When the Affordable Care Act (ACA) was introduced, one of its key goals was to cause increased competition among companies providing health insurances. By 2017, the government has not managed to achieve this purpose. Furthermore, the Health Insurance Exchanges currently provide less choice and competition than ever before. The failure of the reform makes critics claim that the state-based marketplaces where citizens can purchase personalized health insurance are on the verge of collapsing (Kaestner et al. 620). The paper at hand aims to investigate its current status to identify whether this statement is true.
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Current Status of the Health Insurance Exchanges Operation in the US
Contrary to all the previous expectations, insuring companies’ participation in the exchanges initiated by the government is now at the lowest level during the past several years. As a result, customers are deprived not only of their insurance choice but also of even of their insurance opportunity (Antonisse et al. 25). Although some companies are still considering the option to enter the program, the majority of them have already decided to limit their participation to 2-5 states only, which puts people living in other states in a disadvantaged position.
The ACA was initially meant to expand on Medicaid, the program for the poor; yet, in 2012, this expansion was made optional by the Supreme Court. As a result, 19 refused of it, making people who earned less than $12,000 per year non-eligible for subsidies to purchase an individual insurance on the exchanges (Antonisse et al. 42). Since people with a low level of income tend to suffer from a bigger number of diseases, it becomes a challenge to provide all of them with insurances in other regions (Center et al. 119). This makes insurers’ operation in non-expansion states more expensive, which forces insurers to quit the program.
The situation is aggravated by the fact that more than 3 million people lost their employment insurances since their companies found it more cost-effective to pay the required penalty for allowing their workers to choose any plan that seems the most suitable for them on the exchanges. 30 million people who relied exclusively on their private health insurances were deprived of their plans since the companies that provided them failed to cover 10 crucial benefits outlined for the exchange (Center et al. 122). Replacing these plans was excessively expensive.
By the present moment, the total health care costs have increased dramatically due to the fact that a lot of people received medical examination for the first time in their lives and now their diseases, which were neglected for decades, have to be treated. Those who did not buy insurance have to pay a special tax, which has already increased the percent on income far above the threshold. Businesses are therefore discouraged to hire new people since they will have to pay more. Moreover, families can now deduct medical expenses that make more than 10% of their income (as compared to 7.5% before the launch of the program) (Center et al. 125).
The future prognosis is also far from being positive. Pharmaceutical companies are going to pay extra $85 billion in fees in the period up to 2023, which will inevitably lead to increasing drug costs (Kaestner et al. 626).
After 7 years of their enactment, the Health Insurance Exchanges still bring about more problems than benefits. Prioritizing particular groups of the population of the others, the ACA makes a lot of citizens feel disadvantaged by the reform. No practical steps have been performed on behalf of the government to overcome the crises. That allows agreeing with Donald Trump who considers the present-day state of healthcare in the United States a horror show (Flores-Ferrán 75).
Antonisse, Larisa, et al. The Effects of Medicaid Expansion under the ACA: Findings from a Literature Review. Henry J. Kaiser Family Foundation, 2016.
Center, Helm, et al. “A Critical Analysis of Obamacare: Affordable Care or Insurance for Many and Coverage for Few?” Pain Physician, vol. 20, no. 3, 2017, pp. 111-138.
Flores-Ferrán, Nydia. “I’m very Good at and maybe that’s Why I’m Center Stage…”: Pronominal Deixis and Trump.” English Linguistics Research, vol. 6, no. 1, 2017, pp. 74-91.
Kaestner, Robert, et al. “Effects of ACA Medicaid Expansions on Health Insurance Coverage and Labor Supply.” Journal of Policy Analysis and Management, vol. 36, no. 3, 2017, pp. 608-642.