Running head: THE IMPACT OF THE HEALTH CARE REFORM

The Impact of the Health Care Reform

Sabina Appelzoller
RWS 1301
Professor Gallardo
October 25, 2015

THE IMPACT OF THE HEALTH CARE REFORM

Abstract
In the 2008 Presidential Election then Democratic candidate, Barrack Obama, campaigned to
reform the health care system in America. Since assuming office in January of 2009, President
Obama and his administration pushed for improved quality, affordability, and for the expansion
of health care coverage to all Americans. This was made official with the Patient Protection and
Affordable Care Act, which was upheld by the Supreme Court with a 5-4 ruling. For the
proponents of this act, the Democrats, this was a historic victory and landmark legislation
that would reform the US health care system. Although the opponents, the Republicans, have
called it a socialistic and unconstitutional takeover of the health care system. Considering
the impact of the Affordable Care Act will have on the nation, the particular group of enrollees
between the ages of 18 and 34 will face costlier health care plans that are initially higher to
subsidize for older beneficiaries.

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Introduction
On August 28, Senator Barrack Obama of Illinois, had become the official Democratic
Party nominee for the President of the United States at the 2008 Democratic National
Convention. The same night, Senator Joe Biden of Delaware, was nominated for Vice President.
The opposing presidential candidate was Hillary Rodham Clinton of New York, who stated that
she would fully endorse Barrack Obama. During the 2008 presidential election Barrack Obama
made historical strides running for president. His campaign was widely publicized being the first
African American candidate in history.
Throughout his election one of the issues he campaigned for was to reform the health
care system in the United States. With a close run against his opponent, Republican candidate
John McCain, Barrack Obama won the presidency. Barrack Obama had 52.9% of the popular
vote and 365 electoral votes. Since assuming office President Obama and his administration
worked to come up with a proposal for a health care reform. By July 14, 2009 a 1,107 page plan
for overhauling the health care system was introduced to congress (www.wikipedia.org,
https://en.wikipedia.org/wiki/Barack_Obama#Health_care_reform) with the intentions of both
the Senate and House of Representatives approving it by the end of 2009.
Health Care Debate
One of the primary main goals of the Obama Administration was to provide Universal
Health Care to Americans, meaning everyone is provided coverage disregarding their income,
gender, race, age, pre-existing conditions, or their wealth. Health policy experts and democrats
supporting their reasoning argued that it would most likely be possible if an individual mandate
was set in place. Everybody then would be contributing financially and that would prevent health
care access being taken advantage of. President Obama was convinced to include an individual

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mandate in the bill satisfying the Democratic views but now going against the Republicans who
opposed the mandate. With the disapproval of the Republicans they threatened to filibuster any
bill that would contain a mandate. At this point it was critical for the proponents, the Democrats
say it was bipartisan, because it would portray to the public that it was acceptable. This would
not be reached when the opponents, the Republican senators voted to call the individual mandate
unconstitutional (Klein, 2012). Journalist Ezra Klein also wrote in The New Yorker that "the
end result was ... a policy that once enjoyed broad support within the Republican Party suddenly
faced unified opposition."
While the House of Representatives continued to work on the Affordable Health Care for
America Act, the Senate began their own proposal for a bill, with the reason being that all
revenue related bills have to be drafted in the House of Representatives. Overall any bill
including an individual mandate would be filibustered by Republicans, so the Senate would
require 60 votes to end the debate and prevent them from doing so. With Senator Al Franken
switching to the Democratic Party, the Senate would have had the 60 votes for passage. Before
the bill could come up for a vote Democratic Senator Ted Kennedy passed away, depriving the
Democrats of their 60th vote. Negotiations to have the vote of moderate Democrat, Ben Nelson,
came to play to reach their anti-filibuster bill approval. Ben Nelson, who is pro-life, gave his
support and vote with the compromise of modifying language on abortion in the bill. His
demands were met with an abortion amendment, according to Jonathon Cohn from New republic
Magazine, The gist of the abortion amendment is that it'd give states the right to prohibit
coverage of abortion within their own insurance exchanges. On December 23, 2009 the Senate
voted 60-39 to end debate of the bill, with all democrats voting on it and all republicans voting
against it.

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When the new Senator, Republican Scott Brown was elected to replace the late
Ted Kennedy, the Democrats lost their filibuster proof majority and granted the Republicans
enough votes to sustain Republican filibusters.
President Obama met with the leaders of both parties
and concluded that the House of Representatives would
abandon its bill, the Affordable Health Care for
America Act, and pass the Senate's bill, the Patient
Protection and Affordable Care Act, instead. At the top right, President Obama signed the
PPACA into law on March 23, 2010.
The Patient Protection and Affordable Care Act
The Patient Protection and Affordable Care Act was signed into law by President Obama
on March 23, 2010. It is commonly called the Affordable Care Act (ACA). In general it is
referred to as Obamacare, By mid-2012, Obamacare had become the most common colloquial
term used to refer to the law by both supporters and opponents (www.wikipedia.org,
https://en.wikipedia.org/wiki/Barack_Obama#Health_care_reform). This was to be the biggest
change to health care since Medicaid and Medicare in 1965. The Affordable Care Act advocates
that health care is a right and not a privilege. Obamacares goal is to minimize the number of
uninsured Americans and make healthcare available to everyone at an affordable price (Rak &
Coffin, 2013). It would also work to improve the quality of health care provided by insurances.
Insurance companies would now by law have to oblige to new regulations such as spending
eighty cents of every premium dollar on health care and provide free preventative health care.
What is to come from Obamacare?

