Kirstie Bullock

Political Science 1100

Professor Jeanne Westgard
1 May 2014
Health Care Reform
The new Health Care Reform, or Obamacare, has raised a lot of controversy since the
release of its ideas. The purpose of the Health Care Reform is to make insurance more affordable
and makes our budge and economy more stable. It reduces the deficit by more than $100 billion
over the next 10 years and $1 trillion the following 10 years by cutting government overspending
and reining in waste, fraud and abuse. (White House, Overview of Health Reform) It gives
the middle class a tax cut in order to obtain health care; it also reduces premium costs for those
who are not able to acquire health coverage due to the higher prices of health providers. It also
prevents any health provider from declining a prospective member for any pre-existing
conditions. In other words, it no longer allows underwriting in the process of enrolling in a plan.
It helps decrease the out of pocket expenses for individuals and families. The cost is
expected to be $940 billing over ten years. Individuals and families who make between 100
percent 400 percent of the Federal Poverty Level (FPL) and want to purchase their own health
insurance on an exchange are eligible for subsidies. (Jackson and Nolen, Health Care Reform
Bill Summary: A Look At Whats in the Bill) In order to be eligible for these subsidies, they
cannot be eligible for Medicare, Medicaid or covered by an employer.
There will be different ways to pay for the plan. In 2018, insurance companies will begin
to pay 40% in excise taxes on sophisticated insurance plans that are worth over $27,500 for
families and $10,200 for individuals. Dental and vision plans will not be included in these costs.

Tanning services will be taxed 10%. The purpose of taxing tanning salons so much is for the aim
of reducing skin cancer rates. In addition, Medicare Payroll tax will be affected. The taxes began
in 2012 against investment income in order to expand, which includes unearned income. For
families making more than $250,000 per year, or individuals making $200,000 per year, the tax
amount is 3.8% on investment income.
Medicare is also affected by Health Care Reform. It began in 2010 and aims to close the
prescription drug coverage gap, otherwise known as the donut hole. It is estimated to be closed
by 2020. So far, in 2014, Medicare members pay 47.5% for brand-name drugs while in the
coverage gap, while they pay $72% for generic drugs in the coverage gap. The reason for the
difference in price is due to the brand-name drugs giving the members a 50% discount, while
insurance companies pay 2.5% of the drug. This is personal knowledge from working for a
private insurance company that services Medicare members. By 2020, Members will pay 25%
for both brand-name and generic drugs.
In addition to Medicare being affected, Medicaid will be affected. Medicaid will be
expanded to include 133% of the federal poverty level. This is considered $29,327 for a family
of four, for example. (Jackson and Nolen, Health Care Reform Bill Summary: A Look at
Whats in the Bill) This requires states to include adults who dont have children. The Federal
Government will pay 100% of costs to cover newly eligible individuals from now and through
2016. The candidates must be American citizens in order to be eligible for Medicaid.
As for the remaining insurance reforms, insurance companies cannot deny children
coverage with pre-existing conditions. In fact, they cannot deny anyone at all with pre-existing
conditions. They must allow children to be able to remain on their parents insurance plans until
they turn 26. For any individual to enroll, they can use Marketplace, which is a website that

helps individuals find health coverage. It can be customized in order to find private health
insurance, lower costs based on household size and income, and can help find Medicaid and
Childrens Health Insurance Programs (CHIP). The Marketplace advises a person must have
health coverage in 2014 for they can pay a penalty. It can usually be 1% of the individuals
income, or $95 per adult and $47.50 per child, whichever is higher. When the 2015 income taxes
roll around, this is where the fees will be applied. Its estimated at about $695 annually, with the
exception of low-income persons.
There is not currently a mandate for employers to provide health insurance for their
employees; however, employers with more than 50 employees must provide health insurance or
pay a fine of $2,000 per worker each year if any of their workers receive federal subsidies to
purchase health insurance. (Jackson and Nolen, Health Care Reform Bill Summary: A Look at
Whats in the Bill) Immigrants will not be allowed to buy health insurance, even if they pay
completely with their own money. Insurance companies are not required to cover abortion. States
are able to pass legislation to choose to opt out of offering abortion coverage. Individuals would
have to pay for abortion coverage by making two separate payments. Private funds will be kept
in a separate account form federal and taxpayer funds. Anti-abortion Democrats worked with the
White House in order to prevent federal funds going in to abortions except for cases of rape,
incest or the mothers health is in jeopardy.
With all the complexity of the reform, it has started to become clearer. There were dozens
of repeal attempts in Congress and anti-Obamacare Republicans still attempt to prevent the
Health Care Reform. (Culp-Ressler, How Obamacare Opponents Are Twisting the Health
Reform Law To Obstruct Abortion Access) The biggest conflict is the limit on abortion. About
20 states prohibit insurance coverage for abortions. Typically, women pay significantly more

