Essay on How the Bill Came Into Existence: The Healthcare Reform Bill 101

As stated by Cannan (2013), the Healthcare Reform Bill 101 or otherwise known as Affordable Care Act or Obamacare is a landmark healthcare law signed by President Barrack Obama in March 2010. Various key events led to the existence of this act. In July 2009, House Democrats revealed their plans for overhauling health care systems. In November 2009, the House voted for America's Affordable Health Care for Act (Cannan, 2013). The passage of the bill confirmed majority agreement in the Congress' two chambers. In December 2009, a version of the Senates bill was voted by 60 Democrats (Cannan, 2013). Only 39 senators opposed the bill from the Republicans side. In January 2010, a Republican, Scott Brown, won special elections in the Senate to finish the remaining part of Ted Kennedy's term. Brown was against the bill, and to the surprise of many, he won a victory in a state that was consistently voting for Democrats. Obama guaranteed all American protection from ill treatment in the insurance industry. In February 2010, Obama called for a bipartisan healthcare meeting for both Democrats and Republican (Cannan, 2013). He said that approaches from both parties to healthcare shared many things in common than many people would imagine. On 21st March 2010, the version of the Senates bill was passed in a 219- 212 votes in the House of Representatives (Cannan, 2013). Thirty-nine Democrats voted against the bill alongside all Republicans. On 23rd of March the same year, President Obama signed the Healthcare Reform Bill 101 (Affordable Care Act) into law.

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The Timeline of Proposed Changes (20102020)

The healthcare timeline accounts for the reforms in healthcare insurance and the key milestones found within the Affordable Care Act; how it affects healthcare in the US and its citizens. In June 2010, adults with existing problems were allowed to join temporary high-risk pools for the uninsured. Pre-Existing Condition Insurance Plan (PCIP) started offering insurance in July 2010 to those who were denied in the past by private companies (Cannan, 2013). In September 2011, Health insurers were required to go public at a rate of 10% increase or more (Cannan, 2013). In 2012, "pay-for-quality" motive started, which promoted quality services in health care centers. A new tax was initiated on private health insurance plans. In 2013, low to middle-income Americans were opened Health Insurance Exchanges to ease the process of shopping protection services. In 2014, insurance companies could not use any factor such as gender, occupation among others to increase premiums. Small businesses providing coverage became subject to tax credits. In 2015, the income of doctors was based on a quality of service provided not the quantity. In 2016, there was an increment in the threshold to itemize medical expenses on taxes for seniors from 7.5 % to 10 % (Cannan, 2013). At the beginning of 2017, individual health insurance plans, which purchased before January 1, 2014, became illegal. In 2018, all health care plans should offer preventive coverage including those held before preventive care was required. In 2020, the law is scheduled to do away with Medicare Gap.

Key Features of the Law

According to Borochin and Golec (2016), the major key element entailed in the act is boosting the quality of the healthcare services. The salary of physicians is based on quality and not quantity. The higher the quality of the healthcare service offered, the higher the pay of the doctor. It entered into force from January 2015 in all states. Secondly, the law increased access to affordable care and insurance services. The law promotes individual responsibility in that those who cannot afford it can get a basic insurance coverage. If affordable coverage is unavailable, then the person qualifies for an exemption. The law also increases access to Medicaid. People were earning less than $14000 and a family of four making less than $29000 qualify for enrollment in Medicaid (Borochin & Golec, 2016). Establishment of insurance marketplaces also helped to increase the accessibility. Thirdly, the law lowers cost of healthcare services. Insurance has been made more affordable and easier to get to the middle class due to these tax credits. It is possible to advance the tax credit hence reducing an individual's premium payments every month. Lastly, the law provides for new consumer protection. One way to ensure consumer protection is by prohibiting discrimination due to gender or preexisting conditions (Borochin & Golec, 2016). Other ways include doing away with annual limits on insurance cover and ensuring that people in clinical trials are covered.

How Are The Changes Affecting Employees And Employers?

There are various ways in which the companies and staff are affected. An article by Buchmueller, Carey, and Levy (2013), they state that beginning from 2015, the employers were supposed to have a responsibility to offer health coverage to their employees. Failure to do this, the companies are subject to fines. Employers are supposed to provide coverage that meets certain minimum standards. Stores and restaurants have to adhere to this despite their ignorance in the past (Buchmueller et al., 2013). It applies only to bosses with more than fifty workers. Employers with less than fifty workers do not have any responsibility. Employers with less than 25 employees are entitled to tax credits (Buchmueller et al., 2013). For the employees, they have the advantage since the provision of the act requires their employers to provide coverage for them. However, they might be negatively affected in that their companies may want to compensate the insurance costs by cutting back on the insurance policy. For the part-time workers, the law does not allow them to get coverage from their employees. According to the act, people working for less than thirty hours a week are the part-time employees.

How the Changes Have Changed the Organizations' Philosophy towards Benefit-Planning

Changes provided in the Affordable Care Act pushed many organizations towards a new benefit planning to fit in the post-ACA world. Many businesses and firms have changed regarding the philosophy towards employees' health benefits. What organizations have done in the past can be used as a roadmap to the future (DeVoe, Angier, Hoopes, & Gold, 2016). The law reprimands employers who do not provide coverage to the employees if their firms have more than fifty workers. As a result of this provision, many organizations have reduced the number of employees to less than fifty to reduce the costs of insurance. Others cut back on the employees' insurance coverage (DeVoe et al., 2016). It is done to maintain the maximum benefits of the companies. According to the law, only those employees who work as full-time workers are eligible for the coverage by their employers. It has made employees to reduce the number of hours per week that employees work to avoid costs of insurance; that is they ensure the workers work for less than thirty hours a week.

What Direction the Plan Will Take In The Future

There have many political failures to repeal the act. At the various stages of legal systems, many unresolved challenges can be seen for example repeals of employers' responsibilities and mandates, individual mandate or both (DeVoe et al., 2016). Some people have suggested for a replacement of the preexisting condition ban with high-risk pools being established to ensure high premium costs. It makes the future of this plan unpredictable. Following the 2016's elections, the idea becomes even more unpredictable since the new president said that the law might be repealed in future.

References

Borochin, P., & Golec, J. (2016). Using options to measure the full value-effect of an event: Application to Obamacare. Journal of Financial Economics, 120(1), 169-193.

Buchmueller, T., Carey, C., & Levy, H. G. (2013). Will employers drop health insurance coverage because of the Affordable Care Act?. Health Affairs, 32(9), 1522-1530.

Cannan, J. (2013). A Legislative History of the Affordable Care Act: How Legislative Procedure Shapes Legislative History. Law Libr. J., 105, 131-173.

DeVoe, J., Angier, H., Hoopes, M., & Gold, R. (2016). A new role for primary care teams in the United States after Obamacare: Track and improve health insurance coverage rates. Family Medicine and Community Health, 4(4), 63-67.