Patient Protection and Affordable Care Act(2010) “Obamacare”

1. Patient Protection and Affordable Care Act(2010) “Obamacare” Cindy Nguyen, Matthew Pham, Adriana Moya~ 7th Period

2. Purpose • President Obamasigned the Affordable Care Act on March 23, 2010.ObamaCare's health care reform does a number of important things including offering Americans a number of new benefits, rights, and protections in regards to their healthcare, and setting up a Health Insurance Marketplace where Americans can purchase federally regulated and subsidized health insurance during open enrollment. The law also expands Medicaid, improves Medicare, requires you to have coverage in 2014 and beyond, and contains some new taxes and tax breaks, among other things.

3. Supreme Court

4. Supreme Court Democrats~ support Republic~ impede Unanimous opposition from Republicans however the Democrats were able to pass the act. (NO vote in support of the act in either house of congress) The republicans believe that the ACA is unconstitutional. Higher taxes for business with more than 50 employees. • Nearing the election of 2012 President Obama passed the ACA, which provided all Americans with health care a promise Democrats have attempt to achieve for nearly a century. • The Affordable Care Act will end the worst insurance company abuses. • The act provides tax cuts to small business to help offset the costs of employee coverage, and tax credits to help families pay for insurance. • Base constitutionality of act on the federal governments ability to tax its citizens

5. Key Beneficial Features of the ACA • Improving Quality and Lowering Healthcare Costs • Free preventive care • Prescription discounts for seniors • Protection against health care fraud • Small Business Tax Credits • New Consumer Protections • Pre-existing conditions • Consumer Assistance • Access to Healthcare • Health Insurance Marketplace. • Benefits for Women • Providing insurance options • Covering preventive services • Lowering costs • Young Adult Coverage • Coverage available to children up to age 26 • Strengthening Medicare • Yearly Wellness Visit • Many Free Preventive Services for some seniors with Medicare • Holding Insurance Companies Accountable • Insurers must justify any premium increase of 10% or more before the rate takes effect • Timeline of Health Insurance Marketplace (2010) • October - Open enrollment begins • January - Coverage begins • March - Open enrollment closes • Future - All Americans have access to affordable health care.

6. Enforcement of the Affordable Care Act • There is a penalty for not having health insurance, and after the year 2014 every month one goes without insurance will be fined • Allow young adults under 26 to remain covered under your parents health plan.

8. What is the Individual Mandate? -The Individual Mandate is the term in which an individual is mandated to buy at least the minimum health coverage provisions. -Under the PPACA, individuals who do not buy the minimum coverage provision or comply with the Individual Mandate are subjected to a tax based upon their income or simply pay a set amount -The term the Individual Mandate was derived mostly from the beginnings of the 1993 “Hillary Care” movement, where conservative republicans developed the idea of universal health care to oppose Hillary Clinton’s health reform plan.

9. Is it constitutional? • Many states were unhappy with the ruling, and even challenged the act, leading to the Supreme Court

10. Is It Constitutional? • Before National Federation of Independent Business v. Sebelius, the question was…… “ Does the Government have the right to tax or penalize people for not buying the minimum health coverage?”

11. OH YEAH!!! IT’S CONSTITUTIONAL!!! • Republican Supreme Court Justices Kennedy and Scalia argued that this us a big step over personal liberties because, this simply forces people to buy something that they may not want to buy. • They also made it obvious that if this is deemed constitutional, then the government can simply make citizens buy things like broccoli or cars(Republicans actually used that in their arguments) • Democrat Supreme Court Justices Alito and Ginsberg argued that this simply expands health care around the nation and makes it more available by prompting people to buy it. • Another argument was that this is program that everybody will eventually have to buy. • (One of the Court Justices argued that there should be a burial insurance because everybody is going to die at some point)

12. OH YEAH!!! IT’S CONSTITUTIONAL!!! • In the Landmark decision of National Federation of Independent Business v. Sebelius, on June 28, 2012, the Supreme Court declared it constitutional with a vote of 5-4 with Chief Justice Roberts casting the 5th vote for democrats.

13. Conservative Roots of Health Care Reform • The fight of Republicans and Democrats on health care reform goes back all the way to 1986 when Ronald Reagan implanted the Emergency Medical Treatment and Active Labor Act of 1986; This act required nearly all medical centers who provided Medicaid, to allow treatment of anybody in an emergency, regardless of ability to pay • The concept goes back to at least 1989, when the conservative Heritage Foundation proposed an individual mandate as an alternative to single-payer health care. It was championed for a time by conservative economists and Republican senators as a market-based approach to healthcare reform on the basis of individual responsibility and avoidance of free rider problems. Specifically, because the 1986 Emergency Medical Treatment and Active Labor Act (EMTALA) requires any hospital participating in Medicare (which nearly all do) to provide emergency care to anyone who needs it, the government often indirectly bore the cost of those without the ability to pay. • When President Bill Clinton proposed a healthcare reform bill in 1993 that included a mandate for employers to provide health insurance to all employees through a regulated marketplace of health maintenance organizations, Republican Senators proposed an alternative that would have required individuals, but not employers, to buy insurance] Ultimately the Clinton plan failed. After failing to obtain a comprehensive reform of the healthcare system, Clinton negotiated a compromise with the 105th Congress to instead enact the State Children's Health Insurance Program (SCHIP) in 1997.

