In 2009, former President Barack Obama introduced one of the most talked about laws, the Affordable Care Act. After this bill was introduced to the public, there were many people who were in opposition of it and thought it was the worst thing for our health care system; but for millions of American, it was the best thing that could have happened. Now that Donald Trump is President, he has promised America that he will repeal and replace the Affordable Care Act and create something that is better for our country. President Trump has recently introduced the American Health Care Act, the potential replacement for Obamacare. This bill has many people worried and anxious about what could happen to their health insurance. Enacting this bill and turning it into a law is not what this country needs and is a step in the wrong direction. Obamacare was built on the idea of value, not policy, and without it millions of people would be without insurance and our country would suffer extreme financial issues. 

When the Affordable Care Act was enacted, there was a provision that stated that insurance policies cannot refuse coverage to someone based on preexisting conditions. This means that if someone had a medical condition before their insurance went into effect, insurance companies were required to cover them (Secretary). In 2005, I was diagnosed with a cholesteatoma, a benign growth in the middle of my right ear. My parents were both on the same insurance but had recently changed the primary name on our insurance from my dad’s name to my mom’s name. Our insurance company thought because the name’s had changed, there was a new policy. Because of this, they declared my cholesteatoma a preexisting condition, and even though I was born with this condition, they would not pay for my surgery. This instance occurred before the Affordable Care Act was enacted which meant that there was no law that made insurance companies cover preexisting conditions. Once my mom explained what happened to our insurance company, they ended up paying for the surgeries; but if they had decided not to cover the surgery, my family would have had to pay $22,000 for it. My story is not the only case where insurers denied people because of preexisting conditions. In 2009, a family was denied health coverage for their four-month old baby simply because the child was too fat (LastWeek Tonight-Obamacare). If the Affordable Care Act is repealed and the preexisting conditions rule is overturned, millions of people will begin to be denied coverage all over again.

People who think that the Affordable Care Act has been detrimental to our health care system do not understand how helpful it has actually been. Before Obamacare, 48.6 million people were uninsured. Since 2009, over 20 million have been able to get some sort of health insurance (LastWeek Tonight-Obamacare). Under the ACA, many people who would not have been offered the chance to get insurance were able to do so, allowing a larger amount of people to obtain insurance which in turn created greater financial security and better health over all (Obama, 299). The Affordable Care Act has represented the most sweeping commitment of tax dollars, both federal and state, since the creation of Medicaid and Medicare in 1965 (Shi, ix).  In an article in the New England Journal of Medicine, Barack Obama mentions that if the ACA is in fact repealed, President Trump cannot wait two or three years before replacing it and potentially cause many issues within the health care system (Obama, 299).

Most people who have strong views on either Obamacare or the American Health Care Act are not educated enough with Americas health care delivery system to even know the large differences the two have between each other. The health care delivery system in America is made up of four main components. The first is financing. For most people, their health care is financed by their employers. The next component is insurance. This is what actually protects people against risks when they need expensive health services. Third is delivery; any entity that delivers health care services and can either bill for services or can be tax supported. The last component of the health care delivery system is payment. This is the part where insurers determine how much is paid for certain services (Shi, 17).

After being inaugurated, President Trump signed an order to repeal the Affordable Care Act and begin to prepare the replacement for it. Trump did mention that he liked the preexisting conditions and the young adult’s clauses of the ACA. The problem was that he appointed Tom Price to head the Department of Health and Human Services, which is where the replacement for Obamacare will come from. Price has been one of the most, if not the most outspoken critic of Obamacare, believing that the entire thing needs to be repealed and a better plan needs to take its place. Price has come up with his own bill that he believes is better than the Affordable Care Act. Price wants to make it so that the federal government hands out age based tax credits to help Americans buy their own insurance, instead of government subsidies based on income. He wants to eliminate the rule that insurance companies have to cover all customers regardless of preexisting conditions and that they must offer the same price plans to patients regardless of age. If those parts of the ACA are eliminated, insurance companies will now have the ability to offer plans with higher premiums and can now turn people away for any reason if they so choose. Price wants to create tighter eligibility rules and new limitations on the different types of medical services that are available for lower income people for Medicare and Medicaid (Edwards).

Because Tom Price has such a high role in America’s health care system and the fact that he was a former orthopedic surgeon and a member of the House GOP Doctors Caucus, people think what he is doing is the best thing for this country. People are blinded by the fact that most of the changes he is trying to implement will actually help a small portion of Americans, while harming everyone else. Twila Brase, President of the Citizen’s Council for Health Freedom, mentions “As a physician who has thought long and hard about health policy, Congressman Tom Price, M.D., is an excellent choice for Secretary of HHS,” as well as “We appreciate his resolve to repeal every word of the Affordable Care Act and restore freedom to American patients and doctors (Edwards).” As somebody who created a foundation that is dedicated to preserving patient-centered health care and protecting patient rights, it is odd that Brase is so strongly for the changes that Price wants to make because most of these changes actually hurt a lot more people than it helps.

On March 6, 2017, the GOP introduce the American Health Care Act as the replacement for the Affordable Care Act. Under this new act, states are allowed to enroll people in the ACA Medicaid expansion but only until January 1, 2020. After that, there is no further enrollment, which could be detrimental for some people who rely on Medicaid to help pay for their health care. Instead of having the government pay for a percentage of your health insurance, this new act provides a fixed tax credit based on your age, maxing out at $4,000 to help pay for insurance. This means that you are still required to pay for your insurance in full upfront, but at the end of the year you are not required to pay as many taxes. Under Obamacare, the government makes sure you only pay a certain percentage of your health care based on your income. The AHCA also made it so that states were given the option to take their Medicaid dollars as block grants, making it so that 14 million fewer people would receive Medicaid coverage. Because of these changes, older people with low incomes will see huge increases in their premiums as well as more out-of-pocket costs and higher deductibles (Sarlin). Trump’s new plan really only benefits wealthy people or younger more affluent people, which is a small portion of people in America.

