The

Peoples Papers

Thanks, Obama:
The Problems of ObamaCare
Jiwon Lee
April 13, 2015
Introduction

ObamaCare, formally known as Patient Protection and Affordable Care Act (PPACA), or
Affordable Care Act (ACA) for short, is a legislation created to reform the health care industry.
It is designed to not only make health insurance more affordable and accessible, but also improve
its overall quality. The United States Department of Health and Human Services claims that it
gives the American people the stability and flexibility they need to make informed choices
about their health.1 From this description, one may wonder why anyone would oppose such a
beneficial legislation. On the contrary, majority of the American public is against the ACA. The
description of the law above, as it turns out, does not account for the extent of its problems.
On March 23, 2010, President Obama signed the ACA into law. Today, five years after its
enactment, the ACA still has not been fully accepted by many Congressmen and the American
public. The Supreme Court upheld the legislation on June 28, 2012 with a split vote of five to
four. Just like the Supreme Court justices, the American public is strongly divided on the issue of
health care. The infographic on the next page from Real Clear Politics, an independent political
website, is a collection of some of the most cited polls taken in 2015.2 All of the sources reported
that more Americans oppose the ACA than favor it. Other sources have reported that the support
for the ACA today is lower than it has ever been. According to the Associated Press Gfk, one of
the worlds largest research companies, only 26 percent of Americans is in favor of the
legislation. 41 percent said it should be completely repealed, while the rest said it should be
modified.3 These various polls reveal a general disapproval of the ACA by the American public.

Thanks, Obama: The Problems of ObamaCare 1

Public Views on ObamaCare

CBS News

Poll Sources

Pew Research
Reuters/Ipsos
Fox News

Against/Oppose

NBc News/Wall St. Jrnl

For/Favor

Rasmussen Reports
Gallup
0%

10% 20% 30% 40% 50% 60% 70%

Percent of Respondents

Source: "Other - Public Approval of Health Care Law." RealClearPolitics. RealClearPolitics, n.d. Web. 13 Apr. 2015.

The controversy of the ACA is mainly due to its various financial disadvantages for individuals.
Many Americans are currently suffering from its repercussions that are yet to be resolved. The
Republican-led house has voted more than 50 times to repeal or cut back ObamaCare, but faced
objections from the Democrats in the Senate. The only way to prevent further damage now is for
citizens to join the efforts of these congressmen to demonstrate to the policy makers the true
consequences of the ACA. ObamaCare must be revised immediately to alleviate the financial
burdens of Americans.

________________________________________________________________________

Health Insurance Is Mandatory

The Affordable Care Act requires all citizens to have health insurance, or pay a fine. The purpose
of this individual mandate is to encourage citizens to participate in ObamaCare and get health
insurance. The fines are paid in taxes, which ultimately fund the ACA. Unfortunately, this means
that even if people do not want health insurance, they still have to get one. For example, a 26year-old male may not find health insurance to be necessary. He may be healthy enough and find
cures to common diseases through drugstore medications. He may also not have a high-paying
job, so he would have to struggle to fit health insurance expenses on his tight budget. However,
he has no choice but to buy health insurance under the ACA, or pay the fines.
Health insurance is not cheap. According to the National Review, an average American family
with two parents and two children pays around $20,000 a year for health insurance.4 The recent
census revealed that the median household income was $51,939 in 2013.5 With health insurance
taking up about half of the familys annual income, it puts a strain on many Americans financial
situations. Yet, they are forced to endure the heavy burdens of health insurance.
Thanks, Obama: The Problems of ObamaCare 2

