The Patient and Protection Affordable Care Act dubbed ObamaCare is a health care reform in the US aimed at expanding and improving citizens’ access to healthcare and insurance. The act was signed into law by President on 23rd March 2010, but most provisions came into effect in 2014 (ObamaCare Facts, 2015). The specific objective of the law include things such as ; offering Americans more benefits and protections, allow for purchase of health insurance in a marketplace; expanding Medicare for the aged and disabled; improving Medicaid coverage in more states; increasing employer coverage; making it mandatory for people to have monthly coverage which will eventually introduce new taxation methods.
The healthcare reforms is however not a new phenomenon brought by the Obama government. President Bill Clinton's administration in 1993 proposed a similar reform. Hillary Clinton was elected to chair the task force in charge of spearheading the changes. Bill’s package of healthcare reforms which was called the Health Security Act was however not enacted into law. The provisions of this law included mandatory coverage for citizens above a certain income level and listed a minimum and maximum amount to be paid by qualifying individuals. It also proposed a fee-to-service schedule.
The ObamaCare health overhaul plan came in 2009, during Obama’s first term in office. The debate was started on July 14, the same year and lasted beyond summer when a 1000 page plan was introduced. During a joint congress on Sept 9, 2009, Obama explained the plan and even cited Sen. Ted Kennedy, who had battled for the reforms during his career. The plan was then approved on November 7th and December 24th same year by the House (220-215) and the Senate (60-39) respectively. The bill was then amended and passed into law in a 219-212 vote. No Republican voted for it (Disalvo & Stonecash, 2010).
There were different social, economic and political environments prevailing during the time the two policies were introduced. The HSA was proposed in 1993 while the Obama Care was in 2009. Although there was a crisis mentality health before the 1990s in the US, the health care debate had not been on the national stage. However, the political activities changed the perspective. Senator Harris Wofford campaigned on the platform of introducing major health care reforms signaling that the public was concerned about the health care issue. President Bill Clinton also used the idea of health care reforms in his campaigns. This gave him a head start as opinion polls revealed that healthcare reforms ranked among the top priorities (Health Care as a Human Right, 2013). Clinton was therefore elected into government in 1992.
The stage had been set, and it was expected that Clinton would bring an overhaul to the health care departments. The political environment that followed however led to the failure of the HSA. There was internal competition within the Republicans. Newt Gingrich and other party members though that defeating the HAS would assert their power in the party and became very vocal in opposing it. They combined their efforts with those of lobby groups such as the National Federation of Independent Businesses (NFIB) and the Health Insurance Association of America (HIAA). The HSA reform effort eventually failed, and the Democrat Majority Leader announced that the changes would not take place during that term.
Similarly, ObamaCare faced political challenges mainly due to opposition from the Republicans and was barely passed into law (Waldman, 2016). No Republican voted for the law. The Republicans argued that the ObamaCare will destroy the economy by making people overspend on health care. There were also claims that the Act will violate the constitution. However, the Supreme Court clarified the allegations. The act was also opposed by some Democratic and Independent Senators. Numerous lawsuits were filed opposing the Act too (Haggerty et al., 2011).
The economic setting of the two laws also compares and contrasts. The USA had been the only developed country without a universal health insurance policy during the two periods. A large group of people was also not insured through the two periods. In 1992, most people had withdrawn from the insurance due to the 1990-91 recession. This comprised of those living below the poverty line and the lower middle class. There was also an increased trend of employers passing back costs such as insurance cost to the employees. The healthcare in 2009 had also risen leading to workers also being covered by their employers. The healthcare expenditure of the government had increased to 13% as compared to the 10% in 1980 (Obamacare: Before and After n.d.,).
The two policies appear to have been well timed for the introduction. The failure of the HAS is attributed to inner party wrangles but not ill-timing. This is evidenced by the election of Senator Harris in 1992 and President Bill Clinton on the health care platform. The high rating of the health issues in opinion polls also shows that the health problem was being addressed at the correct timing. Similarly, the ObamaCare, which was eventually passed into law in March 2010, has already reduced the number of the uninsured in America, showing that it was adopted at the correct time.
References
Disalvo, D., & Stonecash, J. (2010, April). Why the "Death Panel" Myth Wouldn't Die: Misinformation in the Health Care Reform Debate : The Forum. Retrieved from http://www.degruyter.com/view/j/for.2010.8.1_20120105083456/for.2010.8.1/for.2010.8.1.1354/for.2010.8.1.1354.xml
Haggerty, J., Beaulieu, C., Lawson, B., Santor, D., Fournier, M., & Burge, F. (2011). What Patients Tell Us about Primary Healthcare Evaluation Instruments: Response Formats, Bad Questions and Missing Pieces. hcpol, 7(SP), 66-78. doi:10.12927/hcpol.2013.22693
Health Care as a Human Right. (2013). Debates on U.S. Health Care, 32-47. doi:10.4135/9781452218472.n3
ObamaCare Facts: Facts on the Affordable Care Act. (2015). Retrieved from http://obamacarefacts.com/obamacare-facts/
Obamacare: Before and After - Discover the Networks. (n.d.). Retrieved from http://www.discoverthenetworks.org/viewSubCategory.asp?id=1957
