American Controversy Over the Affordable Care Act

The Affordable Care Act has been a controversial topic throughout the nation. When President Obama passed the law in 2010, we all had high hopes that it would help employers and families afford health insurance. However, the Affordable Care Act, while having good intentions, has been a constant and long-running failure in many aspects. While there have been some positives to the affordable care act, the negatives far outweigh the positives.

About 23 million Americans have gained insurance but 27 million still remain uninsured.

The ACA also changed the age that children could stay on parents’ health insurance, and insurance companies could no longer deny you service because of a pre-existing condition. However, the negatives are big blows to the Affordable Care Act. With rising premiums and the government mandate legally instructing all companies that have more than 50 employees to provide health care, it is making it hard for families and small businesses to afford the insurance that they legally need to have.

What’s even worse is hard working Americans are losing jobs because the government mandate makes it more viable for small businesses to lay off their employees to keep their business under 50 employees so that they are not legally obligated to offer insurance, even though there are many positives to offering insurance even without the mandate.

The Affordable Care Act took away much of the competition between insurance companies meaning that they can raise their prices without losing many of their customers to other insurance carriers.

Prices of insurance have been steadily rising and many professionals predict that they will continue to rise in the coming years.

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Some Americans propose that instead of the Affordable Care Act, we go with Senator Bernie Sanders’ “Medicare for All” bill. With the Medicare for All bill, the age that you can receive Medicare would go down over time until finally, every American would have Medicare. With this bill, all Americans would have the insurance they deserve, and not be afraid to seek medical help when something might be wrong with their health and it could save many lives. The bill would also allow patients to choose their own doctors and not be forced to go to one that works with their insurance. By giving all United States citizens access to Medicare, small businesses and their employees would benefit, creating a stronger national economy.

The Affordable Care Act chased away much of the competition which has negative effects for small business employees and families across the country. Other insurers started to flee after the Affordable Care Act, or Obamacare, came into the game. According to Edmund Haislmaier, a senior researcher for The Heritage Foundation, insurer participation has been declining for three consecutive years now. He also stated after researching and measuring the competition that in 2018, the market was 54 percent less competitive than it was before the Affordable Care Act was introduced to the market. Studies of counties throughout the US have shown that most of the country’s counties have only one insurer. Counties were used for this study because of the fact that rates and premiums are set locally. According to an article on, premiums are set by looking at age, location, use of tobacco, and whether you have a family. After looking at these things, you are put into a “plan category.” Only having one insurance option leads to the problem of people not being able to choose the lower costing insurance and that they are forced to pay whatever the price is set at for them. This is a problem because some people cannot afford to pay some of these rates and do not have the option of opting out of buying insurance or finding cheaper rates. Without competition in the health insurance area, there is nothing to keep rates low. Rates keep rising because there is nothing pressuring them to stay lower for more people. Dan Mangan with the CNBC stated that, “the average price of the most popular types of Obamacare health plans sold on the federal insurance marketplace will be at least 34 percent higher in 2018, according to an analysis released…” This

is following the increase of rates that already were pushed onto Americans in 2017. There are also subsidies given to people that qualify. Subsidies are a big help for people that struggle to afford the monthly rates that come with buying Obamacare insurance. The cost of Obamacare with subsidies is much less than what people without them pay and the subsidies also are not going to have to worry about the higher rates. “More than 80 percent of Obamacare customers who buy plans on government marketplaces get such subsidies, in the form of tax credits, because they have low or moderate incomes” (Mangan).

This is a major help for those who need the help, but as for others, they are dealing with high rates that will be increasing more and more over time. Also, without competition, insurers can use processes like “silver squeezing” and “silver stretching” according to Jon Walker of The Peoples Policy Project. Walker also states that the insurers can make more money by showing that people that qualify for subsidies are not paying full price, but they are still paying for their lower plans with somewhat higher monthly premiums to be paid for. If there was more competition added to the mix, it would force the price of plans down and would also reduce the spreading of prices for the silver plan. Adding more competition back into the health insurance area would help many families and small business owners by lowering prices without having to use subsidies.

