The impact that “Obamacare” has had on America since 2010: Patient Protection and Affordable Care Act (PPACA)
Over the past years, the US has implemented significant health reforms to promote quality health services deliver for its citizens. The most outstanding milestone is the Patient Protection and Affordable Care Act of 2010, otherwise termed as the Affordable Care Act, but commonly known as the Obamacare (Jones, 2017). In March 23, 2010, President Obama signed the bill into law as a promise laid down in his 2008 campaign manifesto to provide Americans with affordable, quality healthcare and curtail the upsurge in healthcare spending, among other purposes (Maloney et al., 2018). This is in line with the World Health Organization’s (2018), principles on health as a fundamental right for everyone, emphasizing the responsibility of governments to ensure complete physical, mental, and social wellbeing of its subjects. Significant reforms have encapsulated the law, to enhance the national healthcare system with significant opposition from the Republican legislators. Since its conception, the PPACA has contributed significantly in reforming this crucial sector. This paper reviews the impact of the legislation from 2010 to 2022.
2010 Through 2014
The PPACA has made significant impact in the health care sector as a result of various health care reforms. The US recorded a noteworthy increase in the number of Americans receiving insurance coverage. According to HHS (2015), since the inception of the PPACA coverage, more than 16 million uninsured Americans received healthcare coverage, significantly curtailing the rate of uninsured Americans across all races and ethnicities. Greater declines were experienced among the African Americans and the Hispanics at a rate of 9.2 percent (2.3 million adults) and 12.3 percent (4.2 million adults), respectively (HHS, 2015). HHS (2015), further reports that between 2010 and 2014, at least 5.7 million young adults were covered through the Act by allowing them to be covered by their parents’ plan until the age of 26 years, with broader expansion of coverage via Medicaid and the Health Insurance Marketplaces. By mid-2014, the rate of uninsured young adults reduced by more than 40 percent (Furman & Fielder, 2015).
More consumers were also protected as they received low cost healthcare with greater service value. Jones (2017), reported that at least 129 million Americans with pre-existing conditions, encompassing nearly 17 million children are eligible for cover because of their medical condition. Moreover, up to 105 million Americans are no longer subjected to lifetime caps on their coverage (Musco & Sommers, 2012), while another 76 million Americans, encompassing 30 million and 18 million women and children, respectively, with private coverage were received preventative services coverage under the Act (Burke & Simmons, 2014). The law further demanded that insurance companies spend not less than 80 percent of every premium dollar on the health care needs of the consumers. As a result, since 2011, healthcare consumers in American have saved more than US$ 9 billion (CMS, 2013). The law also empowered States to not only review but also negotiate premium adjustments. However, in 2014, the average employer-provided family coverage premium increased by 3 percent (Henry J Kaiser Family Foundation, 2014). Nonetheless, at least 6.4 million seniors and physically challenged Americans saved more than US$ 15 billion on prescription drugs between 2010 and 2014 (Jones, 2017). Jones (2017), notes that by decreasing the Medicare prescription drug donut hole, each elderly as well as disabled beneficiaries saved an average of US$ 1,598. Imperatively, between 2012 and 2013, more than 150,000 patient readmissions, 50,000 patient deaths, and US$ 12 billion health care costs were avoided (AHRQ, 2018). Over the same period, Accountable Care Organizations offered coordinated quality care for nearly 8 million beneficiaries (CMS, 2015a). Moreover, the law has anti-fraud provisions that have contributed to the recovery of moneys via the Health Care Fraud and Abuse Control program. During the financial year 2014, US$ 3.3 billion in taxpayer dollars was recovered (CMS, 2015b).
The PPACA implementation from its conception until 2014 also affected other healthcare stakeholders. By 2010, businesses were eligible for a tax credit for no more than six years (NFIB Research Foundation 2013). Meanwhile, health care products and services providers of experienced an increase in operational costs as over-the-counter medications were taxed via Health Savings Accounts and Flexible Spending Accounts. For instance, NFIB Research Foundation (2013), states that OTC venders who did not qualify in either accounts saw their purchases doubled to 20 percent. Moreover, insurers were required to spend more than 85 percent of premiums on health care providers in outsized groups and 80 percent in small groups; those who failed returned the variance to consumers as rebates (NFIB Research Foundation, 2013). In addition, prior to 2014, employers contributed a maximum credit of 35 percent towards their employees’ health insurance premiums; even so, after 2014, businesses have had to pay up to 50 percent, but this was for policies obtained via Small Business Options Program exchanges (NFIB Research Foundation, 2013).