Just over two years ago, President Barack Obama officially gave birth to the Patient Protection and Affordable Care Act (PPACA) – inarguably one of the most momentous healthcare laws in our country’s history. In fact, you’d be hard pressed to find a single person in America who won’t at some point in the next two years be affected by PPACA, should it be upheld. And for those of you thinking you have no idea what I’m talking about, you might be more familiar with PPACA’s alias “Obamacare.”
Advocates of PPACA define PPACA as a federal statute that will ensure all Americans have access to affordable healthcare, and ultimately improve quality of care by rewarding doctors and hospitals who meet Meaningful Use criteria. Challengers of PPACA claim it’s an act of socialism that will degrade quality of care, as the once uninsured masses flood ERs across the country causing demand to rise far more rapidly than supply.
One thing is certain: PPACA has led to an all-out war. Soldiers on both sides of this battle continue to launch politically contentious bombs at one another in the court of public opinion, seemingly oblivious to the fact that PPACA actually headed to the Supreme Court yesterday. And while these proceedings should catch the attention of all Americans (and even those abroad), members of the healthcare community should be particularly keen on how these pivotal six hours of arguments over the next few days play out.
Before anyone goes into this week’s almost certain media frenzy over the Supreme Court hearing, there’s some very basic information that can help get you up to speed on how President Obama’s baby, so-called Obamacare, has grown – from conception to birth to its second birthday.
Conception by the Senate in the privacy of the House.
Many on the right fail to realize that the first iteration of what would become the PPACA was initially passed by the House – where the Constitution requires all revenue-related bills to originate – as a modification to the Internal Revenue Code. Many on the left fail to realize that the Senate used this iteration to catapult their own healthcare reform plan by completely revising it, incorporating terms they knew were favored by the Senate Health and Finance committees. After some debate and negotiations, the Senate passed the bill on December 24, 2009.
Planning for Kiddie Care.
Once the Senate’s version of the bill got back to the House, White House Chief of Staff Rahm Emanuel argued for a scaled back bill in the face of the recently-elected Senator Scott Brown’s imminent stalling tactics. Although President Obama leaned in support of Emanuel’s proposal, he was soon convinced not to back down by House Speaker Nancy Pelosi, who dubbed Emanuel’s pared down bill idea, “Kiddie Care.”
President Obama then introduced a healthcare reform plan of his own, and over time was successful in gaining buy-in. The most viable option at that point for advocates of comprehensive reform was for the House to pass the Senate’s bill, with every intention of subsequently passing amendments to it – much like the Senate did to the House’s original version. After a considerable amount of negotiations that involved controversial concessions by President Obama, including one related to certain restrictions on federal funding of abortions, the House passed the bill on March 21, 2010.
President Obama, the obstetrician… no wait, that’s Ron Paul.
Forty-eight hours after the House passed the bill, President Obama signed the final version of the PPACA into law – giving birth to reform even he probably couldn’t have fathomed would become such an informative machine.
The government’s website lists the following as current key features of the law:
- Rights and Protections – If you have insurance, these consumer protections can help you get the most out of your plan.
- Insurance Choices – If you need insurance coverage or have been rejected due to a health condition or disability, you may be eligible for coverage through one of these programs.
- Insurance Costs – How does your health insurance policy affect your wallet? Find out how the law helps you get the most value for your premium dollar.
- 65 or Older – The health care law strengthens Medicare and provides access to preventive services and prescription drug discounts for seniors.
- Employers – Tax credits and new programs are available to small businesses to help make care more affordable for employers, employees, and early retirees.
However, as long as the Supreme Court upholds the law, these key factors are just the beginning and a great deal of that “change” President Obama so famously speaks about is headed our way. Later this year, insurance companies have to start issuing rebates if they failed to spend at least 80 cents of every dollar last year on actual medical care rather than administrative expenses. Also notable, Women’s Preventive Services – including contraception and domestic violence screening – will be covered without cost sharing. Additionally, effective Jan. 1, 2014, insurance companies can no longer refuse coverage to those with pre-existing conditions.
The major piece of the law that seems to draw the most debate is the “individual mandate” which requires most people to obtain health insurance – or they can be assessed a penalty. And fortunately or unfortunately – depending on what side you’re sitting on – this mandate is precisely what landed PPACA in the High Court.
For more about Obamacare check out my follow-up post, Obamacare, The Problem Child.