Affordable Care Act
|Hail to the Chief?|
|Persons of interest|
“”Obamacare: "Keep calling it that. That way, when everyone loves it, they'll know who to thank!"
The Patient Protection and Affordable Care Act (PPACA or just ACA) is a law passed by Congress and signed by President Barack Obama in March 2010 that reformed the
gag-inducing positively terrific health care system in the United States. The act "puts in place comprehensive health insurance reforms that will hold insurance companies more accountable, lower health care costs, guarantee more health care choices, and enhance the quality of health care for all Americans." It was the biggest overhaul US health care had seen in quite a long time. The act is often referred to by the neologism Romneycare "Obamacare" by its detractors.
Despite having the aim of ensuring that every American has health insurance, it is not even close to being a universal health care system; consequently, everyone in countries with universal health care (ie. almost the entirety of the Western world) is laughing at it.
Health care reform was one of Obama's goals when he took office in 2009. Once debate over health care reform began, it became a big political issue that received much attention in the media along with fierce support and criticism. The Affordable Care Act passed 219-212 in the House and 60-39 in the Senate, a process that took around six months.
“”He has demonstrated, when he stepped into government in a very difficult state, that he could work in a difficult partisan environment, take some good conservative ideas, like private health insurance, and apply them to the need to have everyone insured.
|—Jim DeMint, this quote will live with you forever.|
The Affordable Care Act is meant to lower costs and to improve health care quality. Probably the most notable aspect of the law is the expansion of coverage to 32 million more Americans. Some of the provisions the law implements include:
- a Patient's Bill of Rights to protect consumers from some of the worst insurance company abuses
- resources that assist states in keeping health premiums down, protect consumers, and expand consumers' health choices
- creating a Pre-Existing Condition Insurance Plan that allows people who have
an excuse for insurance companies to deny them the basic right to survivea pre-existing condition to receive coverage
- creating the Early Retiree Reinsurance Program so businesses can better provide coverage to retirees who aren't yet eligible for Medicare
- measures that will help small businesses claim their tax credit and allow the country's health care system to save costs while being more efficient
- allowing younger people to remain on their parents' health care plan until age 26
The most controversial part of "Obamacare" is the "individual mandate," requiring that every American either purchase health insurance or pay an annual fine. The Supreme Court upheld this part in National Federation of Independent Business v. Sebelius, 567 U.S. ___ (2012) which is no surprise as a similar individual mandate was applied to sailors in the early 1790s by the 1st Congress, which had a fairly large amount of members who were framers of the Constitution.
Not all of the act was implemented when it was passed.
Starting September 23, 2010 services such as mammograms, immunizations, and colonoscopies (aka preventive services) will be covered by insurance and insurance companies will be banned from charging co-payments, co-insurance or deductibles for these. Consumers will also have the right to appeal a decision by an insurance company to a third party and choose which provider within their plan's network of doctors they want.
Other provisions are gradually instated between 2010 and 2014. The goal of the act is to provide a new competitive insurance marketplace.
 Criticism from the left
Some from the more liberal side of the spectrum claim that the law doesn't go far enough and that it should bring the US's health care system closer to a universal health care system. Specifically, they point to Obama's campaign support of a public health insurance option, which was included in the House version of the bill. The law's current requirement for insurers to dedicate 80% of their premiums to health care, however, has been seen by some as paving the way for a possible single-payer or public option in the future.
 Right-wing criticism
The law is opposed by many on the right. They see it as a breach of the federal government's power and responsibility, and labeled it as an unpopular law that will be disastrous for the country. Mike Huckabee put out a well known commercial asking people to support the act's repeal. Strangely enough, many health insurance companies are also opposed to the act, presumably because the federal government is curbing their ability to abuse their power. In particular, the GOP has an unreserved and unconditional loathing for this bill, having used any excuse to try to get it repealed under the guise that it is "job killing." As it happens, the bill was run by the Congressional Budget Office, who don't take sides, and they said the effect on jobs would "probably be minimal," and then only because people get healthcare outside their jobs, while repealing the bill would lead to a deficit increase of about $210 billion. The Republican response was something like this:
“”This is a job-killing law, period. Anyone who argues otherwise is ignoring the construct of the health care law and the widely accepted facts.
They also cited a figure of 650,000 jobs, which they claimed was in the CBO report; but it was not, and the Republican statement was rated as "false" by PolitiFact's Truth-O-Meter.
In addition, at least five major court rulings have been made concerning the bill. Four of them declare it to be constitutional and therefore removes the grounds for repeal. One, though — which was also the one involving 26 separate states, led by Florida — said the bill was not constitutional, and referred it up.
On June 28, 2012, the Supreme Court ruled that the law was constitutional, including the individual mandate — owing not to the government's power to regulate interstate commerce, but to the government's powers of taxation, since the only penalty for not purchasing health insurance is that one has to pay more tax. This appears to have been a last second decision, as the popular speculation in the weeks preceding the decision was that the individual mandate, if not the whole law, was almost certain to be struck down.
 More hysterical reaction
Despite the fact that Obama's original health care plan did not include any nationalizations, instead focusing on regulatory measures such as outlawing the denial of coverage based on "pre-existing conditions," the plan's detractors have been squawking that it is a secret communist plot and will lead to the creation of "death panels" that decide whether your grandmother lives or dies (the insurance companies themselves are doing just fine rationing health care, thank you very much). This batshittery extended to the belief that it would create of a secret army at Obama's disposal.
Not surprisingly, these people have not had an original idea on this subject in over 40 years; the arguments presented against "Obamacare" are virtually identical to those presented by Saint Reagan in a 1961 speech. In that speech, Reagan warned that if the U.S. were to adopt Medicare, the country would be on the slippery slope to err... socialism. Needless to say, when Medicare passed soon after that, the promised socialism did not even come close to making an appearance.
Ironically enough, the idea of mandating people to buy health insurance was long supported by right-wing individuals and organizations until it became the staple of Obama's health reform. For example, Newt Gingrich was a longtime supporter of individual mandates, speaking in favor of it even as late as 2011. Another example is the Heritage Foundation, who already in the late 80's came out in support of individual mandates. It makes you wonder what changed their mind.
- Read the Whole Thing!
- Seven Falsehoods about Health Care, FactCheck
- A Final Weekend of Whoppers, FactCheck
- Obama's Private Army, FactCheck
- Job-killing evidence falls short, PolitiFact
- Three Days of Argument: Obamacare On Trial Audiobook - Complete coverage of the arguments to the Supreme Court regarding Obamacare
- Health Care Reform Thought Bubble - A summary of the US debate so far.
- ↑ Healthcare.gov: About the Law
- ↑ Not exactly "ramming in" a bill. (If you want a comparison, ARRA passed in three weeks.)
- ↑ Mitt Romney's Health-Care Reform, The New Yorker
- ↑ 4.0 4.1 Whitehouse.gov: The Affordable Care Act
- ↑ Let the Memes Begin..., The New York Times
- ↑ Harvard Law professor says early Congress mandated health insurance for seamen and gun ownership for most men (Politifact)
- ↑ See the Wikipedia article on HR 3962#Comparison with Senate version.
- ↑ 
- ↑ Politifact
- ↑ http://www.salon.com/2012/06/28/did_john_roberts_switch_his_vote/
- ↑ Hat tip to Louie Gohmert for this one.
- ↑ Rick Santorum calls Newt Gingrich a longtime supporter of insurance mandate (Politifact)
- ↑ How the Heritage Foundation, a Conservative Think Tank, Promoted the Individual Mandate