Commentary+on+the+Health+Bill


 * An Overview of the Patient Protection and Affordable Care Act**


 * Topics:**

History Facts Regardign Health Care Bill Making Process Provisions of Final Bill Constitutional Questions Ideological Positions Party Positions Electoral Considerations Public Opinion Media Coverage Interest Group Attention


 * Relevant Blog Posts:** [|**click here**]**.**


 * Links:**

- [|A History of Overhauling Health Care] - [|**Patient Protection and Affordable Care Act** - Wikipedia, the free **...**] - [|Summary of **Patient Protection And Affordable Care Act** - WSJ.com] - [|HR3590 - Search Results - THOMAS (Library of Congress)] - [|Health **Care** Bill - H.R.3590: **Patient Protection and Affordable** **...**] - [|Politifact: Ten Things to Know About Health Care]. - [|Pollster: Public Opinion on Health Care] - [|Washington Post: Is Health Care Bill Constitutional?]

introduction

Carmen Galvan: History The History of Health Care Bill The issue of health care reform in the United States has been the subject of political debate since the early part of the 20th century. One of the earliest health care proposals at the federal level was the 1854 Bill for the Benefit of the Indigent Insane, which would have established asylums for the indigent insane, as well as the blind, deaf, and dumb federal land grants to the states. This bill was proposed by activist Dorothea Dix, which passed both houses of congress, but was vetoed by President Franklin Pierce. Pierce argued that the federal government should not commit itself to social welfare, which he believed was properly the responsibility of the states. Pierce’s veto was seen as a landmark in social welfare legislation in the United States, the veto establishing federal non-participation in social welfare for over 70 years, until the New Deal legislation of the 1930s, in the context of the Great Depression. U.S efforts to achieve universal coverage began with Theodore Roosevelt, who had the support of progressive health care reformers in the 1912 election but was defeated. Roosevelt ended up removing the health care provisions from the bill in 1935. Fear organized medicine’s opposition to universal health care became standard for decades after the 1930s. Following the Second World War, Harry Truman proposed national health care, but this was defeated. However, in 1946 the National Mental Health Act was passed. The Medicare program was established by legislation signed into law on July 30, 1965, by President Lyndon B. Johnson. Employee benefit plans proliferated in the 1940s and 1950s. Strong unions bargained for better benefit packages, including tax-free, employer-sponsored health insurance. Wartime 1939-1945 wage freezes imposed by the government actually accelerated the spread of group health care. Unable by law to attract workers by paying more, employers instead improved their benefit packages, adding health care. Government programs to cover health care cost began to expand during the 1950s. Disability benefits were included in social security coverage for the first time in 1954. In 1993 President Bill Clinton presented to the U.S Congress a health care reform plan that would have guaranteed health insurance for all Americans. Congressional leaders opposed the plan as it was too expensive and excessively regulated. In1994, members of congress introduced a series of alternative proposals, but no compromise was ever reached. In 1996 Congress passed the Mental Health Parity Act, to require some employers to offer health plans with psychiatric benefits. Health care reform was a major concern of the Bill Clinton administration headed up by first lady Hillary Clinton; however, the 1993 Clinton health care plan was not enacted into law. During the 2004 presidential election, both the George Bush and John Kerry campaigns offered health care proposals. The historic signing came a century after President Theodore Roosevelt first called for a national approach to US health care, and after past leaders such as Bill Clinton tried and failed to reform the grating, costly system.

