Examining Efforts to Reform Health Care

The last few years have been a maelstrom of political activity in the healthcare field. To help clarify the argument, here are several major highlights of the past several years.

2008: With a country in the middle of recession and a major federal deficit issue, 2008 did not seem the year to discuss healthcare reform. But the Obama administration, newly come to power, saw healthcare as a way to make a big difference – and big splash. Meanwhile, Congress also decided that healthcare reform was worth a look. Perhaps they thought it was a battle they could actually win in the midst of turbulent times. Both sides began preparing their agendas.

2009: This was the kickoff year for healthcare reform. The House of Representatives introduced a healthcare reform bill, with a key piece financing Medicare consultations with professionals. This piece is subject to widespread debate and leads to discussion of “death panels” (here is a headline-based take on that media timeline) that would potentially hasten the deaths of the elderly or infirm. Eventually, a compromise House bill was announced, a merger of three different bills offered during the year. Primary concerns focused on the high costs of healthcare and the need for change in the system. The Tea Party protested the reform bill, the Democrats supported it, and the administration rolls up its sleeves. In late 2009, Obama announced the Patient Protection and Affordable Care Act.

2010: By March, both the Patient Protection and Affordable Health Care Act and the Health Care and Education Reconciliation Act have been signed into law. These laws replaced the self-admitted jumble of the House law with a clearer version. The new acts would require most citizens to purchase health insurance through state-based coverage centers, with various levels of federal credit available based on income levels. Individuals without health insurance would have to pay a tax, and many businesses would be required to automatically enroll their employees in plans. Medicaid would be expanded with federal financing, and health plans would shifted to offer more dependable coverage to those with pre-existing conditions…among many other details. The reform was set to go into effect over the following several years.

2011: Republicans, in majority in the House of Representatives, voted to repeal the healthcare form and the Act is taken to court for being unconstitutional. They intended to replace the bill with a version of their own. With the Presidential election on the horizon, the debate became highly political. Obama threatened to veto the repeal. Meanwhile, the 11th Circuit Court ruled that parts of the reform law were indeed unconstitutional. The U.S. Court of Appeals agreed, and by the end of 2011 the case was sent to the Supreme Court.

2012: The so-called “Obamacare” law was brought to the Supreme Court under allegations that it was not constitutional. The Supreme Court overturned previous rulings and said the health care law could be upheld under the federal power to tax, although the Medicaid expansion should be more optional. This was a major victory for the healthcare reform law.


Heart of the Debate

In an effort to make a confusing issue slightly less confusing, here is a breakdown of the two primary stances in the Reform Act debate. As is often the case in the political arena, many points come down to outright contradictions or vastly different interpretations (Medical Billing has an entertaining infographic on the very subject).

Democratic Stance: The healthcare system is broken – millions of Americans have no access to healthcare and no way to get the treatments they desperately need. Obamacare will lower the deficit by 2019 and help employees to save $3,000 a year per employee (families will save $2,300). People with pre-existing conditions who would be denied health care by a profit-hungry system will soon be given coverage, and discriminatory tactics will be outlawed. Small businesses will find health coverage easier to plan for, and new fraud-prevention rules will strengthen the Medicare program. Finally, the most expensive health care system in the world will be able to cut its costs and improve quality.

Republican Stance: The healthcare system is broken – federal and state spending on healthcare is already bankrupting the system, and a reform bill expanding coverage would make the problem worse. By 2019, revenue raised by taxes would have to increase by $503 billion to support the bill. Individual choices in healthcare are being take away from people, forcing individuals to purchase healthcare even if they don’t want it. Under Obamacare, everyone must pay even more for programs like Medicare, which is expected to go bankrupt sometime in the 2010s. Insurance companies, meanwhile, are raising their rates in order to maintain their profit levels, making premiums more expensive no matter who is paying them.