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Obamacare will provide new benefits, rights, and protections. Some benefits include free
preventative care, OB-GYN care without referrals, free or reduced prescription drugs, free birth
control and vaccines. Now young adults can remain under their parents plan until the age of 26.
At least 28 states have expanded their Medicare and Medicaid coverages and now more people
can be covered by it. Some protections include that insurance companies cannot deny someone
coverage or charge them extra for their health status such as having a previous condition. Gender
discrimination in prices will now be prevented also. To apply for coverage it is required to go to
a Health Insurance Marketplace (online comparison websites). Some states even have their own
state specific Marketplace set up. For those states who have not set up their own Marketplace
will be using the general Health Insurance Marketplace website, www.healthcare.gov. If states
decided to use their own marketplace the states must address a range of regulatory and design
issues to ensure that their exchanges are sustainable and meet the needs of their populations
(Hoffman, 2012). If one did not obtain health insurance during the open enrollment they will be
penalized by being mandated to pay a fine (individual mandate).
Efficiency of Obamacare
One half of the American people will get coverage by their employer, one third will get
coverage by the government with Medicaid or Medicare, one tenth will buy their own insurance
themselves, and a little under one tenth about 30 million of the American people, will
unfortunately still remain uncovered. Since the law was passed in 2010 at least 28 states have
expanded Medicaid allowing millions to gain coverage through Medicaid. In addition millions of
young adults have also gained coverage through their parents plans.
Conclusion
Overall more Americans are getting health care coverage because of Medicaid or
Medicare, but how exactly are we affording it? The general answer is through taxes, targeting the

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health care industry itself, wealthiest Americans having to pay more into Medicare, and hospitals
and insurance companies participating in the Medicare program will get paid a little bit less. As
described by public health contributor Scott Gottlieb from www.forbes.com, In order to offset
the high cost of the older, and probably less healthy people who are joining Obamacare plans, the
White House must coerce a sufficient number of thirty-somethings to also join. Problem is, the
health plans are too pricey to make economic sense for many young adults. Now that the ACA
allows young adults to stay on their parents plans until the age of many of the 32% of on
exchange enrollees were teenagers who were part of the familys policy. Under 20% of
Obamacare enrollees were between the ages of 18 and 34 (Gottlieb, 2014) which is still not
enough to satisfy the needs to subsidize for the elders insurance. Scott Gottlieb who analyzes
policy, regulation, and public health compared various incomes in different states to see what a
Classic Silver plan would cost a 30-year-old. In general in Texas it would take up about 10% of
income where Arizona will consume 14% of their income on health care premiums. The health
plans are intentionally higher for young adults to subsidize older beneficiaries. The future of the
Obamacare is uncertain leading back to if Congress and the question whether anyone in
Washington did any market research before they launched this scheme, to see whether
Millennials would show up (Gottlieb, 2014).

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References
Barrack Obama. (n.d.). In Wikipedia. Retrieved October 23, 2015, from
https://en.wikipedia.org/wiki/Barack_Obama#Health_care_reform
Cohn, J. (2009). Breaking: Nelson says yes; that makes 60. New Republic. Retrieved from
http://www.newrepublic.com/blog/the-treatment/breaking-nelson-says-yes-makes-60
DeMichele, T. (n.d.). Obamacare facts: Facts on the affordable care act. Retrieved October 23,
2015, from http://obamacarefacts.com/obamacare-facts/
Gottlieb, S. (2014). How much does obamacare rip off young adults? We ran the numbers. Here
are the results. Forbes Pharma/Health Care. Retrieved from
http://www.forbes.com/sites/scottgottlieb/2014/03/28/how-much-does-obamacare-rip-offgeneration-x-we-ran-the-numbers-here-are-the-results/
Hoffman, M. S. (December 2012). Health insurance exchanges under the patient protection and
affordable care act: Regulatory and design challenges. Journal of the American College
of Radiology, 9 (12). Retrieved from http://0www.sciencedirect.com.lib.utep.edu/science/article/pii/S154614401200539X
Klein, E. (2010). Unpopular mandate. The New Yorker. Retreived from
http://www.newyorker.com/magazine/2012/06/25/unpopular-mandate
Rak, S., Coffin, J. (March 2013). Affordable Care Act. The Journal of Medical Practice
Management. Retrieved from
http://search.proquest.com/openview/5001573538a2084d2c4c5facd624408f/1?pqorigsite=gscholar