Nicholas Garza: Constitutional Questions

Our forefathers created the Constitution in order to control the power of the Government. In question today is the Patient Protection and Affordable Care Act, and has its establishments stayed within the bright lines of the constitution. Major conflict arrives with the “individual mandates” within the Act. These mandates require citizens and legal residents of the U.S to have government approved healthcare by 2014. If the individuals do not abide the mandate, they will be issued a tax penalty of $695. Now the issue at hand is power. Is it a constitutional power of Congress to issue such mandates on the people of the U.S? Congress attempts to make the case that it has the authority to require an individual mandate pursuant to its powers under the Commerce Clause of the U.S. Constitution. Though it is hard to actually find bright lines in the commerce clause due to its constant evolution, their power has never gone this far. Nevertheless, the federal government, in defense, will likely claim that even if Congress does not have the authority for such a mandate under its Commerce Clause powers, it nevertheless has the authority pursuant to the Constitution’s Tax and Spending Clause because the individual mandate entails a tax penalty. Supreme Court jurisprudence on this issue has shifted over the years with two somewhat conflicting lines of precedent. The first is an extremely broad reading of Congress’ tax and spending powers that generally has upheld most congressional tax enactments as constitutional if they raise revenue. But another line of Supreme Court cases has held that Congress cannot resort to its taxing power to effectuate an end which otherwise is not within the scope of its other enumerated powers under Article I of the U.S. Constitution. These differing lines of Supreme Court precedent have never been reconciled. Thus, it is not clear how the Supreme Court would rule on the issue of whether Congress has the authority under its taxing power to enact the individual mandate even if it lacks such authority under the Commerce Clause. Analyzing the act with regard to certain other claims challenging the constitutionality of the Act has resulted in similar uncertain conclusions. For example, there is a colorable claim that the individual mandate’s tax penalty is a “direct tax.” Under Article I, section 9, direct taxes must be apportioned, and because the individual mandate’s tax penalty is not apportioned, it may be an invalid exercise of Congress’ taxing authority. Questions will continue to arise throughout the span of the Act. In time, hopefully the questions can be answered, but for now I do not believe these questions will create any real trouble for the Act. Our government is on a “fast food diet” that is determined to make them distinctly obese. As a citizen, I can only hope the new growth helps the country as opposed to weighing it down. Sources: http://www.law.state.ak.us/pdf/press/042010-ExecSummary.pdf [|**Patient Protection and Affordable Care Act** - Wikipedia, the free **...**]

Whitney Hoffpaur: Facts The health care reform seems to be one of the main topics of the past year. By a vote of 219 to 212, the House of Representatives passed the health care bill on March 21, 2010. President Obama was instrumental in passing of this bill with the hopes that it will expand health coverage to billions of Americans. This will make health coverage affordable and hold insurance companies accountable. It also gives all Americans “peace of mind”; people will know if they loose their job or become an independent contractor they will still have health coverage for them self and their family. Some might argue the average citizen feels as though they could not make a informed decision because of the complexity of the bill itself. While it seems all Americans have their own opinions about passing the Health Care Bill I believe it is best to stick with the stone hard facts concerning this bill. There is currently over 32 million people in the United States that are uninsured. $940 Billion is the estimated cost of the health care reform over the next ten years. So, many people ask…How will we pay for this? There are numerous areas the government will cut back and tax more. For example it is the government’s intentions to establish a tax of ten percent on indoor tanning salons; this would raise $2.7 billion between a 10 year span. They will also tax insurance company’s forty percent who provide coverage to plans valued at more than $10,200 for individuals. Many people believe the government is trying to “take over” like Canada or Britian but the government will not take over hospitals or privately ran businesses. Also, all hospital staff and health care centers employees will not become government paid employees. The government does not intend to pay the entire bill for Americans; they will simply help them buy insurance. The United States system that is in place now will still stand. For example: Medicare, Medicaid, and CHIP will stay in place. The insurance companies will be regulated more heavily. Some of the changes that will be made are: the government will place minimum services they must cover and by 2014 the insurance companies will not be able to deny any persons sure to a pre existing condition. The government plans on making health coverage a law. Therefore, if you do not carry coverage you will pay a yearly amount of $965. The government intends to cap premiums for people who make below a certain amount. For example: a family of four making $88,000would have a cap of 9.5 percent of their income. The less a family makes a year the lower their cap would be. So, do companies have to pay for health insurance? Employers will not be required to buy coverage for their workers but, the companies on a much larger scale will. If the company has more than fifty employees they will be required to provide health coverage to their employees. Which can cost $2,000 per employee. However, if they choose not to pay for this expense the companies will be subject to fines and the fines for this can be very costly. There are a two more topics that I would like to cover regarding the bill. There has been much debate over the government paying for elective abortions but the fact is the government will not pay for such procedure. The people will be able to buy a plan that might cover this. With this plan the patient would pay for this service not the taxpayers. Some House members have argued the illegal immigrants should be able to buy health insurance with their own funds but after much debate this seems highly unlikely.

