Affordable Care Act
Senator Wayne Fontana | Brookline District Office930 Brookline Boulevard | Pittsburgh, PA 15226-2106
For months now, we have watched Highmark and the University of Pittsburgh Medical Center’s (UPMC) battle grow over providing services for so many individuals in our region. I have heard from dozens of my constituents saying government must get involved and stopped this from happening. However, what if you are one of the unfortunate individuals who do not have health insurance to receive these services? Imagine being told you can’t see a doctor based on factors you cannot always control. Don’t these people matter too?
After months of partisan debate, in March 2010, Congress narrowly passed the Patient Protection and Affordable Care Act in hopes of reducing the nation’s escalating uninsured population. The new mandate, dubbed “Obamacare,” requires uninsured individuals, a bove a certain income level, to purchase health insurance or face penalties which become effective January 1, 2014. In addition, the creation of state insurance exchanges will take place under this act where people and small businesses can buy private coverage from a range of competing insurers. This new law is estimated to extend health coverage for about 32 million uninsured Americans.
The act protects all citizens and adds a safety net by imposing new restrictions on health insurers, barring them from excluding customers with preexisting health conditions as well as requires that all customers be charged the same rates. A wide range of healthy individuals will be needed in order for these new exchanges to be successful and keep rates down. However, individuals will have the ability to “opt out” of purchasing health insurance. If a person decides to opt out of buying coverage, they will incur a penalty starting at $95 or 1 percent of their income in 2014, whichever is greater, growing to $695 or 2.5 percent of their income by 2016.
The Affordable Care Act also requires businesses with 50 or more employees to provide a minimum level of health insurance for each employee, or pay a penalty of $2,000. Qualified businesses would receive a 35 percent tax credit to lower the cost of providing insurance.
Medicaid’s size will be fundamentally restructured and expanded under the new law by raising income levels of those who qualify. For decades, Medicaid has been a health-care benefit available only to people with income levels below the federal poverty line. At the end of May, Pennsylvania administered Medicaid insurance to 2.2 million people. The expansion of Medicaid would include an estimated 800,000 Pennsylvanians and 17 million people nationwide.
The federal government will pay for all the cost of the expansion of Medicaid, apart from additional administrative outlays, for several years. The states’ share of the cost of the expansion will reach 10 percent by 2020. The Health and Human Services Department has the ability to withhold a state’s entire Medicaid allotment if the state does not comply with the Medicaid provisions.
Many leaders and lawmakers across the country feel that this new law is unconstitutional because it forces individuals to purchase insurance as well as increases states’ Medicaid spending. For that reason, 20 states have joined together and challenged the Affordable Care Act, including Pennsylvania. In March, the United States Supreme Court heard arguments in several lawsuits over the law and a decision was made by the court on June 28, 2012. Essentially, the Supreme Court upheld President Obama’s health-care overhaul, including the requirement that all nonexempt Americans buy health insurance and the provisions expanding Medicaid, but, the court struck down the requirement that states lose all of their federal Medicaid funding if they decline to participate in the expansion.
Most Republican-led states have been counting on the law to be overturned and have failed to begin the process to set up exchanges. This is the current situation Pennsylvania faces. In fact, Pennsylvania’s Insurance Department has yet to spend any of its $33 million in federal grants to develop the marketplaces. Governor Tom Corbett has said that no decision has been made on whether our state would participate in the Medicaid expansion. The question now remains if Pennsylvania can meet the January 2014 deadline. If our state can’t or doesn’t meet the deadline the federal government will step in and run our health exchanges for us.
Pennsylvania has already joined the more than a dozen states with laws pertaining to the provisions of the Affordable Care Act. In March, the Pennsylvania Senate passed Senate Bill 10 which amends the Pennsylvania Constitution to prohibit the government from mandating that an individual obtain health insurance coverage. The General Assembly would need to reapprove the constitutional amendment in their 2013-14 session and then present it to voters before it could become state law.
As a world leader, many nations look to the United States to set the tone for how citizens should be treated and what services should be received, yet we still have millions of people in our country uninsured. Many decades ago, President Harry Truman was the first president to propose a universal health care plan for our country and many unsuccessful attempts have been made thereafter by both Republican and Democratic Presidents and leaders alike. Furthermore, health care is close to one-fifth of the U.S. economy, and we spend about 50 percent more on it than any other industrialized country. However, the United States still remains the only industrialized nation to not have universal coverage for its citizens. What has taken us so long to pass such a measure?
What this new mandate does is offer the promise of guaranteed coverage at affordable prices. Every taxpayer should be entitled to the care they need and we should not be putting more hurdles in the way to prevent such a goal. Pennsylvania has had plenty of time to start to developing health exchanges and instead the administration is pushing constitutional amendments to deny people of their rights. I can only hope that this latest United States Supreme Court ruling will be the final word and let the country know that we need to get down to business so that uninsured families across the United States no longer have to suffer.
