TheRoad to Healthcare Reform
TheRoad to Health care Reform
Healthcarereforms are some of the most contentious and debated social,political and economic issues in the United States. They have beenassociated with controversies and political confrontation which haveimpacted negatively on some of the proposed reforms. The enactment ofthe “Patient Protection and Affordable Care Act of 2010”,commonly known as Obamacare is the most recent comprehensive federalstatute that has introduced widespread changes in the health caresystem. However, there are other reforms that have had comprehensiveimpacts on the accessibility, affordability and quality of healthcare services in America (Jacobs & Skocpol, 2015). The “SocialSecurity Amendments of 1965” proposed by President Lyndon Johnsonmarked the beginning of the modern health care system. Thelegislation created Medicare and Medicaid, which have been importantfeatures of the American health care system. Medicare provided apublic funded medical insurance program for the elderly, whileMedicaid covered poor members of the American society (Cohen et al.,2015). Other legislations in the 1980s ad 1990s targeted the role ofemployers in providing health care insurance for their workers. These reforms aimed at creating a universal health system that isfinanced through the payroll and government revenue. Some of theselaws include the “Employee Retirement Income Security Act of 1974”,“Consolidated Omnibus Budget Reconciliation Act of 1985”, and“Health Insurance Portability and Accountability Act of 1996”.During Clinton’s administration, health care reforms proposals wererejected and therefore not enacted into law. In the 21st century,presidential campaigns have focused on health care reforms, whichemphasized the importance of relooking at the health care system inthe country. This led to the enactment of the “MedicarePrescription Drug, Improvement and Modernization Act” and Obamacareduring President Bush and President Obama administrationsrespectively (Cohen et al., 2015).
Althoughthe Obamacare was passed into law, it has been faced with politicaland legal challenges. There have been numerous efforts fromindividual and groups opposed to the reforms to repeal thelegislation. Some of the organizations and groups that expressedpolitical and legal opposition to Obamacare include conservativelobby groups, republican politicians and tea party movements. Themain political argument that was raised against Obamacare was theincreased cost of insurance, expanded deficit and disruption ofhealth insurance plans that existed before the statute was drafted. Additionally, republican politicians argued that the provisions ofthe Obamacare were unconstitutional. Consequently, the law hasattracted several legal challenges in the Supreme Court. In the“National Federation of Independent Business v. Sibelius”, thecourt ruled that the individual mandate in the Obamacare isconstitutional. In another case, the court ruled that the federalgovernment has no mandate in forcing the states government to expandthe Medicaid program according to the provisions of Obamacare. Otherchallenges have been initiated by conservative groups such as theRoman Catholic Church due to the mandate for coverage ofsterilization and other artificial family planning methods (Jacobs &Skocpol, 2015).
Fromthe legislative and executive perspective, the most important issuein the health system is an expansion of medical coverage to increaseaccessibility and affordability of health care services. This can beachieved by expanding the scope of Medicaid program. Based on theprovisions of the Obamacare, Medicaid coverage could have expanded tocover up to 17 million Americans within a decade. However, this hasbeen limited by some legal challenges such as lack of cooperationfrom states governments. The health insurance marketplace is anotherimportant issue under Obamacare. In addition to expanding Medicaid,Obamacare aimed at increasing coverage through private insuranceprograms. Other issues include dealing with staffing issues and theincreased health spending at the government and individual levels. The law has been supported and defended by President Obamaadministration and Democratic Party politicians. However, republicanpoliticians, some state governments, conservative lobby groups andlabor unions have been opposed to provisions of Obamacare (Jacobs &Skocpol, 2015).
Throughoutthe history of the United States health care reforms, politics haveplayed a critical role. Sometimes, health care reforms arecharacterized with political cooperation resulting into bipartisaninitiative while other reforms result in conflicting and contrastingpolitical views and dynamics. In the 1960s, health care reforms thatled to the restructuring of the social security systems andestablishment of Medicare and Medicaid received support from thediverse political establishments. The bipartisan support, as well asthe overwhelming Democrats’ majority in the legislature, resultedin a landslide victory and easy passage of the reforms (Cohen et al.,2015). However, half of the opposition legislators voted against theestablishment of Medicaid and Medicare. In contrast, the Obamacaredid not receive overwhelming support from politicians. Consequently,the reforms were barely passed, underlining the lack of consensus anddeep-rooted political difference. The lack of consensus in thepassage of the law has resulted in political challenges in theimplementation of Obamacare when compared to Medicare and Medicaidprograms (Cohen et al., 2015).
Cohen,A. et al (2015). Medicareand Medicaid at 50: America`s entitlement programs in the age ofaffordable care.Oxford New York: Oxford University Press.
Jacobs,L. & Skocpol, T. (2015). Healthcare reform and American politics: what everyone needs to know.Oxford New York: Oxford University Press.