Jacob Jordan: Party Positions Garrett Lange: Media Coverage It is no secret that the Obama administration has been working on a new health care bill, called “The Patient Protection and Affordable Care Act”. This is of course due to a necessary change, but the media plays a part of when this Bill passes and what its contents are based on the coverage this topic receives. Media Coverage is one of the most influential tactics to spread information and sometimes propaganda about certain topics, and on top of that, they can actually influence the bill itself, or even speed up or slow down the process it takes to pass a bill based on the pressure they put on it. Christmas Eve, 2009 was a great day for the Obama administration; it was the day that they had passed The Patient Protection and Affordable Care Act that they had fought so long and hard for, and were proud to show a huge stride to go along with their slogan of “CHANGE”, which many people were beginning to question. The media attention drawn toward this topic weighed very heavily on the outcome. The constant pressure delivered by the media to get this bill passed was very influential in getting it done quickly, although for most people, it wasn’t soon enough, and many people did not like the elements of what was reported by news groups. According to “The Pew Research Center for the People & the Press”, recorded from a survey of a little of a thousand people, many say the media has done either a poor or fair job on explaining the proposals and their details; roughly about 70%. They also go on to say, “Republicans and independents are somewhat more critical than Democrats of coverage of the health care debate.” Considering that Republicans criticize everything Democrats do, in an effort to relieve them of there rule, it comes as no surprise that would happen on this topic as well. Media is so influential that certain people thought that the media’s coverage along could “derail” the much wanted Health Care Reform. “ Just because some of us might be ready for health care reform doesn't mean that the media are ready to cover it properly. And that could have important implications for how reform plays out. ” Many reports on certain issues are also meant to lean to one side or another, stretching the truth regardless of facts to make a certain political party or interest group look more favorable than another. For instance, if Rush Limbaugh were reporting, it would lean more towards conservatism, while if it were Alan Colmes, it would obviously have a more liberal spin to the reporting. As it is clearly shown here, Health Care Reform is a long-term process that requires patience, and should not be expected to be fixed overnight. During that waiting period, the media’s reports and allegations can easily hinder a bill from being approved, which is a shame since many reporters do not always get the facts correct before reporting them. Healthcare is not the only topic to be so influenced. Any topic that seems important enough to improve a TV channels’ ratings or increase a magazines’ subscriptions will most likely get covered, regardless of what it might do to the actual topic. Media coverage is not always straight-forward, and definitely not always accurate. It is very important to research facts for yourself rather than believing anything you hear on television. Sources: http://www.alternet.org/health/117809 http://www.kff.org/healthreform/8023.cfm http://people-press.org/report/533/many-fault-media-coverage-of-health-care

Tawonda Nelson: Public Opinion

HEALTH CARE REFORM

It’s been a simple substance for just about anybody to mischaracterize communal opinions on the Health Care Reform. Opinions come into view to be crosswise the board when it comes to U.S President Obamas recently passed reform. However individuals from different Political Parties astonishingly concur on more than a few issues. Inquisitively when the public opinion option was framed as a government program that would contend with Private Health Insurance on 48% supported it, when framed as an option between the governments provided and Private Health Insurance, approximately three quarters supported it. As in previous surveys those with burly opinions are more likely to be against the plan rather than support it. Poll summary said the recent numbers 24% strongly favor and 37% strongly oppose. Otherwise the Fox news poll found that 45% believe their excellence of Health Care would be worse under Democratic Plan, 58% think the reform would cost them money, 91% say they have Health Insurance and 84% rate that Health Coverage as admirable. There is some perplexity on the reform. Dr. Morone states that Americans are generally uniformed about the Healthcare Bill and the results of this latest poll are not about the substance of the bill but about the conflict surrounding it. He also mentions that Health Care is a very high intensity low information issue. People respond to as conflict escalates; people turn against what’s being discussed and lose confidence in it. Americans also are so hesitant to support what they see expensive. Although the public opinion won’t have much impact on how law makers vote on the bill Obama use the information to make an improved argument for Health Care Reform. He tries to convince people to be interested in the reform but a lot wasn’t buying it. Health care in America is always making news on increasing cost; jagged quality and limited admission are the grist on headline after headline and beyond these care issues, stories about fraud and abuse, drugs and device recalls pop up on the front page nearly as often. According to the survey opinion varies widely with regard to the current legislation, 21% are completely satisfied 28% want changes made in law, 39% want the law repealed and to start the healthcare reform process from scratch, while 13% do not want any government Health Care Reform. When the public was asked about why they were so dissatisfied with the Legislation, some of 20% said that they did not like the process by which it took place not exactly the same as being dejected with the program them. An additional subject that almost all survey participants did not like was the Democratic and Republican alike was the obligation that all Americans buy Health Insurance. Many carry on to focal point on Americans being divided on whether they want to repeal the Affordable Care Act. Lost in this is the detail that for the majority part, Americans have identical opinion on what they want the act to do such as cover those with pre-existing conditions, increase insurance company regulations and close the Medicare gap. The one exemption seems to be the requirement for individuals to purchase Health Insurance which is overpoweringly opposed by those who would like the appeal.

