What would happen if ACA shuts tomorrow?

Abhinav Shashank
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James Truslow in his famous book “Epic of America” introduced a concept which is today the national ethos of the USA. The ‘American dream’, where every American has an equal opportunity for everything! But are all Americans getting a chance to live that dream? How far is the reality from it? Are we getting any closer to it? The efforts we are putting today, are they sufficient?


What is ACA?

In 2010, Patient Prevention and Affordable Care Act was introduced as an effort to reform the healthcare reform, but the debate whether it was a reform or an unnecessary burden on Federal budget started was before. The debate hasn’t stopped and certainly won’t. Till date, there have been around sixty attempts to modify the act. What is the reason for debate?

People who have been benefitted by Affordable care Act have stories to tell. There is one thing for which Affordable Care Act is praised even by the opponents. Let us take up an example to understand that. The story of the Clint Murphy, who happens to be a supporter of the Affordable Care Act, despite being a former Republican. Clint lives in Savannah as a real estate agent. He survived an acute episode of testicular cancer. Now that is a great news, except for one thing! He won’t be able to avail Health insurance because of a pre-existing condition.

For many others like Clint, with pre-existing conditions, ACA is a boon. The Insurers cannot turn down people with pre-existing conditions under Affordable care Act. Besides this, certain advances have been made in Medicaid and Medicare as per ACA.


Major changes under Affordable Care Act

  1.    People under or equivalent to 133% of the Federal Poverty Limit can now avail Medicaid. Formerly, this was 100% of the Federal poverty line.
  2.    People with pre-existing conditions cannot be denied Health Insurance or charged extra.
  3.    People earning less than or equal to 400% of Federal Poverty line can avail low-cost insurance.
  4.    Women get preventive care benefits that include contraception, screening process and much more.
  5.    The previous share of Federal Government in Medicaid was more than or equal to 50%. This figure has been increased to 90 to 100% of the total cost.
  6.    Children below the age of 26 can stay on the Health Insurance of their parents.
  7.    The subsidies, government is going to provide under Affordable care Act will put pressure on the Federal Budget. To compensate for that Federal Government has included two initiatives which have been approved by the Supreme Court. These are:
  •        Individual Mandate: According to this, every person in US is required to have a health coverage. This brings healthy people in the loop to act as a cushion for risk engagement. If a person chooses otherwise, then he/she will be penalized for it. The fines started in 2014 with $95 or 1% of their household income, whichever is greater. They were increased to $325 or 2% of their household income in 2015. The full penalty will be levied in 2016 which will be $695 or 2.5% of their household income. The system has been previously tested in Massachusetts and it was successful.
  •        Employer Mandate: Under this mandate, the employer with 50 or more employees in the company should be able to afford the pay of the employees such that they are covered by a health insurance. If the company fails to comply, it’ll be fined.


Why was Affordable Care Act needed?

Patient Prevention and Affordable Care Act was introduced when America just came out of an economic downturn. The 2008 global crisis had a huge impact on the healthcare industry of the US. Millions of people lost their jobs and health covers. As high as 50 million Americans were without healthcare coverage. It has six years since the Affordable care Act was passed and millions of people got health cover, still 32 million citizens are yet to be covered and what needs to be done has to be figured out. Is shutting down ACA one way?

Many say it has helped them. Most of these are patients, which should be the target. After all, this all for the greater good of the patients. Is it a good idea to shut down Affordable Care Act? Let’s see how it’ll affect America.

 

6 ways shutting down ACA will affect America

  1.    The Federal budget deficit would increase by $137 billion.
  2.    Approximately 25 million of Americans would lose health insurance.
  3.    The immediate price of premiums will go up.
  4.    As pre-existing clause is done away with, 1 in 2 Americans would be affected by this.
  5.    No tax rebate for businesses with less than 25 employees.
  6.    Over 20 million women would no longer get access to preventive care which included contraception, cancer
    and others.


Reasons for these effects?

  1.    An increase in the federal deficit is one the most surprising after effect of shutting down ACA. The reason behind this increase in deficit is that the number of healthy people taking mandatory health insurance under individual mandate and other provisions is very high. Thus, the amount of revenue collected is way more than the amount of money spent on subsidies and covers.
  2.    Almost 25 million would lose health insurance due to the fact that when ACA was made the major focus was on covering more and more people. Once ACA is removed, people under 133%, but above 100% of the federal poverty line would no longer get cover. Moreover, young adults below the age of 26 will not get the healthcare cover of their parents.
  3.    The cost of premiums is something which ACA has controlled the most. The people with pre-existing who were being covered had to pay a very high premium. Besides this population, people under 400% federal poverty line will no longer get low cost insurance.
  4.    When ACA came in, people with pre-existing conditions were the most relieved ones. As ACA is done away with, things will roll back to the old times where these people either had to pay a lot for health cover or just pay a lot for healthcare.
  5.    The most terrifying that could happen is small businesses who aren’t capable of paying higher taxes are made to do so. This is because at present approximately half of the uninsured population is either a small business owner or a dependent. The tax rebate this section of the population gets is up to 50%.
  6.    Under Affordable Care Act, almost 20 million women get access to preventive care, which includes cancer screenings, contraception and so on.


What should be done with Affordable Care Act?

The Affordable Care Act is a very elaborate and has over four hundred sections and even more provisions. Each provision addresses a unique problem in US healthcare. Is repealing such an elaborate law the best idea? Or reviewing it and making it better?

Before Affordable Care Act came, hospitals spent around $100 billion on uncompensated care. Keeping that in mind, let’s discuss the elephant in the room! Whether the providers would still treat the population the same way, knowing that the particular population has no health cover and most likely no means to pay?

 

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