American Healthcare: What are the Options?
Currently the United States’ healthcare is based on the Affordable Care Act (ACA), also known as Obamacare. It is seen as a failed system, so for some reason the U.S. Senate has decided that it needs to be immediately repealed even if there is no plan to replace it or there are better plans to amend it. President Trump has taken on the duty of fixing the American healthcare system, though he hasn’t been able to provide a a single, standard option. Instead, there are multiple plans floating around that are being mashed together. Trumpcare is touting Obamacare as failing and is supposed to be the better option, but so far for what has been detailed out for Trumpcare, it appears he is keeping some major tenets of Obamacare, while totally trashing tenets that the American people support. This blog aims to clarify what both what Obamacare and Trumpcare are, and picking out the similarities and differences, while attempting to start a conversation and piquing interest around the healthcare system.
The United States’ current healthcare initiative is called the Patient Protection and Affordable Care Act (PPACA) or Affordable Care Act (ACA). It is more commonly known as “Obamacare”(which was originally coined as a negative term by Republicans to draw ill-conceived comparisons between Obama’s healthcare option and Hillary Clinton’s failed option). It was signed into law in 2010 with the goal of increasing the amount of Americans that have access to affordable healthcare, while simultaneously decreasing the growth in healthcare spending. It aims to make these changes through consumer protections, regulations, subsidies, taxes, insurance exchanges, and other reforms.
Part of the reason that ACA was signed into law is because the the growing costs of Medicare and Medicaid were increasing healthcare costs that had to be paid for by the federal government’s budget. Currently, Medicare and Medicaid account for over a quarter of the federal budget. In fact, the number one reason people go bankrupt in this country (thus putting an even greater strain on the national deficit) is due to medical costs. The enforcement mechanism of ACA is through a 2.5% (maximum) tax on income if people do not retain health insurance for 9 of every 12 months. So while it is not necessary to buy into ACA, it is strongly encouraged and in the end inevitable.
The basis of providing Obamacare is that insurance companies must offer 10 benefits (i.e. meet the ACA’s criteria to ensure policy holders are getting coverage for important and necessary hospital visits); plans existing prior to 2010 are grand-fathered in. The costs from ACA can be explained here and here and clarified here.
The Top 3 Pros for Obamacare include:
- More people have health insurance overage.
- Coverage is more affordable to people and thus offers a wider range of coverage options.
- People with pre-existing conditions can no longer be denied coverage.
The Top 3 Cons of Obamacare include:
- Obamacare policies cost significantly more (likely more than the penalty tax). Premiums are likely to double.
- The Obamacare policies limit doctor choice.
- The Obamacare policies limit hospital choice (like state-of-the-art, international cancer hospitals).
For more points and in-depth ideas about the pros and cons of Obamacare, please see here. For an in-depth look at the benefits of Obamacare (like children can be applied to parent’s plans until age 26, and also provides scholarships and fund to double the number of healthcare providers) see here. For a look at what is wrong with Obamacare (like how confusing and massive ACA actually is, as well as increasing preventative costs in the short term), see here.
Trumpcare is a little harder to define because in its current state it is very general. In essence, it refers to any healthcare changes being made under President Trump. This can be a lot though, see as there are a handful of proposals being thrown around. The major provisions for Trumpcare include repealing the individual mandate (tax penalty for lacking insurance), repealing employer mandate (company plans have to meet criteria), ending states’ ability to expand Medicaid through Obamacare, eliminating cost-sharing subsidies (reduced deductible, copayments, and coinsurance), and repealing all new taxes created under Obamacare. For a list of greater changes (like charging elderly 5 times that of youth, and allowing states to obtain waivers for insurance companies to charge more from people with pre-existing conditions) that Trumpcare could bring about if ratified, see here.
For a comparison between Obamacare/ACA and Trumpcare/BCRA, please see here and here. For an excellent and very open conversation from people who care about policy, here is Pod Saves America’s initial take on the healthcare debate.
It appears that Americans don’t want Obamacare, but they also don’t want Trumpcare or whatever the Senate is trying to Frankenstein together. American dissatisfaction with their current healthcare system is evident, but it is unclear as to what exactly they want. And if they have an idea of what they want, there is no clear plan for how to implement it or pay for it. By attempting to understand the current system and attempting to foresee the advent of the Senate/Trumpcare system, it can become clear what Americans are hoping to get out of their healthcare and thus even change how healthcare in this country is provided and managed.
