I’d never considered the cost of health care. I’d always taken it for granted. For me, going to the doctor simply meant me and my doctor. It didn’t occur to me the finances and politics involved. Reading these articles brought these two elements and a myriad of other things into my view. The Patient Protection and Affordable Care Act is more than meets the eyes. Looking further into the background and context of this legislation, I found a multitude of information and additions that really opened my mind to the world of health care.

The Affordable Care Act, or the so-called Obamacare, looks to be a very strong health care initiative. The big picture is that people have more access to subsidized insurance plans (average reduced cost of 76%) and the termination of price discrimination based on medical history. The debate is the mandate that people must partake in an insurance plan otherwise face penalties of 1% of household income or $95 per person for the first year and 2% of household income or $325 per person. There will be questions concerning whether the government is overstepping with its involvement in health care and the insurance mandate and the costs and consequences of this legislation. But from what I’ve read, the Affordable Care Act appears to be doing a great job.

The NYTimes article written by Quealy and Sanger-Katz argues that the Affordable Care Act helped push back inequality by redistributing income. It was supported by the fact that of the increase in five percent of Americans who signed up for insurance, the majority were blacks and Hispanics living in rural areas. Their percentage of uninsured increased dramatically from 26.2% and 24.1%, respectively, to 16.5% and 16.1%. The poorest of neighborhoods also experienced higher levels of people who gained insurance. Interestingly enough, the study could actually be understating the actual levels. As the article mentions, the survey may not reach those who may not have as strong a digital footprint. So, the benefits could be greater than what’s shown on paper. Seeing as though health care costs are big expenses, the availability for more affordable health care greatly improves quality of life. This is a strong method to help reduce the income gap as this legislation will target poorer people and provide them alternatives to increase their overall spending power with subsidies.

The financial growth of the health sector also speaks volumes for the Affordable Care Act. With an influx of 10 million newly insured, the NYTimes reports that analysis shows that the “health care system benefited from the law.” In addition, there are more patients willing to now go to the hospital and pharmacy. Most health care companies also generated good profit and the industry beat the S&P500. So it seems the legislation integrates with the economy fairly smoothly. Though, there was some debate as to the expansion of Medicaid. I’m unclear the part Medicaid plays specifically, but I’m getting the sense that fewer doctors are taking patients with Medicaid. I’m sure some finances are involved and am interested in seeing why this happens.

I think the Affordable Care Act really opens up doors for people. There are a lot of logistics and hitches, but the reduced costs and freedom of mind are well worth it. With a society as advanced as ours, it’s still a wonder how not all people have access to health care. How does a coverage gap even exist? Should money and politics factor into our well-being?

 

-Jia Jun (Jay) Wu

As most of us already know, the price of crude oil has fallen dramatically over the past 6 months or so. Not only has it fallen by over 50% during that time, but there are a number of analysts predicting it will continue to fall to as low as $35 a barrel on the NYMEX. Quite frankly, the fact that prices that low are even conceivable is quite miraculous as many never expected to see it where it is right now ever again. So what is the reason for this dramatic drop in its price? For the most part, it is due to an overwhelmingly high amount of supply. This has been driven by the emergence of the United States as one of the world’s largest oil producing countries and that is thanks in large part to a new and highly controversial technique of drilling known as fracking.

This new technique allows us to extract natural gas and oil from shale rock. Essentially, large amounts of water, sand and chemicals are injected into the rock to displace the oil and natural gas inside. This process has revolutionized the energy sector and spurred much economic growth in regions where the technique is practiced. But this has not come without consequence.

There is a host of environmental and health concerns regarding the practice leading many to desire a ban on the entire procedure all together. Firstly, fracking requires a very large amount of water to be transported to the sites for use on the shale. Worse, there is concern of potentially carcinogenic chemicals being released into the groundwater around the sites from their use within the process. Even stranger, there have been documented reports of small earthquakes resulting from the fracking process in areas and cities not far from the sites. Finally, this process has been so successful in extracting more resources that many companies are resorting to it for extraction purposes. Consequently, companies are relying on it to be the solution to find more oil and energy and not putting resources into finding ways to generate cleaner energy.