By giving all US citizens access to Medicare, businesses would be able to weigh the pros and cons of offering health care to decide what would be best for their business. There are many reasons companies would choose to offer health care without being legally mandated to do so. According to marketing expert Krystal Barghelame “Offering health care keeps employees happy, saves the business money on taxes, gives yourself and employees access to more and better doctors, and boosts employee productivity” (Barghelame). Keeping employees happy means that they are more willing to stay at the company, and raises morale, giving them more reasons to try to do better work. Boosting employee productivity should be priority number one in any business.

Employees are the backbone of companies, and without employees, the company obviously cannot function. Making sure employees feel taken care of is a great way to make sure a company will always have hard working, loyal employees. Many employees are willing to give up increased wages in order to get benefits like health care, but there are still many others that would rather have the increased wages. Having the option to choose the job that works for a person’s preference is important and mandating every company to offer healthcare takes away the choice of the employees that would rather have the increased wages. Competition is the backbone of the economy and the government mandate takes away much of the competition that employees should have when choosing a job. Letting businesses choose to offer health care or not, is great for the job market by opening up many opportunities that are not there with the government mandate. Everyone should be able to choose if they want health care or higher wages. Giving everyone access to Medicare would allow the government mandate to be taken away, which gives businesses more control over their company, gives employees more options, and in turn, helps the economy.

Replacing the Affordable Care Act by offering Medicare to all citizens will improve the current healthcare crisis, especially for small business owners with fewer than 25 full-time employees. With the Affordable Care Act, business owners are not required to provide employees with health insurance. However, many employers choose to offer insurance as a benefit, so their company may seem more appealing to a potential employee. This has been challenging for small businesses as many have seen a rise in premiums making it difficult to

offer insurance as a benefit. As stated by Laurence Seidman, Professor of Economics at the University of Delaware, offering Medicare to all citizens would take the burden off the employer and give all citizens access to health insurance. There would be no high premiums but instead, the employer would be responsible for paying a higher Medicare payroll tax (913). This was presented in a scenario by Lainey Newman involving one of the United States’ largest companies, General Motors. Providing health care to their employees adds on an additional cost of $1500 per car. If Medicare were to be available to all, GM would not charge that additional fee per car and would instead pay a straightforward tax (Newman). This would take a large financial burden off the business and allow them to put the savings back into the company or provide additional incentives to their employees, which would contribute to a stronger economy.

In addition to providing economic relief to small business employers, providing Medicare for all would allow employers to concentrate entirely on their business. According to Seidman, small business owners devote a lot of time to health insurance decisions for employees. They are faced with the task of choosing what they feel is the right insurance for their company and need to keep on top of constantly changing policies and plans (915). Offering one insurance would eliminate the burden a small business owner may face. It would also eliminate the burden on the employee or potential job seeker. Some individuals may base their entire job decision on the benefits the company may provide, especially health insurance benefits. They may not seek a position they normally may have been interested in to settle for a position where health insurance is offered.

Once in the position, the employee may also face a fear of losing health insurance coverage if they were to leave their job. Allowing access to Medicare would also free the burden on the employee which may lead to a more productive worker (916). The burden of looking for affordable private health insurance also falls on entrepreneurs. Some individuals fear being without insurance or worry about having to provide insurance for employees if they were to form a small business. They may forego creating a business and settle on a job that provides them with benefits. Access to Medicare would also benefit entrepreneurs as affordable health insurance would not be a factor when faced with the decision to start a business (916). Taking the burden off employers, employees, and entrepreneurs, individuals would be able to concentrate on their business, job, or new endeavor, which would help strengthen the economy.

Repealing the Affordable Care Act has many benefits: however, just like everything, there are a few counter arguments as to why we should keep the Affordable Care Act. According to Susan Weinstein, Co-executive director of Families for Depression Awareness, before the Affordable Care Act (ACA), about 50 million Americans did not have insurance: however, with ACA, 27 million people still remain uninsured. ACA has also made it so adult children can remain on their parent’s health insurance until the age of 26. The previous age limit was full-time students and would end around the age of 22.

