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Health Policy Determinants Timeline

Health policy issue in the discussion is ObamaCare, otherwise known as the Patient Protection and Affordable Care Act (PPACA) or Affordable Care Act (ACA). This health policy was signed in March 23, 2010 with the plan of providing worth and affordable health care for American citizens while reducing expenditures in health care (Pipes, 2010).

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Adoption of ACA or PPACA came because of many events that saw Americans craving for a much better policy. There was a rise in the Health Care Expenditures. Just before ACA has been adopted, there were reports that expenditures on healthcare were always increasing. Using the period of 2000-2010, health expenditures grew at an average of 3-7% annually. It took place because of the new costs of technologies and medicine. It is true that new technology accounts for the rise in expenditures in almost all sectors of economy, healthcare being one of it. Pre-existing conditions and guaranteed issue is another relevant event. This concept of guaranteed issue was a regulation of the state level nature that had many effects on the health policies that were sold to the companies with 2 to 50 employees. The requirement for this was a mandatory cover for everyone and anyone with a policy desire despite the existence of pre-existing conditions that may have been expensive. This issue has always had a significant financial loss to the insurance companies. Health insurance issue was another major event. The state prohibited its citizens from purchasing insurance plans through different state lines. According to the state, it reduced competition of insurers thus keeping the costs of premiums much higher. According to various health reports, more than 44 million American citizens currently lack health insurance due to its extraordinary cost. The increase of wealth and disposable incomes of Americans is another event. The US population is known for having had huge income increases and high purchasing power since the beginning of 1950s. It in turn has a great influence on the always increasing health care expenditures. It has however affected citizens with low incomes as health expenditures cover them in general terms.

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The ACA or PPACA policy, like the previous policy, has its pros and cons that consider it either effective or ineffective. One of the issues that make it effective is the fact that a huge number of citizens will have the right to use eminent and reasonably priced health insurance. For the uninsured citizens, the health insurance marketplace of the state will provide free and low-cost insurances. In addition, there will be no denial of insurance coverage by insurance companies based on pre-existing conditions. It also comes with the law that insurance companies will no longer drop anyone with their coverage. The ObamaCare policy in turn curbs the ever-increasing growth of health care expenditures. The factors that render the policy ineffective include high tax rates for high-income earners. The government imposes such high taxes on individuals with high income to get funds for over ten million citizens. Those with direct effects are an employer with an individual mandate. Over 4 million citizens are bound to lose the company-sponsored health care plans. Businesses would rather pay the penalty that the policy requires and let employees purchase insurance plans on their own (Atlas, 2010).

The ACA or PPACA policy originates from the Original Heritage Plan of 1989, which had all these similar features. Most of the features of the ACA, such as the mandate form the basis for the ideas previously supported by republicans. The policy includes a community rating that requires insurance companies to establish policies for everyone despite their status; an individual or personal mandate that requires everyone to get insurance and subsidies that ensure affordable insurance plans. Later, the ObamaCare originated from the Senate by the Senate Majority Leader, Harry Reid, with a name “the Senate health-care bill”. The Supreme Court ruled it out as a revenue-raising legislation with violation of Constitution (Pipes, 2010).

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The adoption of an individual mandate, the employer mandate, and tax credits resulted in the compulsory prerequisite of individuals to obtain health insurance and for large employers to offer indemnity for the full-time employees. The tax credits aim to reduce the overall premium costs for families, small businesses, and individuals. The other event is high tax rates for the high-income earners, insurance companies, and large businesses. On average, the individuals earning over $200,000 and pharmaceutical companies benefiting from health care are faced with this. As much as these taxes provide funds for insurance of low-income earners, health care services have become costly for senior citizens (Atlas, 2010).

There is the creation of state-specific marketplace health insurance. Here, families and individuals are able to shop for more subsidized health care insurance that mainly bases on their income. The policy is important as it enables citizens to establish whether they qualify for benefits like Medicaid or Medicare. It makes it clear that those with work coverage cannot get marketplace subsidies. These subsidies are obtained at the time of an open enrollment when one qualifies for a special enrollment period. With adoption of the initiative and set deadline, the number of people enrolled for the program has hit 4 million thus showing an uninterrupted augmentation in the number of natives supporting the initiative. Having botched to meet the set cut-off date, the government had to move its deadline to March in order to meet 6 million targets. It is a clear indication of the little trust American individuals have towards the new policy. With the solution it brings, the policy introduces other negative factors that affect the majority of Americans.

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