The controversy has gone so far that Governor Andrew Cuomo of New York recently banned the practice altogether, despite originally being a strong advocate of the process because it was helping to stir up business in the struggling regions of upstate New York. Governor Cuomo cited a health report from the acting state health commissioner, Dr. Howard A. Zucker, which found fracking to be severely detrimental to the health of the environment and the people living near the sites. Simply put, when asked he would want his family to live near a fracking site, he said he would not allow it. Most notably, he cited concerns about water contamination and air pollution. Now, while this is all well and good, I feel as though we as the public should have more details regarding the studies that were conducted to come to this conclusion. The New York Times article simply stated Dr. Zucker cited many scientific studies to back his claim but gave no detail about the studies themselves and how they were conducted, what they measured and what the exact results were. More transparency regarding the matter I think is necessary so more individuals can fully understand the consequences of such practices if it really is that unhealthy for them and the environment.

Lastly, earlier on I briefly mentioned the economic impact of fracking on the price of oil. I should also mention that another reason the price has continued to fall or at least remain so low is because companies are not cutting back on production. Particularly in Saudi Arabia, where most of the world’s oil comes from, they have not cut back on supply in an effort to drive other companies out of business and keep a firm grasp of their market share. To a certain extent it is working because many American companies have gone under not able to turn a profit because their costs to drill for the oil were too high. But even still, our supply is more than triple what we have expected it to be as the last report from last week fracking allows companies to drill not only vertically but also horizontally. This means they can make more from pre-existing sites but also make more new sites altogether. This has kept the price of oil much lower, raising a lot of concerns about corporate profits moving forward. A number of companies have already lowered their forecasts for the year from a strong dollar and low oil prices. So this process is not only hurting the environment but it is also hurting the business conditions for many American businesses as well. Hence, I believe something should definitely be done to limit the process as a whole.

The NYT article titled, Obama Health Law: Who it helped most, gave me an interesting perspective on something that hasn’t been really talked about. It discussed whom the law helped the most. According to their findings the law helped the people who seemingly needed it most, blacks, Hispanics, and people who live in rural America. Even women got more help from it than men. However, while the more extreme estimates state “that the national uninsured rate for adults under 65 fell to 11 percent from 16 percent”, I don’t believe that is enough. Obamacare, in many cases gives away health insurance for free, and in other cases it is virtually free. For a law that was sold as “insuring everyone in America” Having 11% uninsured should not be acceptable!

While the healthcare law is helping to level the playing feel in some respects, there is still a sizable gap. “The director of analytics and data at Enroll, said he attributed the racial trends to two main factors: existing high uninsured rates for those groups, and disproportionate poverty, meaning more people who qualify for Medicaid.” I don’t think that’s enough of a justification, if the insurance is free or almost free, then we should have seen a virtually 100% enrollment. One thing that is not refutable about Obamacare, is that it was targeting the poorer among us, and at that it seems to be pretty effective. In its essence, it was a large-scale wealth redistribution effort that has had success in taking from the rich and giving to the poor. Only time will tell if we will begin introducing new such legislation to do the same…

Lyla Turner’s story is truly heartwarming. A 50 year old women in a medial job, given the opportunity to go back to school, partly because of the government subsidy she gets for her insurance. It truly sounds like the American dream, but as is the case with Mark Segina it is not all hunky dory. Many people, including Mark Segina, still cant afford the insurance premiums. As I continued reading the article the flaws of the healthcare exchange have become more and more obvious. Like everything else government run, bureaucracy and fraud gets in the way of making things happen. That has long been a criticism of Obamacare, and was used to try and prevent it from happening, and unfortunately it seems to have become the reality.

The NYT article titled “Is the affordable care act working” gives a look at all of the fundamental aspects of Obamacare and a look at what has changed since its adoption. It discusses how uninsured Americans have dropped by about 25% this year, through the use of the exchanges as well as the broadening of the Medicaid program. However regarding the affordability of the Affordable Healthcare act, “by requiring insurers to provide a broader array of benefits and to cover people with pre-existing conditions — caused premiums to rise for some who already had insurance.” This was a horrific unintended consequence of a bill that many people agree wasn’t fully thought out.