This is where the question of freedom comes into question. One of the main arguments for
universal healthcare is that health insurance is a right, not a luxury. Thus, everyone has the right
to get health insurance. However, if this is the case, people should also have the right to not get
health insurance. Grace Marie Turner is the President of the Galen Institute, a non-profit, public
policy research organization. She asserts that, Free citizens will be required to spend our own
personal, after-tax money to purchase an expensive private product.6 As Turner points out,
people should have the freedom to allocate their budget.
Despite the financial burdens, some people still favor the ACA. They argue that the government
provides subsidies for individuals to make health insurance more affordable. These subsidies are
tax credits that individuals can use to obtain health insurance. While this is true, the subsidies
have been strongly disputed recently. Halbig v. Burwell is a court case that challenges the ACA
and its ability to provide subsidies under federal regulation. The challengers argue that the text of
the ACA only allows the government to provide subsidies under state-run health insurance
markets. On July 22, 2014, the D.C. Court of Appeals ruled in favor of Halbig, which means that
all the states that do not have their own markets will no longer be able to provide subsidies.7 The
infographic below from Business Insider shows that 36 states do not have their own markets and
will lose their health insurance subsidies.8 Timothy Jost, a health law professor at the
Washington and Lee University School of Law, claims that approximately five million
Americans will lose their tax credits and thus, their health insurance due to this ruling.9 The
complete burden of health insurance will soon fall into the hands of the patients.

Source: Jennings, Katie. "A Federal Appeals Court Just Invalidated Obamacare Subsidies In These 36 States." Business Insider.
Business Insider, Inc, 22 July 2014. Web. 13 Apr. 2015.

Thanks, Obama: The Problems of ObamaCare 3

__________________________________________________________
The Alternative Is Not Much Better

Some people choose to pay the penalty rather than pay for health insurance. However, the fine is
not cheap either. Even worse, the price of the penalty increases every year. The infographic
below from the IRS shows the increase in the cost of the individual mandate from 2014 to
2016.10 From $95 per adult to $695, the penalty has gotten incredibly more expensive in just two
years. The price will continue to increase at an unreasonable rate, leaving people with no option
but to buy health insurance.

Source: W:car:mp:fp. 2014 Instructions for Form 8965 (n.d.): n. pag. Web.

Proponents to the ACA might point out that there are exemptions to the individual mandate for
those that really cannot afford either option. One cannot deny this fact, but the exemption does
not apply to many that need it. The infographic on the next page from the CBO shows the
number of Americans that are expected to pay the fine for not having health insurance.11 100
percent is the poverty line, which means that millions of Americans that are barely making ends
meet will have to pay for either health insurance or the fine. Even those that are below the
poverty line, approximately six million people, do not qualify for the exemption and will have to
somehow afford the expensive product.
The infographic calls to attention another severe repercussion of the ACA. There is a significant
difference between the initial estimate and the revised estimate. For example, there was a 0.4
million people increase from the initial to the revised estimate for those that are 200 to 300
percent above the poverty line. This means that a third of that group was initially not expected to
pay the fine. The uncertainty and the growing harm of the ACA are affecting increasingly more
people, perhaps even more than what the creators of the ACA originally anticipated.

Thanks, Obama: The Problems of ObamaCare 4

Percent Above the Poverty Line

Americans Expected to Incur the Individual

Mandate Penalty
Greater than 500%

1.2

0.9

400%-500%

0.5

0.6

300%-400%

1.1

0.7

200%-300%
100%-200%
0.4
0

0.2

0.4

Initial Mandate

1.2

0.6

Less than 100%

Revised Estimate

1.2

0.8

0.6
0.6

0.8

1.2

1.4

Numer of Americans (In Millions)

Source: States, Congress Of The United, and Congressional Budget Office. CBO (n.d.): n. pag. Web.

________________________________________________________________________

Higher Quality, Higher Cost

The Affordable Care Act also affects those that already have health care. Under the 80/20 rule of
the ACA, health insurance companies are required to spend 80 percent of the patients premium
dollars, the money received from the patients, on health care. Prior to the ACA, health insurance
companies would spend much of the premiums on the company itself rather than the actual
health care for its patients. Under the ACAs new and higher standards, health insurance qualities
have improved.
However, there are several drawbacks to this benefit. The first is that insurance companies have
raised the cost of premiums to accommodate for the decrease in percentage of premiums spent
on company funds. According to the Western Free Press, this increase was $2,100 per family.12
So although health insurance policies have improved, people have to pay more for the benefits.
The infographic on the next page from healthcare.org represents the increase in the cost of
premiums before and after the ACA for medium low premiums in California.13 Both young and
old people have experienced severe increases in their premium costs, nearly 150 percent. This is
not just the case for people in California. Most places in the United States are making their
premiums more expensive for young and old people alike.

