 2008. The president realized that some insurance companies imposed lifetime limits on the amount of care an American citizen received. Children with pre-existing conditions were discriminated against in the country, and the middle class did not have equal access to healthcare services. Various critics appealed against the Affordable Care Act’s provisions, and the Supreme Court had an obligation to deliver the verdict. The court upheld the president’s signature healthcare legislation.

President Obama had a major role in formulating the health policy. He set a health agenda because he considered it a primary public issue in need of reform. Following his encounter with several Americans, the president said that individuals with pre-existing conditions were denied health coverage and families with insurance were financially strained due to high insurance costs. In his persuasive speech, he also noted that uninsured citizens and businesses could choose an affordable healthcare from the available options in the competitive market. He built his program support by establishing the White House Office of Healthcare reform for a well-coordinated administration effort for the subject matter (Joyce, p181). He appointed experts and directors to spearhead the reform. However, some of the administrators were not consistent. This led to too much delay, but he embarked on a strategic attempt of delegating the Congress to draft the Healthcare reform Bill (Starr, p52). His predecessors attempted to introduce a reformed healthcare policy in the United States, but their efforts were rendered futile. Political differences proved to be an impediment in the Clinton administration when Clinton’s policies were not put into effect in 1993 (Foster, 17 May 2012). Former U.S president Clinton also formulated some healthcare provisions that would protect healthcare consumers’ rights and allow them to enjoy fair healthcare packages (). However, some politicians disapproved the provisions and in the end, they were not upheld. On the other hand, president Obama relentless with his campaign on a reformed health policy in America and upon taking his presidential office, he signed the Affordable Care Act into law in 2010. He was successful when motion was finally passed and upheld by the Supreme Court with more health insurance provisions to be implemented in 2014.

Under the Democratic Party, President Obama identified the health problem and saw the need to formulate a reformed healthcare policy. The policy went through a five-step process, which includes agenda building, policy formulation, policy adoption, policy implementation and policy evaluation. According to Schmidt et al (p295), the previous American healthcare system dwelled on the assumption that working-age persons received healthcare insurance from their employers. A considerable percentage of American citizens were uninsured at the beginning of the Great Recession in 2008. Young people were not entitled to health insurance benefits due to the traditional Medicare program in the United States. This and other healthcare problems such as high medical costs prompted the healthcare reform agenda with President Obama as its steward. Despite the industrial advancements that were evident in the United States by the 21st century, the universal health insurance was not available to American citizens (Schmidt et al, p296). Teitelbaum et al (p3) argue that policy and law are fundamental aspects in healthcare and public health improvements in the United States. The president’s legal principle was a framework of quality healthcare and according to him, if the healthcare reform was not endorsed, majority of American Citizens could lose their healthcare with a subsequently large federal deficit.

President Obama sought to establish a universal health insurance system for all Americans. He steered the health policy proposal through congress relentlessly by articulating its importance to the public. The proposal lacked federal monopoly and its concepts were anchored on the universal healthcare coverage. The drafting of a healthcare plan was largely delegated to congress by President Obama. Even after Congress passed the law, there were political debates around it that moved it to be under the control of the Supreme Court. American politicians, in the appellate courts, filed lawsuits against various aspects of the 2010 Affordable Care Act. However, the president has an advantage in influencing public opinion, and this was evident in persuading efforts of President Obama. “In times of crisis the presidency is arguably the most crucial institution in government because, when necessary, the president can act quickly, speak with one voice and represent the nation to the world (Sidlow et al, p287).”

Congress

Before becoming law, the Affordable Care Act went through several steps. In the United States, the president or members of the congress exclusively introduce law in the form of a drafted Bill. President Obama delegated the Congress to draft the healthcare Bill so that the legislators would have a sense of responsibility in the process (Sidlow et al, p282). Therefore, Congress embarked on the drafting process. During Congress’ annual recess in August, the healthcare Bill had three versions. Two versions were in different committees in the senate while the other version rested in the House of Representatives. This clash of ideas presented a vague approach of Obama’s healthcare plan. The public wallowed in confusion, in relation to the healthcare bill and its provisions, and it was difficult for President Obama to gain approval from Americans because of the misinformation. The normal congressional process involved congressional committees that delved into the crucial reform issues. The healthcare reports from the White House Office of Healthcare Reform showed the Congress the importance of reforming the American healthcare system. The basic message it passed to Congress was that the future economic state of the country and its fiscal stability highly depended on the healthcare reform proposed (Joyce, p182).

The Senate, Health, Education, Labor and Pension (HELP) Committee was the first to present its healthcare reform proposal on 9 June 2009 (Joyce, p183). The Senate Finance Committee was also in the process of drafting the healthcare reform proposal, but it delayed because of conflict on the cost and deficit reduction. Another draft from the House was issued on 19 June. The three committees in the House that discussed the healthcare reform were Education and Labor, Energy and Commerce, and Means and Ways. The House leadership introduced the America Healthy Choices Act on 14 July 2009 (Joyce, p183). The different bills drafted by the congressional committees were centered on the estimated costs that the Congressional Budget Office (CBO) was to analyze and address in the means of the reform plan.

The committees needed to be assured that the citizens or stakeholder’s feedback on the healthcare reform was positive before further debate. House Democratic Leaders and fiscally conservative Democrats propagated the healthcare reform in the House. “In the House, reform moved forward in July as House Democratic leaders agreed with fiscally conservative Democrats on negotiations to trim the Bill’s cost (Joyce, p190).” The combination of the elements of the HELP and Finance Committee bills was done by Harry Reid, a Senate Majority Leader. He also inserted the provision of limited public option according to the ideology of the liberals. President Obama struck a deal with hospital industry to eliminate public option so that the industry could be supported. The Senate began to consider the healthcare reform amidst lengthy debate, which was more prolonged than that of the House.