One thing that was not discussed at length, is the actual healthcare that these patients under expanded Medicaid and cheaper private insurance get. It is widely known in the medical field that many doctors do not except Medicaid because of how it pays, and so Medicaid patients have always had limited choice when it comes to their medical professional. By expanding Medicaid, we aren’t resolving the underlying issue of how to get doctors to except it, because without medical professionals willing to see you, what is the point of having the insurance in the first place. There have been many repots of doctors who used to take Medicaid, dropping the insurance because it no longer made sense for them. They don’t want their practices to become all Medicaid patients, where they are paid, in many cases, more than 30% less than the Medicare insurance rate. So while Obamacare has helped “insure America”, is it really changing the healthcare Americans are getting?

Health care is one of the biggest issues to tackle. Over the years, the only way to get covered was to pay the high premiums or have an employer supply the benefits. Obama pushed for his Affordable Care Act to help the nation get insured and slow down health care spending. In response to this act, there we’re many mixed responses. These New York Times articles try to answer a important question, “Is the Affordable Care Act working?”

Throughout the articles, it seems to show that the Affordable Care Act has shown more positives than negatives. It greatly reduced the amount of people insured by about 25 percent and many of them have enrolled in Medicaid. However, according to the “Is the Affordable Care Act Working” article, the problem of uninsured will probably not go away since, for example, people who are illegal are cannot be insured. In addition, there are still 23 states that decline to expand Medicaid and there are still people who find insurance undesirable.

On a more positive note, the act did make insurance more affordable, especially for low-income households. Blacks, Hispanics, 18 to 34 year olds, and those who reside in rural neighborhoods were greatly benefited by this act. It was interesting to see the infographic that showed the change in insured Americans. Majority of the change concentrated in the west and in states such as Arkansas, Virginia, and Kentucky. On the other hand, the estimates for those who are still uninsured in 2014 are concentrated in the south where many are conservative.

For those who are insured under the Affordable Care Act have given mixed responses. It was interesting reading different personal accounts. There were many individuals like Lyla Turner who could not affordable healthcare, but now with subsidies, she can affable a plan. There are also accounts where the act helped save lives of people who needed healthcare. One of the best benefits of this act is that children and dependents are allowed to be on their parent’s health insurance until their 26. In my opinion, this is generous and it allows for people to continue education without thinking about paying for insurance. However, this act still needs improvement since the whole process is confusing, time consuming and some think, forced.

The Affordable Care Act benefits most low-income and rural families. Some middle class families have even seen an increase in their premiums, and the rich barely benefit from this. In what ways can the Affordable Care Act improve to attract more people and benefits everyone? Right now, I think it’s heading in the right direction; we just need to see more results.

-JanYing He

Probably the most important piece of legislature that was passed under the Obama administration was the Affordable Healthcare Act, or as many know it, Obamacare. The law itself was passed in an attempt to help the healthcare industry in America. Prior to it the industry was marred by high premiums leaving many unable to afford healthcare and at risk. For many, the only way to have healthcare was through their employer. Essentially being left behind by other first world countries and our neighbors to the north in having an affective healthcare system, something needed to be done. And despite heavy opposition from many, the bill passed. Now that it has the question has become, did it bring about any significant improvement?

The simple answer to that question is yes it did. The number of Americans without healthcare has been reduced by roughly 25%, or approximately 8-11 million people. About 10 million Americans who had no coverage in 2013 signed up for it in 2014. Furthermore, the national uninsured rate for those under the age of 65 fell by 5% to 11% in total. Of those over the age of 65, largely because of the benefits of Medicare, more than 98% have coverage.

A closer look at those numbers reveals that the younger generation of Americans appears to have benefitted the most from the plan. Of those between the ages of 18-34, the uninsured rate fell from 21.6% to 14.2%. I know for myself personally, I benefitted because I am now allowed to remain on my parents’ health plan until the age of 26, longer than I was originally permitted to be. Along with the younger generation, it appears those in the lowest 20% of income also benefitted mightily form the plan, or at least more so than other those of higher economic classes. Their uninsured rate fell from 26.4% to 17.5%, a nearly 10% decrease that is far more than the other income classes.

