Obamacare

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About

Obamacare is the colloquial name for the Patient Protection and Affordable Care Act (aka ACA, PPACA) enacted in 2010 in response to reform initiatives in 2009. It requires all health insurance plans to cover ten essential benefits:

  1. Outpatient care
  2. Emergency services
  3. Hospitalization
  4. Maternity and newborn care
  5. Mental health and addiction treatment
  6. Prescription drugs
  7. Rehabilitative services and devices
  8. Laboratory services
  9. Preventative services, wellness services, and treatment for chronic diseases such as emphysema, MS, or cancer.
  10. Pediatric services

It also prevents insurers from refusing coverage on the basis of "pre-existing conditions", which insurers were free to define however they liked (and could equate to basically anything ever recorded on your medical chart, such as a hangnail).

It has been attacked by the political Right, especially free market libertarians, since it was first proposed – despite being heavily based on a plan created by the right-libertarian Heritage Foundation think-tank and supported by the political right as an alternative to the Clintons' universal healthcare proposal in the 1990s. Attacks included:

  • distortions and misrepresentations (many people now believe popular myths about it)
  • fighting various provisions of the law so as to make it less effective:
    • the Medicaid expansion mandate (successful, see NFIB v. Sebelius); result:
      • states no longer have to accept it
        • leaving millions (who would otherwise have been covered) without healthcare...
          • ...because they fall into the gap between those who can benefit from tax subsidies and those poor enough to receive Medicaid
    • the individual mandate (unsuccessful, see NFIB v. Sebelius); results would have been:
      • eliminating a major revenue source for insurers
        • ...forcing them to raise insurance prices even more
    • tax credits to insured individuals outside of states which accepted the Medicaid expansion (unsuccessful, see King v. Burwell); results would have been:
      • many more individuals in Republican-controlled states who could not afford health insurance, thus:
        • deepening criticism against it (the law itself is blamed for the problems caused by damage to it)
        • removing a source of funding for it, increasing insurance costs
        • creating many more uninsured emergency room visits, increasing healthcare costs overall
    • screwed around with the "risk corridors" mechanism
      • causing difficulties which resulted in further rises in the price of insurance[1][2]
    • see also Constitutional challenges to the Patient Protection and Affordable Care Act
    • further attempts to screw around with how insurers are reimbursed for high-risk loads (House v. Burwell, currently unresolved)[3]
      • ...which would similarly increase insurance prices

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    Footnotes

    1. 2016-05-24 Republicans Are Breaking Obamacare So They Can Declare It Broken
    2. 2014-12-12 Republicans Dealt A Quiet Blow To O-Care In The CRomnibus
    3. 2016-12-29 Rapid Developments In House v. Burwell