Thanks, Obama: The Problems of ObamaCare 5

Source: Roy, Avik. "Rate Shock: In California, Obamacare To Increase Individual Health Insurance Premiums By 64-146%."
Forbes. Forbes Magazine, n.d. Web. 13 Apr. 2015.

Another drawback is that many insurance policies could not meet the new standards and were
canceled. According to the Associated Press Report, 4.7 million Americans lost their health
insurance policies because of the ACA.14 Many of them either were offered another policy by the
same company, or had to find a completely different policy at the health insurance marketplace.
A study done by the Henry J. Kaiser Family Foundation found that 39 percent of those that lost
their health insurance policy under the ACA wound up paying more for their new insurance.15
Many Americans were perfectly content with their old insurance benefits, but they must now pay
for benefits they did not necessarily want.

________________________________________________________________________

Employees Are Losing Their Work Hours

Under the Affordable Care Act, all businesses with 50 or more full time employees must provide
health insurance to at least 95 percent of their employees and their dependents up to age 26. A
full time employee is legally defined as someone who works from 30 to 36 hours a week. This
employer mandate negatively affects employers and employees alike. It is especially detrimental
for small businesses because many of them cannot afford health insurance for all of its full time
employees A research by Journal Sentinel has found that many businesses are cutting their
employees hours to 29 to avoid paying for their insurance.16 This means that not only do
employees lose their health insurance, but they also lose the money earned in those couple hours.
Employers also struggle as an increase in part time workers makes running a business harder.
Thus, the employer mandate of the ACA harms many small business employers and employees.
Thanks, Obama: The Problems of ObamaCare 6

Source: Conover, Chris. "Who Can Deny It? Obamacare Is Accelerating U.S. Towards A Part-Time Nation." Forbes. Forbes
Magazine, n.d. Web. 13 Apr. 2015.

The infographic above from the Federal Reserve Bank of St. Louis shows the ratio of part time to
full time employees.17 There is a noticeable increase in the ratio after 2010, when the ACA was
enacted. It is not that employers are hiring more part time employees, but that they are taking
away the hours of their full time employees to make them part time employees. The ratio is
higher than it has ever been. The ACA is infringing upon the jobs of many Americans.

__________________________________________________________
Possible Solutions
Because the ACA still benefits the Americans that align with the ideal criteria of the legislation,
a complete repeal of the ACA may be unnecessary. In addition, it may be too late and too
difficult to revoke the law, since the Supreme Court upheld it. However, the problems of the
ACA still need to be resolved. While repealing the law may be highly unlikely, changing the
particular areas of concern is still possible.
One solution is to pass a bill asking for those changes. Many Republicans oppose the ACA
because they believe that private companies can provide better health care service than
government-run programs. This is helpful in two processes of passing a bill. The first advantage
is in the first step of getting a bill to become a law. Anyone can write a bill, including ordinary
Thanks, Obama: The Problems of ObamaCare 7


citizens. However, only Congress can introduce one. Because so many Congressmen oppose the
ACA, it will be easy to get a member of the Congress to introduce the bill. The second advantage
is in the House of Representatives. Because the House has 435 members, it is hard to take every
members opinions into account. Therefore, the House has rules that give the majority party great
advantage. In fact, the members of the minority party do not have much power at all in the
House. Since the current majority party is the Republican Party, the revision of the ACA is likely
to pass the House.
Similarly, citizens can vote for congressmen that oppose the ACA. These congressmen will then
have the power in politics to revise the legislation. This solution requires a collective effort from
citizens to support those congressmen. In the upcoming election, citizens must participate and
vote if they want the problems of the ACA to be resolved.
Another solution is to bring the law to court. Like Halbig v. Burwell, parts of the ACA may be
challenged to change the problematic areas. While this solution involves numerous cases and
requires working with tedious details of the law, the small changes will solve the issues one by
one. Because the court has the final say on the law, these changes would be permanent and
highly effective.
These various solutions all require ordinary citizens and policy makers to work together. Citizens
need the power of the policy makers and the policy makers need the support of the citizens.
Thus, citizens and policy makers alike must take action. It is only when this binary relationship is
achieved that the ACA can be revised.