However, while this certainly all looks very well on paper, it is not so easy to call the plan a huge success. For starters, while those who are poorer now have more healthcare coverage, what about those in the middle class? Many of these individuals have not fared as well. If  more people have coverage than that means insurance companies have more costs to cover, if they have more costs to cover than that means rates have to go up for existing plans. And this has been the case for many of those in the higher economic classes. For many, those premium plans they had in the past have increased in cost, meaning they are now paying the same amount of money for worse coverage or they have to pay more for the same coverage plan. And I think that is an important factor to consider in evaluating the Affordable Care Act, more people have healthcare, but at what cost to the quality of coverage? How “affordable” is it actually?

The question then becomes, how do we keep costs lower? Well, just speaking on personal experience, I think there needs to be more regulation regarding the cost of services within the industry. Just recently my grandfather had to spend a night in the hospital for a back issue. The bill? Just over $17,000. Yes there were a number of tests and procedures that were conducted on him, but all came back inconclusive and he was ultimately given some pain killers and sent home with no actual diagnosis of what the problem was. A closer analysis of the bill revealed that 3-4 doctors were asking for money for services rendered. What did some of them do? Simply, introduce themselves and say they were part of the “team”. That is about 30 seconds of their time and they were never seen again. They were asking for over $500 for their services. The cost of those hospital dresses? Almost $200. I do not know what the affect of the Affordable Care Act has been on insurance companies themselves or doctors in terms of salaries and profits, but these prices are completely out of control, there is no doubt about it.

 

All the articles for this class were interesting reads. In “A Perfect Fit for Some, but Not Others,” the varying perspectives of Americans from different geographic, financial, racial, and medical backgrounds was a good insight to how the Affordable Care Act has affected the nation. The majority of positive feedback regarding the impact of the policy was expected, but I found it depressing to hear that though some of the interviewees have grave health problems, they are not able to get insurance or afford medical procedures to improve their conditions. The Affordable Care Act has surely decreased the number of Americans that are uninsured, and that is a major improvement that can take us a step further to achieving full coverage of everyone. “Obama’s Health Law: Who Was Helped Most” breaks down demographics of people getting the most out of the act, and I found it surprising that different cohorts receive a different amount of opportunities to be insured.

In “A Perfect Fit for Some, but Not Others,” one of the interviewees Sharon Tomalavage argued that adults should not be obligated to get insurance. Rather, the focus should be on children. As visualized in the info graphic article, Americans in younger age groups received less insurance benefits, while older Americans had the highest insurance increase. It is understandable that seniors require the most health attention, but children have plenty of health problems as well. One way to put it is, adulthood is the calm after a storm, and before another. Of course that is not always the case, as it depends on the health of the individual. But in general, adults require the least medical attention, so it was interesting to find that adult Americans had higher insurance occurrences than children.

I also found another point interesting. The government requires Medicaid candidates to have an income of at least $11,670 to $46,680, which is a group of people who are way above the poverty level. But isn’t Medicaid about aiding low-income families to get the care they deserve? In the interviews, one of the Americans, Teresa E. Stoikes, was not qualified for Medicaid. Although she is financially struggling, she was rejected for Medicaid because she was too poor. I find the standards for being eligible for Medicaid and the nature of the health care program are contradictory. If Medicaid was designed to help the underprivileged afford the medical attention they need, why would it be offered to people living in extreme poverty?

To go back to one of our first discussions: why is income inequality deleterious to general society? We have mentioned that income inequality leads to rising health problems because people with lower wages work longer hours to receive sustainable pay. The amount of stress fostered from overworking is the major contributor to prominent health issues. However, I have began to think that income inequality is not only a possible factor that creates health problems, but it also fuels existing problems in a different manner. Although “Is the Affordable Care Act Working?” article says that the policy has not majorly affected health spending, the act may have indirectly led to uninsured Americans to reduce their health spending. Going back to Stoikes’ interview, Teresa states that she is afraid to go to the doctor despite her severe health issues. Since she is not qualified for Medicaid, she has accumulated a large amount of medical debt. As a result, she refuses to see the doctor for her worsening diabetes symptoms. This is a grave problem as the Affordable Care Act is perhaps missing people who actually need the aid the most.

