Review: Unraveled: Obamacare, Religious Liberty, and Executive Power
Review: Unraveled: Obamacare, Religious Liberty, and Executive Power
Unraveled: Obamacare, Religious Liberty, and Executive Power, Josh Blackman. Cambridge: Cambridge University Press, 2016.
Summary: A history of the writing, passage, and defense, both in the courts, and by the executive branch of the Affordable Care Act, against those who would attempt to unravel it and prevent it from becoming part of the fabric of American society.
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The New York Timesreports that Kentucky Gov. Matt Bevin has informed the Obama administration that he intends to shut down his state’s health insurance exchange. The move will mean that Kentuckians will have to seek health insurance from the federal exchange. The newly-elected Republican governor may also make changes to the state’s Medicaid expansion program. Both moves would fulfill promises…
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When the Affordable Care Act was first implemented, many (mainly Republican) states refused to set up health insurance exchanges, putting pressure on the federal government to run the exchange. The hope was that it would fail having to coordinate coverage for more than half the nation. When the exchanges largely functioned as they should, a…
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How do the exchanges work? – As we explained in Part 1 of the Obamacare Series, the majority of Americans will not be affected by the new insurance exchanges. Only about 23 million people, or 7% of the population, will need to use the online insurance markets.
The exchanges themselves have been described by the President as a Kayak.com for health insurance. At healthcare.gov, Americans will be able to input their income, location, number of dependents, and other information before the software offers them a list of plans for which they qualify. The average cost of a plan on the exchange has been calculated at about $328/month.
Is everyone without insurance required to join? – Actually, no. There are closer to 60 million uninsured Americans today, but about 30 million of them will be exempt from exchanges for a number of reasons. People with low incomes, illegal aliens, some Native Americans, and even the IRS employees union will seek exemption. Some entire states have also gotten exemption through the State Innovation Waiver, which allows them to skip out on the insurance exchanges if they independently reform statewide healthcare in a way that is just as comprehensive and affordable as the ACA.
What do the law’s supporters say? – The exchanges have numerous advocates; some of their main arguments about the plans that qualify for exchanges are listed below:
Affordability: In order to qualify for the exchanges, private insurance plans must follow the 80/20 rule, meaning that companies must spend 80% of their revenue on healthcare only. If a company can’t spend enough to reach that 80% benchmark, the difference will be refunded in the form of tax breaks and lower rates for low-income individuals.
Prevention: The ACA requires all plans to offer preventive services like genetic testing for women who may be at higher risk for breast cancer at no cost to the patient. This mandate is also expected to keep long-term costs low, as preventive care has been proven to lower future medical spending.
Access: Two of the most well-known provisions of ACA-qualifying insurance plans are the raised age limits for children to stay on their parents’ insurance plans and the end of insurers denying patients for having pre-existing conditions. Young people will now have access to their parents’ insurance until they turn 26.
What are some criticisms? – The ongoing government shutdown has brought the opposition to the Affordable Care Act back into the spotlight in American politics, and arguments against Obamacare exchanges are numerous:
Rate of Spending: Obamacare supporters insist that affordability of healthcare is key, but detractors insist that when costs eventually rise the system will not be sustainable. It has been shown that the recent decrease in medical spending is a result of the recession, not changes in the industry.
Bad for Jobs: The ACA only requires businesses with 50+ employees to provide insurance to those working full-time. The law explicitly sets “full time” at 30 hours per week, and many businesses have responded by cutting their staffs and/or employees’ hours to avoid having to pay. The Congressional Budget office has estimated that Obamacare could cause 7 million people to lose their jobs.
Bad for Seniors: Some of the provisions of the ACA include reductions in Medicare payouts to hospitals and home health care companies. For both doctors and patients involved in senior citizens’ healthcare, this has caused a financial burden.
Are there alternatives? – Though it does not offer many, the ACA does include special exemptions from the for certain healthcare organizations. "Cost-sharing ministries" run by religious communities cover the healthcare costs of their members using only monthly fees that tend to be far lower than those of insurance companies. Instead of charging premiums based on a member’s health, the cost-sharing ministries collect equal fees from all members and pay out for anyone when needed.
(Photo, a word cloud showing the most-used words in the Affordable Care Act, courtesy of TexasTribune.com)
Aakash Abbi is the Managing Editor of HitListNews.org and can be reached at [email protected] or via Twitter at @AakashAbbi