Senator Charles Schumer anticipated the feedback of the CBO on the revised budgetary estimations aligned to the Medicare provision. A healthcare reform Bill was finally passed by the Senate on 24 December after a lengthy debate that resulted to a party line vote of 60-39. According to Joyce (p193), the final bill excluded the Medicare expansion to persons of 55-64 years and public option as per the approach of the Democratic senators. Both the Senate and the House had passed a bill by the end of 2009 despite their different approaches. The Democratic Party and the Republican Party had criticisms against each other with the Republicans disapproving the Democratic plan as an adverse measure. On the other hand, President Obama termed the Republicans as obstructionists who were not flexible enough to realize the positive impact the health reform would bring to the United States.

In 2010, it was apparent that the White House was adopting the “Senate’s Bill first then reconciliation” strategy which was disapproved by the Republicans. The latter deemed it as an inappropriate strategy. Nevertheless, the Congressional Budget Office presented a revised estimation of the Senate’s bill with reconciliation. Much of the support from the entire Congress depended on the positive estimates of the CBO regarding the healthcare Bill. “President Obama used the CBO numbers on the short and long-term deficit reduction effects to attempt to sway other wavering House members (Joyce, p197).” With a vote of 219-212, the House approved the draft legislation on 21 March 2010.

Feedback

            The Healthcare Bill, which later became the Affordable Care Act, instigated various reactions from stakeholders in the United States during the Obama administration. The validity of the healthcare legislation was petitioned by various small business lobbying groups and the national Federation of Independent Businesses amidst 26 states. As originally passed, the healthcare Bill provoked reactions from Republicans who believed that it would be detrimental to the country in the long-term. The final Bill came from the Senate, which comprised of a majority of Democrats. However, it had to pass through the reconciliation process for amends on some of its earlier provisions. Republicans protested against the Bill in fury vowing to repeal it. Currently, republican politicians are campaigning for a change in the Affordable Care Act, and they are determined to win the presidential 2012 presidential elections in a bid to avert the law. The Supreme Court’s recent positive ruling on the healthcare ruling has also elicited various reactions from government officials and the public. According to Hoppe (28 June 2012), Senator John Cornyn expressed his disappointment on the Court’s decision and his focus on the election of a Republican president to end Obamacare.

On the other hand, proponents believe that the Affordable Care Act has been beneficial to multitudes of Americans and that the legislation will continue to help the most vulnerable communities in the United States such as people with pre-existing conditions, children, young adults and people with poor economic backgrounds. Republicans argue that the healthcare legislation compromises America’s federalism considering it an unprecedented expansion of the federal authority (Hoppe, 28 June 2012). Hence, according to them, the legislation presents a legal challenge. While a majority of the Republicans is determined to dismantle the law, democrats and most American citizens have embraced it as a major improvement in the healthcare system. The opponents’ passionate repulsion is caused by the compromise of federalism, which according to them has been understated in the Affordable Care Act. Before the Supreme Court made its ruling on the legislation, trials of various lawsuit cases concerning the Medicare and Individual Mandate provisions were presented and evaluated. The Republicans expected the Court’s ruling to be based on the constitutionality reflected in the federal law.

Recently, in the campaign for 2012 presidential election campaign, public opinion on Healthcare issues is more on Obama’s side. According to Kaiser Family Foundation’s latest tracking poll, President Obama surpassed Mit Romney on the healthcare legislation. “Although public opinion on Obama’s signature Healthcare laws remains negative, voters say Obama would do a better job “dealing with the future” of the law. They also trust him more than Romney with Medicare, Medicaid and on the issue of lowering Healthcare costs (Baker, 31 July 2012).” The tracking poll of the Kaiser Family Foundation shows the skeptic sentiments of Republicans in relation to the law and the GOP. Political personalities such as Rep, Michelle Bachmann of the House Tea Party Caucus and Senate Minority leader Mitch McConnell showed their negation of the current healthcare legislation despite the Supreme Court’s ruling and their intentions to repeal from the appropriate avenues (Baker, 31 July 2012).

Conclusion

            Concisely, the Affordable Care Act is a beneficial legislation to all American citizens since it promotes equitability and the health insurance coverage and protection. Despite the controversy that ensued after it was passed by Congress and approved by the Supreme Court, majority of Americans still believe in the President to have the ability of refining it further and assuring them a universal healthcare system with balanced provisions. President Obama, through his persuasive skills and political strategies in policy formulation and implementation, stands a chance of winning the votes of the American public one more time. The Congressional process of drafting Bills is lengthy and extensive to reach a consensus for the interests of the citizens. The feedback has been both positive and negative since the law was passed and upheld and it determines largely the presidential fate of President Obama. Therefore, according to the public opinion polls, the Affordable Care Act might still be in place after the 2012 elections.

References

Baker, Sam. Poll: Obama Tops Romney by Double Digits on Healthcare. 31 July 2012. Web. 4 August 2012.

Foster, N. What is Public Policy? 17 May 2012. Web.4 August 2012.

Hoppe, Christy. First Reactions to Healthcare Law Decision. 28 June 2012. Web. 4 August 2012.

Joyce, Philip. The Congressional Budget Office: Honest Numbers, Power and Policymaking. Georgetown University Press, 2011. Print.

Schmidt, W. S., Shelley, C. M. & Bardes, A. B. (2012). American Government and Politics Today. Cengage Learning.

Sidlow, Edward, Henschen, Beth, Gerston, Larry and Christensen, Terry. Govt, 2011 California Edition. Cengage Learning, 2010. Print.

Starr, Paul. Remedy and Reaction: The Peculiar American Struggle Over Health Care Reform. New Haven: Yale University Press, 2011. Print.

Last Completed Projects