Overall, I think the Affordable Care Act is a great progress toward coverage for all. Hopefully it will continue to improve and become equivalent to the inexpensive health care in Canada. But according to the last article, if Ted Cruz becomes president, he vows to tear down Obamacare. As described in the first article, Americans that were strictly Republican tended to remain without insurance. So, Cruz’s declaration makes sense to appeal his party. It was funny to read that Ted Cruz made a mistake of thinking that the Affordable Care Act forces Americans to buy insurance through its network, and not anywhere else.

 

A strong economy and constant economic growth is the main concern and goal for any individual and government. When the economy is not strong and thriving, people become impatient and demand that the government acts. This puts pressure on the politicians to find a quick solution. The quick solutions are often times not sustainable and not well thought out. It may temporarily solve the economic crisis, but it will come back, in addition to new issues. Fracking is only one method that falls into this category, and Governor Cuomo was smart in banning it.

It is likely true that if Cuomo had allowed fracking in New York State, the areas with the new abundance of natural energy to sell would thrive. More jobs would be available, leading to more investments and purchases, leading to more jobs and economic growth and possibly mobility. Embracing this would likely decrease levels of poverty and give Cuomo’s administration a stronger following from the rich, since they will likely be the ones to make use of the land. The cost of gas and oil would decrease and people outside these communities would benefit as well. It definitely seems like a win-win situation.

Looking longer-term, fracking will only hurt the economy. It is not sustainable to rely on natural energy sources for economic growth. While the situation in the state of New York is very different than a developing country, the idea is very similar. Once a new energy source comes along, the economy will experience a downward spiral again and potentially erase any gains that were made. This time, the negative impact to both the environment and health of the community has already been done.

Companies engaged in fracking do not deny the risks of fracking to the environment and health of the communities around them. It can cause earthquakes and contaminate the water and the surrounding areas. People have to deal with more pollution from the use of these gases and risk consuming contaminated water. Let’s clarify people really quick. It is only the poor who have to continue living in the area, not those who are actually investing in the fracking, that have to suffer. The rich can stare from afar. The quality of the land diminishes with the arrival of these frackers who are supposed to help improve lives. Advocates for fracking claim that it is a case-by-case basis. Those who are careful can avoid introducing health complications to the surrounding areas. However, accidents happen. No company can guarantee that no mistakes will be made. In addition, there is no hard data that suggests what will happen to the environment with the continued use of fracking. Most predictions do however point to terrible outcomes.

Rather than sticking to the past, governments should encourage new energy sources that will not harm the environment or the health of people. This will help keep an economy healthy and potentially lower health costs, as less people will be inclined to sicknesses from pollution and contaminants. Alternatively, governments can invest capital into new industries that are not even energy related. To jump-start an economy does not require dramatic, harmful tradeoffs for temporary wealth. The people want constant growth and prosperity, and the government can provide that without fracking. Cuomo completed a great first step by banning fracking in New York.

The Affordable Care Act is a policy formed with great intentions, but hindered by poor planning and execution. A universal health care system, in theory, would improve the lives of everyone in the country. Anyone can afford treatment when needed, and everyone is able to receive a periodic checkup to avoid illness. The greater social impact would be tremendously positive as well, as the country overall would be healthier and people would be able to live better, longer. Yet, the general “One size fits all” philosophy behind the act (in the sense that everyone needs to buy from the marketplace no matter what his/her situation may be) creates sporadic results.

Despite the issues in the policy, the Affordable Care Act managed to show some positive results. For instance, the end of 2014 insured 10 million people because of this act. The subsidies provided from the Affordable Care Act are the primary reason that those who could not otherwise sign up for health care are able to. This is one of the most important targets for the government, as these are the people who are in need of help finding care. While it still remains true that the wealthier classes are still the ones that have the majority of their group covered, the poor made the most significant gains. While receiving health care at an affordable price is not necessarily closing the inequality gap, it certainly is allowing the poor to live a life with a little less stress and worry.

