By Alejandro Freixes, CCNN Head Writer
The Patient Protection and Affordable Care Act (PPACA), often referred to as “Obamacare” or the Affordable Care Act, was signed into law by US President Barack Obama on March 23, 2010. It represents the biggest transformation of the country’s healthcare system since the passage of Medicare and Medicaid in 1965, and has been a source of intense debate among Democrats, Republicans, and independents (those who don’t identify with one particular party).
A lot of the Obamacare law centers around the issue of health insurance, which is when people or businesses pay money to an insurance company in exchange for having medical costs partially covered. Without health insurance, it’s very expensive to pay for medicines and treatment, because you have to cover 100% of the cost out of your own pocket.
If someone can’t afford the price of insurance, they’ll often avoid going to the doctor and develop harmful physical conditions that can lead to death, disabilities, or very expensive treatments. If an uninsured person ends up in an emergency room, the hospital is required to treat them, even if they can’t pay the bills. This costs healthcare providers money, and the uninsured patient often ends up with thousands of dollars in debt that they have to pay off for much of their lifetime.
Indirectly, medical debt caused by treating the uninsured can even affect those who are insured, because someone has to pay the cost. If the hospital has to take the hit financially, they need to make more money, and so the costs of healthcare rise for everyone. The government also has to cover the costs of programs like Medicaid, and so taxpayers may be charged more to make up the difference.
So, what exactly does Obamacare do? Well, quite a bit. It’s 300,000-400,000 words long, so we could talk about it for hours, but there’s a few main issues causing division among American voters and politicians. Before we get to that, though, let’s talk about some of the big changes. The Affordable Care Act does everything from forcing fast food chains like McDonalds to display the calories in their food, to forbidding insurance companies from denying coverage to someone based on disabilities. It allows kids up to age 26 to be covered by their parents’ health insurance, extends the Medicare program to smaller hospitals, offers bonuses to small businesses that give healthcare to employees (but penalties if they don’t in certain cases), and reduces costs on seniors, while raising prices on younger people.
As far as the debate over pros and cons, here are the main issues in a nutshell: Supporters of Obamacare believe it pressures insurance companies to provide more affordable rates and cover those with chronic (permanent) health conditions, while encouraging uninsured people to purchase insurance – thus saving taxpayers and hospitals from treating people who can’t afford medical bills. Opponents believe Obamacare forces people and businesses to buy medical insurance (even if they can’t really afford it), punishing them with economic penalties if they don’t, and that the government is interfering with freedom of choice. Basically, each side believes costs will go up and the quality of healthcare will go down, depending on whether Obamacare is allowed to continue or not. There’s strong arguments on both sides, but since the Affordable Care Act is going to impact your health, it’s important to read up on it not only to be informed, but also to form your own critical opinion.
Currently, there is a major showdown in the US Congress over Obamacare, as the House of Representatives held their 41st vote to remove funds from Obamacare. Passing by a 230-189 vote along party lines, most Republicans voted to defund Obamacare and most Democrats voted against defunding it. If they’ve voted 40 times without succeeding, why are Republicans pushing so hard right now? Because on October 1, 2014, the Obamacare system really gets going with open enrollment as people begin shopping for insurance under the plan.
Now, it’s not like Obamacare has been sitting around since 2010, twiddling its thumbs while waiting for October 1. Several changes have already gone into effect, like how parents can add children up to age 26 to their insurance and new insurance companies can’t deny coverage to chronically ill children. By January 1, 2014, though, insurance coverage obtained under Obamacare goes into effect, with penalties beginning at $95 a year per person (or 1% of a family’s income, whichever is more), for those who refuse to purchase it. Insurance companies will be unable to deny coverage based on pre-existing conditions, and can’t charge higher rates because of someone’s medical history. On March 31, 2014, the open enrollment period ends for the year, and won’t reopen again until October 2014. By January 1, 2015, businesses with 50 or more workers must provide health benefits or they’ll be forced to pay fines.
Although the threat of a “government shutdown” is being used by anti-Obamacare lawmakers in Congress to pressure defunding of the healthcare law, it’s unlikely to happen. Both sides will increase the sharpness of their words, and there might be short-term delays in funding, but eventually Obamacare will continue. The Democratic-led Senate will just reject defunding requests from the Republican-led House of Representatives, ending in a stalemate. Even Republicans like Senator John McCain believe their party, led by House Speaker John Boehner, will not succeed in preventing the change. McCain, expressed “we will not repeal or defund Obamacare” because of the Senate, “and to think we can is not rational.” He added that it’s “pretty obvious that (Boehner) has great difficulties…” and Republican representative Harold Rogers believes “a government shutdown is a political game in which everyone loses.”