 In America, most people usually get their health benefits from their employers who purchase health insurance from private sources. There is public health insurance available for people who do not get it from their occupation. Medicaid and Medicare are financed through the government to help elderly people and certain disabled people, as well as families who are poor and are below the state line poverty levels (Shi, 18). President Trumps new plan for health care mentions that the cap for Medicaid funding will be cut by a large portion (LastWeek Tonight-Obamacare). This means that it will be even harder for people to obtain government funded health insurance. If this does occur, roughly 8 million people will either lose their health coverage or be at risk of losing their insurance. Under Obamacare, 20 million people were able to gain health insurance and if Trump’s bill goes into effect, half of those people will be uninsured once again. According to the CBO Report on the American Health Care Act, roughly 52 million people will be out of health insurance under the AHCA in 2026, compared to 28 million people who would not have insurance that same year under the ACA (Obamacare Facts).

Since this new plan has come out, many people have voiced their concerns and have explained how this bill is dead upon arrival, that there is no way this will work. Members from both parties have talked about all the bad things that could come of this, if it is in fact passed. The American Medical Association, American Hospital Association, American Nursing Association and AARP have all come out against this bill. When asked about their thoughts on the bill, many governors of states all over the country did the best they could to not say too much. They were very wary of giving any extreme opinions but made sure people knew they were opposed. When this bill was announced, Trump made it seem like it was a stepping stone; that if enough people were against it, renegotiation would occur. Since then, Trump has mentioned that if this bill does not get passed, he is not going to try to fix it and will keep the Affordable Care Act in place.

Even though the AHCA was created by the GOP, there are Republicans that are against this bill. There were four members of the Senate GOP that announced that unless there are changes made to capping the expansion of Medicaid, they could not be in favor of this. Multiple senators got together and wrote a letter mentioning that this bill “does not provide stability and certainty for individuals and families in Medicaid expansion programs or the necessary flexibility for states (Jacobs).” Democrats also are not happy with the AHCA. Democrats are arguing that eliminating minimum coverage for insurance plans as well as decreasing the availability of tax credits will drive up the cost of insurance by at least $1,000 a year and possibly 15 million people forced out of their insurance policies (Jacobs).

Although there are many people who think that the American Health Care Act could be detrimental for our country, there are people who think that anything is better than Obamacare. The Affordable Care Act was created under the presumption that it will allow more people to afford health care. Even though many people did benefit from the ACA, many did not. For some, Obamacare increased people’s premiums by 14%, causing them to lose their insurance because it was not affordable anymore (Brandy, 640). In 2009, Barack Obama made an empty promise to America. He mentioned that under the Affordable Care Act, you can keep your doctor and you can keep your health care plan. This was not true at all because insurers can drop policies at any time and doctors change their networks all the time (LastWeek Tonight-Obamacare). Since then, many people have been dropped by their insurance plans and have suffered ever since. The American Health Care Act is a hope for a better health care plan.

Since the Affordable Care Act has been in place and the plan for the American Health Care Act has come out, many people have shared their personal stories of how Obamacare has helped them and saved their lives. One story comes from a grandfather advocating for his grandson. At twenty years old, this man’s grandson was diagnosed with Stage 2 Hodgkin’s Lymphoma cancer, an extremely fast growing cancer. Once at stage 4, this disease requires a bone marrow transplant to stay alive. Because he was in college, this man barely had enough money to pay for one treatment, but he did in fact qualify for his insurance to be covered through the ACA insurance exchange, which is just an expansion on Medicaid. Because of Obamacare and Medicaid funding, this man’s grandson is alive today and is in in remission. This story, along with many others goes to show how effective the Affordable Care Act actually is and that repealing this law is not going to solve any problem, but create more within America’s health care system.

Besides costing millions of American’s their health care plans, the American Health Care Act is focusing on the wrong things, making our health care delivery system worse than it already is. In the AHCA, there is a new provision stating that states are allowed to un-enroll high dollar lottery winners. This provision is extremely pointless and was only created because Trump and the GOP really do not want people who become wealthier under the AHCA to then benefit more from it. Donald Trump and Paul Ryan are doing everything they can to make sure only the wealthy, affluent American’s prosper under this new bill. Under this plan, people in the top 1% of incomes will get a tax break of roughly $33,000, while those in the top 0.1% will get a tax break of nearly $200,000 (LastWeek Tonight- American Health Care Act). So this bill is taking money from the middle class and giving it to the wealthiest people in America. Unless you are extremely wealthy, the American Health Care Act does not help you at all. This act is pointless and not realistic for most people in America.

Health experts have also talked about how they do not agree with this bill. Many of them are upset that there was nothing in the AHCA that mentioned lowering the cost of health care. Others believe that it is actually too similar to Obamacare. Some moderates and liberals feel that there should be more spending in order to prevent American’s from losing their health coverage and they do not like the fact that this bill helps the wealthy while cutting aid for middle-lower income people (Sarlin).

As far as finally finding a solution to America’s health care problem, there is not one yet. Although the American Health Care Act is nothing at all what this country needs, there still needs to be improvements to the Affordable Care Act, if the AHCA is in fact not passed and does not replace Obamacare. Obamacare has done so many wonderful things for health care and making sure that everyone has health insurance and can afford it, such as allowing 20 million people to gain coverage and slowing the increase in health care costs. On the other hand, if implemented, the America Health Care Act will result in 10 million people losing their coverage and increasing premium rates by a large margin. Are both of these acts perfect, no. but the Affordable Care Act is defiantly the better of the two. It helps so many more people and is economically better for America.