Another positive side effect of the Affordable Care Act is the fact it can allow for people to pursue other endeavors without worrying about losing healthcare from not being a full time employee. As the case for Lyla Turner, who could continue her education and later pursue a higher income job, instead of sticking to her limited growth potential job. She was only able to do this because her income bracket allows her to purchase healthcare for a highly subsidized cost after she stopped working full time. This ideally would allow for those in the lower economic classes to find a way to pursue higher education or other alternatives to move up the ladder.

Even with all the positive aspects, the problems with the policy are loud. The positive impacts are not seen for everyone. For starters, providing health care will not directly help close the income gap. It frees up one burden for a few people, and gives them an opportunity to pursue alternative high potential career paths, but for many it is only an extra cost. Middle class families do not receive the same subsidies as those who make slightly less income do. In that case it is just another cost to add in to an already limited budget. Younger people have to carry the cost of health care and student loans, even though it is the older people who need the coverage. Although more people can afford and have coverage, not everyone is benefiting from it.

Is there a solution to fix the Affordable Care Act? Likely not in the near future. The idea of a universal health care system is difficult to manage in a society that does not want the government to mandate extra costs. The mission is great and should be one to pursue, but it needs to be done in a way that will actually help everyone. It can’t be a “one size fits all” system. Rather, it needs to specifically target the different classes with different policies.

 

 

The Affordable Care Act has been one of the most significant healthcare legislations passed in recent decades, and has created numerous debates on its effectiveness, costs, needs and political agendas. After various technological mishaps, and countless advertisements both on behalf of the Obama administration as well as third-parties, 10 million more people have insurance in 2014 due to the healthcare legislation. Now that these people have finally been insured, the underlying statistics and trends are interesting to analyze as it may say something about income inequality. According to “Obama’s Health Law: Who Was Helped Most” by Kevin Quealy and Margot Sanger-Katz, the majority of people who signed up for the Affordable Care Act were “people between the ages of 18 and 34; blacks; Hispanics; and people who live in rural areas.” Not surprisingly, more people signed up for the healthcare Act in Democratic states than Republican states, as the legislation gave states the choice to opt-out of the Medicaid expansion. It really is a shame that certain states haven’t encouraged this healthcare Act due to political agendas from certain parties within the States, as it does really benefit the lower-income families living there. I don’t necessarily see the direct correlation between new healthcare legislation and decrease in income inequality as stated by the article; “[its] essentially redistributing income — in the form of health insurance or insurance subsidies”. The Affordable Care Act definitely does helps those low-income families that usually don’t have insurances due to the unaffordable premiums or the fact that their jobs rarely provide it.

The New York Times article “Is the Affordable Care Act Working?” presents more statistics showing the healthcare Act’s effectiveness in its implementation, and how it also benefits the health care industry as a whole. The number of uninsured Americans has decreased by 25%, even with the 23 states that have declined to expand Medicare. It is projected that the number of uninsured Americans however, will hover around 30 million for the next several years if the 23 states still don’t expand the health insurance plans. These states are making it difficult to reach about 4 million low-income Americans who are living in these regions and have not obtained affordable health-care insurance. The next point to focus on regarding the Act is if it truly is affordable. This fortunately was true as well, as the subsidies that come with the plan decreased the cost of premiums for the 85% of insured individuals that were qualified for the subsidies.

In addition to benefiting the general public, the Affordable Care Act has enabled the health care industry, specifically various hospital companies throughout the US to profit immensely. I found this aspect to be very interesting because I previously interned at a middle-market investment bank that focused on healthcare companies. During my investment banking summer internship, I focused heavily on emergency services, and hospital companies. Some of my responsibilities were to analyze the companies’ business models, and understand the various external factors that affected their revenue streams and profitability. I researched large companies such as Healthcare Corporation of America and found out that this healthcare Act significantly decreased bad debt expense on behalf of the hospital chains since more patients were insured, and ensured more payments to the hospitals and physicians. There were much more inpatient flows than before, and since there were more insured patients, physicians received more compensation, creating a domino effect of positives for the hospital chains’ top and bottom line. As shown in the article, most hospital, health insurance and pharmaceutical companies posted healthy profits within 2014.

