Health Insurance in The Affordable Care Act

A person’s health is unpredictable; therefore, even if a person thinks they are healthy now, an illness or a freak accident could occur within a very short amount of time. Health insurance is available to the United States populations for those reasons. (Olivero) A staggering twenty-nine million people had no form of health insurance in the 2015 census. Although the percentage dropped by 1.3 percent from 10.4 percent in 2014 to 9.1 percent, the number is still high. (Barnett) By choosing not to have healthcare a person risks having to pay penalty fees, financial ruin if a person would become seriously ill, no preventive or primary care, and may have difficulty finding follow-up care. (Olivero) Health insurance affects when people get care, where they get their care, and ultimately how healthy they are. The uninsured population can hurt when preventable conditions and chronic diseases remain untreated because of their lack of medical care. (KFF)

Some people argue that the problem of health insurance started as early as the 1930s. In an effort to keep the government out of the industry, the A.M.A. created a private sector model. This model was private health insurance. Over the years, they fought legislation by expanding insurance coverage. In 1965, however, Congress created Medicare because the private insurance companies failed to cover an appropriate amount of the elderly. This caused a rise in the demand for healthcare, which ultimately led to quickly rising medical costs. In an effort to get control of prices, the insurance companies started taking over the medical field by controlling treatment regulations tied to compensations. Today, insurance companies control a large part of medical care. The problem now is to bring down the costs, legislation must pass regulations to allow more ways of coverage than just a private insurance. (Chapin) In the 1980s, the healthcare first started to become more privatized, and by the 1990s the cost of health care was rising at twice the rate of inflation, and by the end of those ten years, forty-four million people, or sixteen percent of the population, had no health insurance at all. Now, in the twenty-first century, health care costs are still rising, and people are still uninsured. (PBS)

A large part of why this problem continues in the cost of health insurance. With the Affordable Care Act, people now have to pay a penalty; however, but some people continue to get away with not having to pay anything. The cost issue leaves many people somewhat stranded. They can’t afford to buy their own health insurance, but they don’t qualify for a federal subsidy either. Also, you can be exempt from paying a penalty if you have experienced certain hardships. (Pietrangelo) Forty-five percent of nonelderly adults who were uninsured said the reason was too high of costs. A person can also lose coverage in different situations such as changing jobs, losing a spouse or parent, or age. Also, not all employers provide insurance to their employees. With government programs such as Medicaid and CHIP, low-income children have options, but adults do not have as many choices. Another group of uninsured are the undocumented immigrants. Because they do no reside here lawfully, they do not qualify for Medicaid or any private insurer. Even legal immigrants can only earn tax credits if they are under 400 percent of the poverty line. After receiving qualified immigration status, an individual must wait another five years before qualifying for Medicaid. (KFF)

One major policy option is accepting and expanding the Affordable Care Act in the states who have not yet. If more states choose to expand the Medicaid coverage under the ACA, more low-income individuals will have access to health insurance. Since a major reason for people living uninsured is cost, as stated before, lowering the cost and making federal programs more available would help lower the number of uninsured individuals in the United States. A second option to help resolve some of the issue is to look at the private insurance companies. Today, many insurance plans include very high deductibles and premiums that the insured have to pay. Economists have proposed that the government help insurance companies pay for the sickest, most expensive people if there are not enough healthy people to balance them out because those are the people who drive up the cost of premiums to begin with. With a balance of sick and healthy, the premiums of insurance policies will be able to lower. The ending result of lower premiums will be more people being able to afford health insurance. (Abelson) Finally, some economists believe the US should take a European route when it comes to health insurance. For example, in the countries of Britain, Italy, Spain, and Sweden, every citizen is enrolled in a government-run health system. In these countries, a majority of healthcare is paid for completely by the government; however, private insurance still exists for the people who can afford it and want a private plan. By having a government run health insurance system, it helps all the people who cannot afford private insurance, but do not qualify for the country’s current subsidy programs. (The Economist)

The solution that I would choose for this problem would be giving a large majority of the financial responsibility on the government. The largest problem of our health insurance system is the cost, and as mentioned before, most uninsured people are uninsured simply because they cannot afford the cost of insurance, yet do not qualify for government subsidies. By giving the financial burden of healthcare to our government, I believe more people will utilize health insurance benefits, and the population may become healthier because of it. When people do not have insurance, they often do not receive preventative and primary care (Olivero). However, some of the uninsured population today still receive care and do not pay their bills.

According to Jeff Smedsrud, CEO of HealthCare.com, that cost is then turned over to insured people, making the cost of healthcare even more for them (Pietrangelo). The fact that The Affordable Care Act was enacted years ago, and states still will not implement its full potential makes it hard to see the light for the future of that attempted policy fix. Also, the second reason, in my opinion, would also be hard to agree upon between the government and the insurance companies because it is hard to know where to draw the line when it comes to who is paying for what. The cost of healthcare has been too high for many for so long, and several attempts have been made to fix the system and failed. The European model is proven better than the US model in two main ways. One, America spent a total of seventeen percent of the GDP, not even covering every citizen, while none of the European systems costed more than twelve percent of their GDP. Secondly, Europeans have a longer life expectancy than the United States. (The Economist) To lower the number of uninsured citizens in the US, copying the European model seems to be one of our best chances based on the information I have gathered.