14. Republicans Then • Republicans developed the idea of an individual mandate when Hillary Clinton’s “Hillary Care” plan was released in 1993; Republicans responded with the idea of an individual mandate to combat her health care reform • The 1993 Republican alternative, introduced by Senator John Chafee as the Health Equity and Access Reform Today Act, contained a "universal coverage" requirement with a penalty for noncompliance—an individual mandate—as well as subsidies to be used in state-based 'purchasing groups'. Advocates for the 1993 bill included prominent Republicans who today oppose a mandate, such as Senators Orrin Hatch, Chuck Grassley, Bob Bennett, and Kit Bond. Of the 43 Republicans Senators from 1993, 20 supported the HEART Act. Eventually they removed the mandate from the bill, stating he had decided "that government should not compel people to buy health insurance".Atthe time of these proposals, Republicans did not raise constitutional issues with the mandate, the way it was viewed by the Congressional Budget Office in 1994 was, effectively, as a tax. • Champions of this health care reform were largely republican and were apart of health care groups like the Heritage Foundation and the American Enterprise Institute • Bill Clinton again replied with his speech in Tulsa, Oklahoma to the National Governor’s Association; He stated that employers would be required to buy health insurance for their employees which was widely supported by the republicans in senate at the time • Conservative thinking at the time was based on this; we want to impose health care on everybody, so if a man who does not have health insurance demands for emergency treatment will not raise the prices of health care for everybody who actually pays for it.

15. Republicans Then • Democrat Senator John Edwards sought a democratic presidential nomination in 2004 when he based part of his campaign to only mandate children, not adults to be supplied under health insurance • -Edwards ran again for the nomination in 2008, and changed his clause that all must be mandated to buy health insurance • -Mitt Romney who supported a health care law and an individual mandate, which was evident when he signed in his Massachusetts health care law, recently promised to repeal Obama care in the last presidential election. Mitt Romney’s individual mandate was supported by Newt Gingrich who worked closely with the Heritage Foundation in developing the Individual Mandate

16. Why the rush? • The Obama administration wanted to pass the ACA in the first half of his first term because it was a campaign promise to reform healthcare, so he wanted to build trust with the nation and there was a democratic majority in congress that allowed the bill to pass. Not a single republican voted to pass it in either house of congress. He also wished to target the rising unemployed American voters. • The 2010 midterm elections produced a sharp reversal of partisan fortunes. Republicans picked up a net 63 House seats to win a 242-193 majority, their best showing since 1946. They also picked up 6 Senate seats, leaving them with 47 and within striking distance of a majority in 2012, when 23 of the 33 seats at stake will be defended by Democrats. The result was a major setback for President Barack Obama and his administration, stifling his agenda and endangering his signal legislative achievements, notably health care reform and financial regulation.

17. State Exchange vs. Federal Policy • Some states have chosen to utilize the optional clause in the ACA to run the insurance within their own states. There are websites for exchanges that individuals can sign up for online to determine their own policies. The difference between the state implemented and federally implemented exchanges is that within the state it allows power to stay on a local basis and not a federal one, and it also allows for individuals to purchase cheaper insurance. The cost is lower because although there are still regulations on what individuals need, the states have some power to allow different coverages in different circumstances and may charge lower rates.

19. Work Cited • http://www.hhs.gov/healthcare/rights/ • http://www.hhs.gov/healthcare/facts/timeline/index.html • http://www.democrats.org/issues/health_care • http://www.cc.org/news/republicans_039obamacare039_impedes_job_growth • http://www.irs.gov/uac/Affordable-Care-Act-Tax-Provisions-for-Large-Employers • http://kff.org/infographic/the-requirement-to-buy-coverage-under-the-affordable-care-act/ • http://www.gpmlaw.com/resources/newsletters/health-law-alert-supreme-court-upholds-aca.aspx • http://yro-beta.slashdot.org/story/12/06/28/1616240/supreme-court-affordable-care-act-is-constitutional • http://www.washingtonpost.com/politics/supreme-court-considers-main-constitutional-question-in-health-care-law/2012/03/26/gIQAkyKWdS_story.html