As much as the law benefits healthcare companies, the main value proposition it offers is still primarily for the millions of uninsured Americans. The NY Times article “A Perfect Fit for Some, but Not Others” does an excellent job of portraying how the law can benefit some while possibly harming others. Lyla Turner, a hairdresser in St. Louis, serves as a great example of how the Act can alleviate financial problems in regards to healthcare plans. She received a generous subsidy that decreased the cost of her marketplace plan, making it very affordable for her. There are more benefits in her plan with an attached cost that is less and a higher deductible. It seems quite picture perfect when put in Turner’s context, and surprising when politicians argue that it might actually be more expensive than normal. I found out the reality however, when reading Mark Segina’s story. Their new health insurance cost was shockingly more than their mortgage payment. It made sense to get all the medical treatment that they could get while covered, but having the plan in a long-term period did not seem realistic. In his case, it does seem that the “insurers are going to charge what the market can bear and keep pushing the envelope until it collapses.”

The debate over the Affordable Care Act has been very contentious, and I believe there needs to be more transparency regarding how insurance premiums are configured, and how much medical costs truly are. Personally, when I go to the doctor and have a check-up or a treatment without coverage, I am shocked to see the high costs that do not really have a full explanation. The various insurance cost and premiums that go along with it, need to have a better explanation as well, as the public needs to be educated on why premiums may be higher for certain individuals while it may be lower for others. Overall, the Affordable Care Act does seem to benefit millions however, as millions of low-income families that previously did not have access to quality healthcare plans, are now able to afford them. We have to see how the plans can reach millions of others in states that have not complied with the Act, and how the law can truly affect health outcomes of many Americans.

As soon as something like “universal healthcare” is mentioned, Westerners usually rationalize that with dreaded communism ideology. A negative connotation associated with protecting everyone from hospital debt. And I find that very sad. Why can’t everyone be entitled to free healthcare? Why should U.S. citizens be subjected to paying insurance premiums with the insurance companies making out like bandits? To me, it just isn’t fair. I think what Obama tried to do is noble and needed.

The Affordable Healthcare Act impacted Americans in different ways. For some, it was very positive, and others, not so much. People had criticisms and much to say when it debuted (or failed to debut with technical issues) in 2013. The Republicans did almost everything in their power to stop it. And repeal it. They fought tooth and nail and have vowed to end it once a Republican takes the office again. But that’s a whole other debate.

The Act had many positives going for it. It reduced that amount of uninsured by 25%. It allowed children to stay on their parents’ health plan up until the age of 26. I know I’ll (as well as my college colleagues) will really benefit for the next few years under this. Like every action, there is an opposite reaction. People who already had coverage saw their health insurance premiums increase. In some areas, competition between insurers increased, bringing the overall price of premiums down. In other cases, the amount of insurers decreased, in regard to falling within the specific guidelines of the Act, causing prices to increase. The Middle class has been having the biggest issues with this (as usual) and have seen the highest increases.

The young (age 18-34) seem like the largest group that has benefited, along with huge reductions with the Hispanic and Black communities. Even still, both groups lag far behind Whites and Asians for percentage who have insurance coverage. The lower class reduced about 9% of uninsured, having the highest percent change out of all the income groups. This bill was for them – those that had the most trouble covering their healthcare.

States that expanded Medicaid saw a huge decrease in their uninsured – more people received much-needed coverage and were able to afford it. States that fail to expand Medicaid are only hurting themselves. After checking (and predicting this) most of the states that have failed to do so are the southern and mid-western states – mostly republican. (http://familiesusa.org/product/50-state-look-medicaid-expansion)

Those that were affected varied across the country. It seemed that the mid-western and western U.S. benefited more so than the east. Those that remain the most uninsured are from the southern states, such as Texas, Louisiana, Mississippi, Florida, the Carolinas, Tennessee, and Alabama, most of the states that have not expanded Medicaid. One thing’s for sure – this Act, even with its issues and faults, still helped out a good percentage of the population. With an estimate and constant 30 million people remaining uninsured, states need to change some of their policies to help their people. I think this Act can be amended to be made better and cover more people – but it started something that I think every single person should be entitles to.

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