Obamacare and Federalism Research Paper
Historically, most of the policies implemented by the United States government have often been faced by a swirl of conflicting arguments, assumptions and myths. The responsibilities and capacity of the government and local authorities has on often been superseded by the popular expectations, which have thwarted their efforts to respond effectively. Those policies that are implemented at the federal level do not always reflect the diversity of opinion at all the other levels and the progress of these policies has further been affected by the numerous theoretical debates on the general federalism framework in the constitution. This study will carry out a meticulous study on one such policy, precisely the Obamacare policy with a critical view on its history, pros and cons, its effectiveness and whether or not it is consistent with the constitutional framework of federalism.
The history of a mandatory health care spans from the founding years of the congress in 1790 but the actual history of the Affordable Care Act as the Obamacare is formally known, spans from when Bill Clinton was president in the 1990s after he introduced what was popularly known as the ‘HillaryCare’ (Geyman, 2013). The same socialism and conservative arguments that have been in existence since the formation of the congress were used with every individual required to purchase a private insurance. The ‘HillaryCare’ was later turned down by the congress which led to the formation of another policy with the name the ‘RomneyCare’ that traces its roots to its modification and implementation in the Massachusetts State. This policy led to the implementation of the Obamacare formally known as the Affordable Care Act and despite the socialism and conservativeness mirroring the preceding policies, the administration of President Obama, succeeded where all other presidents and administrations failed after it was successfully signed into law.
The signing into law of this policy has elicited mixed reactions from all corners of the country with divergent views and arguments emanating from all levels including the federal, state and the local level. These debates have unearthed different pros and cons concerning the policy as will be underlined below.
Some of the cons that have been suggested by the proponents of this policy as asserted by Geyman (2013) include the fact that millions of individuals without insurance will have access to quality insurance to their health at an affordable price. More than half of those who are uninsured will also get acquire these health insurances at a subsidized rate or even for free, after acquiring their health insurance from the government’s marketplaces.
Over 15.9 million more people below the poverty level will have access to Medicaid. Over nine million children will also be covered by CHIP. Unlike the yester years, no individual will be denied health coverage or charged more for being sick. Small businesses also have access of 50% tax credits of the total premium costs in their health insurance. Health care spending has also been significantly cut under the Obamacare with the rates going down and the preventive services expanding further.
Despite the pros above, various cons have been noted as opined by Somin (2012). Despite the cost spending going down, new taxes have emerged with the high earners being taxed more. The expansion of Medicaid has also been orchestrated by federal funding implying that not all states will implement this expansion with the same case applying to CHIP. The cost of insurance of every individual will also be increased as a result of the requirement by all insurance companies to cover sick people. The premiums of insurance have also increased since it is now obligatory for all insurers to provide insurance covers. Employment has also been hampered by the direction that all business with over 50 employees to provide their own health coverage by 2015, prompting some businesses to lay off some of their employees.
Federalism is basically defined as mechanism in the constitution that divides authority between national level, state and the local levels. Similarly federal controversies that have surrounded numerous policies in the past currently engulf the Obamacare policy. One Judge in one of the court cases involving this policy questioned the federal limits by implying that a government that mandates every individual to buy health insurance could mandate every individual to do anything it wishes and the courts should thus be used in order to limit this federal power. A solicitor general on the other hand by the name Donald Verrilli defended the Obamacare by implying that the limits of the federal government were clearly stipulated in the democratic policy and so the federal government could not implement a policy that was not effective and beneficial to the general community (Ney, 2012). The effectiveness of the Obamacare is nevertheless visible since it has filled a gap of over 55million Americans who initially had no access to health care and it is thus consistent with the constitutional framework of federalism which actualizes a set of objectives in good governance and creating a balance between the national and the local level to safeguard the population against government’s abdication on one side.
In conclusion, this study affirms that despite the demerits of the Obamacare for instance the added taxes, funding Medicaid and CHIP only through federal funding, hampering employment and the increased insurance premiums there are numerous pros that have resulted from the policy. These include curbing the healthcare spending, expansion of the free preventive services, cutting the tax credits of small businesses by 50%, providing quality and affordable health services to millions, expanding Medicaid to over 15.9 million people and covering more than 9 Million children using CHIP. With the potential benefits surpassing the demerits, it is evident from the study that this policy has been consistent with the constitutional framework of federalism and despite the diverse views and arguments, similar voices are expected to be evoked from the federal, state and the local level in the near future.
Geyman, J. (2013). The Affordable Care Act: What to Expect in 2013, physicians for a
National Health Program. Retrieved from http://www.pnhp.org/news/2013/january/the
Ney, S. (2012). Making Sense of the Global Health Crisis: Policy Narratives, Conflict, and Global Health Governance,. Journal of Health 37, 253-254.
Somin, I. (2012). A Mandate for Mandates: Is the Individual Health Insurance Case a Slippery Slope? Law and Contempolary Problems 75, 79-98.