The ACA wouldn’t discriminate on your health status. So if a person had cancer or any other illness an insurance company could no longer deny coverage for that individual. (Weinstein). While the ACA had great intentions, it came short on a lot of those. The uninsured rate is rising due to the small businesses laying people off and their premiums rising more than the employee’s paycheck. If Medicare was available to all, everyone would be covered with health insurance, no matter their age, health, or employment status. The ACA allows people to be covered no matter what condition their health is in, but the same will be true with having Medicare available for all. Kara Gavin, a Research and Policy Media Relations Manager at the U-M Institute for Healthcare Policy and Innovation, with 25 years of

experience in communicating about science medicine and health policy writes the article, 8 Things to Know About Affordable Care Act Enrollment. In this article, Gavin states that those without private insurance may owe more in taxes and run the risk of not being able to afford doctor bills if they fall ill. If an individual goes without health insurance for most of the year, they will receive a tax penalty that spring. This can be a max of 700 dollars for a single adult or 2,100 dollars for a family. (Gavin) However, if someone has ACA they would be saved from all that. It makes it so Americans have insurance they can barely afford to prevent being fined. With Medicare for All, people would not have to worry about being fined for not having healthcare, or having insurance that makes it difficult to afford a doctor visit while sick. While the Affordable Care Act has many benefits, the cons outweigh the good as to why we should repeal the ACA.

America should allow Medicare to be available to all and stray away from The Affordable Care Act. According to Physicians for a National Health Program (PNHP), Senator Bernie Sanders’ bill, Medicare for All Act, would allow everyone to be covered with affordable health insurance. This bill would not stick patients with only doctors that their insurance covers and would allow them to choose the one they’re most comfortable with. There would be no premiums, deductible or copays for medical services. (PNHP) This would help small businesses by not having to carry insurance with high deductibles that they can no longer afford to give to their employees. As stated previously, with the cost of insurance going up it’s pushing some small businesses to lay off employees to stay under the 50-employee limit.

As reported by Yoni Blumberg, a verified journalist and reporter for CNBC, 70% of Americans support Medicare-for-all and only 20 percent completely disagree. Passing Bernie Sanders’ Medicare-for-All bill would aim to reduce the uninsured rate from 12% of Americans to 0. America letting Medicare be available for all would be a lot closer to how the rest of the world provides health care to their citizens. (Blumberg) 12% of Americans uninsured may seem like a small number but that’s still millions of citizens going uninsured due to the high cost, not to mention the thousands that are barely squeaking by with the health cost increasing. Medicare available to all is the answer to making sure all citizens are insured and letting small companies afford to keep their employees.

As stated by Gerald W. Boychuck, author of National Health Insurance in the United States and Canada: Race, Territory and the Roots of Difference, that was awarded the Donald V.

Smiley Prize: “We have seen Medicare being available to all citizens work wonders in Canada. Public health being offered to everyone in Canada has greatly shown how the ability of the program can create a wide range of support throughout the country.” (Boychuck, 152) It is important for Americans to educate themselves on what the Affordable Care Act is, and how it is affecting small businesses, in their own neighborhood, and across America. Small businesses not being able to afford to have over 50 employees causes the unemployment rate in America to rise.

This causes the domino effect: small businesses lose money because they are now short staffed and can’t work as efficiently, so people go on unemployment, which causes the government to give out money instead of making money. Having Medicare available to all would prevent small businesses from laying off workers and help strengthen America’s economy. Bernie Sanders is doing his part by trying to pass the Medicare For All Act, now it’s your turn to do your part and help become part of the solution. Your voice is powerful. With the holidays right around the corner it is the perfect time to talk to family members and friends about helping people learn about how ACA is hurting some small businesses and that having Medicare be available to everyone will help save businesses and many Americans from being laid off of work. Your voice matters and can save some small businesses. Making Medicare available to all citizens will save small businesses, help America’s economy and possibly even help you or a family member.

In order to strengthen the economy in the United States, and benefit small businesses and their employees access to Medicare should be given to all citizens. The Affordable Care Act has introduced higher prices to health insurance in the United States and has caused businesses and families to struggle to pay the rates and premiums. With the Affordable Care Act being introduced, other insurance competition fled the race. The government is mandating everyone to pay these prices when people should really be given a choice whether they want to pay for it or not. Getting the Medicare for All bill passed would help the economy. To some people, the Affordable Care Act may be beneficial, but without this helping everyone it is starting to affect the economy as a whole and should not continue to be used.

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American Controversy Over the Affordable Care Act. (2022, Feb 14). Retrieved from

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