than men because of caring for their reproductive health care. The Health Care Reform plans to
address the gender-based differences, which is a plus for women. What it will do is eliminate copays for many of womens essential preventative services such as contraception. With this in
mind, since the reform leaves abortion services up to a states determination, the opposers are
claiming Obamacares provisions are for punishing women who seek abortions by making them
pay large out-of-pocket costs. Abortion coverage restrictions were a nonissue for an incredibly
long amount of time, says Elizabeth Nash of the Gutt-macher Institute. That law really
encouraged states to go in and pass these abortion coverage restrictions in their own health
exchanges. (Smith, Abortion coverage: The new battleground for states)
When the designs of the reform were introduced, many felt they were being forced to
purchase something they did not want to buy. It was argued against capitalism, which is having a
choice among the providers and to stay out of the marketplace altogether. A federal district court
judge ruled it as unconstitutional. Technically speaking, the government isnt forcing anyone to
purchase health insurance, but they are going to tax Americans for it, which they do have the
right to do. This seems to show an encouragement in a way for an individual to obtain health
insurance. It seems, however, that the big issue is not being looked at. The largest reason for
bankruptcies in the United States was from unpaid medical bills. Obamacare may not completely
get rid of the situation due to some high-deductible plans, for example, as discussed in 2013.
However, 2014 may be shedding a little more light on the decision.
Supporters were cautious at first. It was thought that the goal of 7 million sign-ups were
unattainable. Supporters even advised not to read too much in to the figures. The numbers dont
affect the functioning of the law, and, as with anything new and life-changing, there could still
be some problems. The crucial thing to understand about the Affordable Care Act is that its a

Rube Goldberg device, a complicated way to do something inherently simple, says Paul
Krugman of the New York Times. The biggest risk to reform has always been that the scheme
would founder on its complexity. And now we know that this wont happen. He continues to
explain that many other advanced countries have government-provided health insurance. We
have our own program similar to that. Its known as Medicare, for older Americans. Medicare
shows that it is politically possible to provide health insurance with a government-ran program.
It has shown to be a victory for the Democratic Party. It has shown that it is already
working by providing vital aid to millions of Americans. With the previous statement that
Obamacare may not completely get rid of the situation, it can significantly help. In order to
prevent any diseases or any other life altering health problems, it is best to see a doctor, who may
be able to catch any symptoms prior to the climax of problems. Preventive care can be less costly
and can give insight as to the individuals current health situation.
With the anticipation of the Health Care Reform start, it seems that things are working
itself out. The Health Care Reform is attempting to cut government overspending while allowing
individuals to attain health insurance. It makes insurance affordable for the middle class in the
poverty levels. If an individual chooses not to enroll in a health plan, then they will pay taxes
when their 2015 tax return comes around. This is meant for an encouragement to enroll in order
to prevent any issues such as bankruptcies from high medical costs. Those with pre-existing
conditions can rest easy, because they can now get the coverage they need in order to treat their
conditions. In order to fund the reform, taxes are put in to place where health can be affected, or
so it seems, such as taxes on tanning salons. Its estimated to reduce costs by more than $100
billion in the next decade and more than $1 trillion for the second decade. Indeed the Democrats
are able to stand proudly with their victory, while the Republicans transition to the change.

Works Cited
Closing the Coverage GapMedicare Prescription Drugs Are Becoming More Affordable.
Medicare.gov. CMS. February 2014. Web. 1 May 2014.
Get Covered: A one-page guide to the Health Insurance Marketplace. Healthcare.gov. N.P.,
N.D., Web. 1 May 2014.
Overview of Health Reform. Whithouse.gov. N.P., N.D., Web. 1 May 2014.
CBSNews. Healthcare Reform Opponents May Rue a Victory. CBS. N.P. 16 January 2011.
Web. 1 May 2014.
Culp-Ressler, Tara. How Obamacare Opponents Are Twisting The Health Reform Law To
Obstruct Abortion Access. Thinkprogress.org. N.P. 13 February 2013. Web. 1 May
2014.
Fayed, Lisa. The Health Care Reform Tan Tax: Salon Tanners To Feel The Heat of The Health
Care Reform Bill. About.com. N.P. 9 November 2010. Web. 1 May 2014.
Jackson, Jill and Jolen Nolen. Health Care Reform Bill Summary: A Look At What's in the
Bill. CBS News. N.P., 21 March 2010. Web. 1 May 2014.
Krugman, Paul. Krugman: Despite complexity, health reform has won. The New York Times.
The Salt Lake Tribune. 5 April 2014. Web. 1 May 2014.
Mangan, Dan. Medical Bills Are the Biggest Cause of US Bankruptcies: Study. CNBC. N.P.
25 June 2013. Web. 1 May 2014.
Smith, Kathryn. Abortion coverage: The new battleground for states. Politico. N.P. 31 January
2013. Web. 1 May 2014.