__________________________________________________________
Conclusion

The Affordable Care Act was created to provide more people better health care. However, it
caused several repercussions. From paying fines to losing work hours, the ACA has infringed
upon the financial situations of many Americans. Despite the opposition of the majority of the
American public, the ACA is still in effect. The issues of the ACA must be resolved immediately
before further damage is done.
Although the ACA was enacted over five years ago, it is still a work in progress. It is constantly
being reviewed and revised. While the benefits are increasing, so are its burdens. With each new
advantage, a new disadvantage arises. This never ending zero sum pattern must end. It is not too
late; the problems of the ACA can be stopped now. The ACA has been changed before, and it
can change again. The possibility is there. It is now up to citizens and politicians to recognize the
suffering of Americans and take control of the health care reform.

Thanks, Obama: The Problems of ObamaCare 8

__________________________________________________________
Endnotes

1 "About the Law." About the Law. United
States Department of Health and Human
Services, n.d. Web. 13 Apr. 2015.
2 "Other - Public Approval of Health Care
Law." RealClearPolitics. RealClearPolitics,
n.d. Web. 13 Apr. 2015.
3 "Obamas Health Care Fails to Gain
Support; Americans Expect Fixes, Not
Repeal." Associated Press GfK Poll. GfK
Public Affairs & Corporate
Communications, Associated Press, n.d.
Web. 13 Apr. 2015.
4 "The Top Ten Worst Things in
Obamacare." National Review Online.
National Review Institute, n.d. Web. 13
Apr. 2015.
5 Raphael, Steven. "Immigration and Poverty
in the United States." The American
Economic Review 99.2, Papers and
Proceedings of the One Hundred TwentyFirst Meeting of the American Economic
Association (2009): 41-44. Web.
6 Turner, Gracie Marie. "Grace-Marie Turner
Archive." National Review Online. N.p.,
n.d. Web. 13 Apr. 2015.
7 United States Court of Appeals. St. Louis,
MO: United States Court of Appeals, 2000.
Web.
8 Jennings, Katie. "A Federal Appeals Court
Just Invalidated Obamacare Subsidies In
These 36 States." Business Insider.
Business Insider, Inc, 22 July 2014. Web.
13 Apr. 2015.

9 Furrow, Barry R., Thomas L. Greaney,

Sandra H. Johnson, Timothy S. Jost, and
Robert L. Schwartz. Health Law. N.p.: n.p.,
n.d. Print.
10 W:car:mp:fp. 2014 Instructions for Form
8965 (n.d.): n. pag. Web.
11 States, Congress Of The United, and
Congressional Budget Office. CBO (n.d.):
n. pag. Web.
12 Cook, Christopher. "Obamacare Is Not
Working." Western Free Press. Western
Free Press, n.d. Web. 13 Apr. 2015.
13 Roy, Avik. "Rate Shock: In California,
Obamacare To Increase Individual Health
Insurance Premiums By 64-146%." Forbes.
Forbes Magazine, n.d. Web. 13 Apr. 2015.
14 "Policy Notifications and Current Status,
by State." Yahoo Finance. Associated
Press, n.d. Web. 13 Apr. 2015.
15 Appleby, Julie. "Survey: Most Buying On
Insurance Exchanges Were Uninsured."
Kaiser Health News. Henry J. Kaiser
Family Foundation, 19 June 2014. Web. 13
Apr. 2015.
16 Boulton, Guy. "Effects of Obamacare's
Employer Mandate Remain Uncertain."
Journal Sentinel. Journalmediagroup, 13
Apr. 2015. Web. 13 Apr. 2015.
17 Conover, Chris. "Who Can Deny It?
Obamacare Is Accelerating U.S. Towards
A Part-Time Nation." Forbes. Forbes
Magazine, n.d. Web. 13 Apr. 2015.

Thanks, Obama: The Problems of ObamaCare 9