Michael Nemitz: Impact on Small Business Owners In life, nothing is free; this concept is displayed in current times with the creation of the health care bill. While the promise of free healthcare is appealing, the prospect remains unclear, to the effect, of who is actually paying the doctors and hospitals. Estimated costs for the healthcare plan costs rest around 1 trillion dollars; this money must come from somewhere. It was once said that Americas’ backbone was the farmers, who are now our modern day entrepreneurs and small business owners. The small business owners of this great country are being threatened by the impending taxes being raised for the health care bill. The small business owners’ goal is to generate revenue for their future by increasing their profit margins; this is the reason they created a business in the first place. Beginning June first, 2010 business around the country will have a new, heavy tax imposed on them. As the big machine of the “free” medical care takes it first steps many small business are already beginning to loose hope of creating revenue. Many businesses were, however expecting this, yet they were expecting it at the end of the year. Small business, generate their revenue by subtracting their overhead and upkeep from their business income. When dealing with a small business, your overhead is your taxes, fees, and costs of goods. An average small business executive will pocket between three and five percent of their total revenue. In the end healthcare will be more e3xpensive then original costs for healthcare, around 115 million dollars more. (this is the rough version I mean to add more but I'm not sure what i need to add to it...)

Maria Ortiz: Bill Making Process

The bill making process The Patient Protection and Affordable Care Act (PPACA) intents to expand the health care coverage to about 31 million of uninsured Americans by combinations of cost controls, subsidies and mandates. It is said that this bill is the major health care reform bill, signed into law by President Obama and the most controversial also. It was primarily introduced in the House of Representatives as a “Service Members Home Ownership Tax Act of 2009” by Charles Rangel on September 17th of 2009. It was originally drafted by the Senate as an alternative to the Affordable Health Care for America Act. The passage in the Senate was temporarily blocked by a filibuster threat by Nebraska Senator Ben Nelson, who resided with Republican minority. With the election of Scott Brown the House decided to pass the senate version and amend it with a third bill, the Health Care and Education Reconciliation Act of 2010. Senator Nelson agreed to the bill after it was amended to offer a higher rate of Medicaid reimbursement for Nebraska. It was pass by the Senate on December 24th of 2009 with 60 votes from the democrats and independents versus 39 votes from the republicans who voted against it. It passed the House of Representatives on March 21st of 2010 with 219 votes from the democrats and independents versus 178 votes from all the republicans and 34 votes from some democrats who voted against it. Without mentioning that there were 4 empty sits on the House of Representatives at that time. It was finally sign into law by President Barack Obama on March 23rd of 2010 creating a huge controversy. Together with the Patient Protection Act, the Health Care and Education Reconciliation Act will ensure 95 percent of all Americans to have access to quality, affordable health insurance and put students ahead of private banks. 

Bradley Rodriquez: Public Opinion

In 2009 a new health care bill was introduced that would drastically impact the nation. This new bill will reform the old health care in both positive and negative ways in the eyes of the general populous. Some of the outlying factors are controversial at most, yet the most prevalent, and probably the most obvious, is how this new bill will impact both the upper and lower classes in America and influence public opinion. There are various improvements from the previous health plan that are of note. Some of those being that unlike the previous health plan this new Act now requires a state to accept all employers and individuals in that state that applies, prohibit the establishment of individual eligibility rules based on health status, ect. Yet one interesting part of this new act is the requirement for the Secretary to establish the Consumer Operated and Oriented Plan (CO-OP). This section will foster the creation of nonprofit health insurance issuers to offer qualified health plans in the individual and small group markets. Furthermore, it will set guidelines and formulae for the calculation of credit amount based upon the taxpayer household income as a percentage of the poverty line. In short it will emplace taxes on citizens based on their household income in order to help fund the health plan. Therefore upper class America will end up being taxed at a higher rate and lower class at a lower rate. Public opinion is divided nearly in half and the reason is clear; upper class Americans aren’t happy with the fact they will have to pay more. Albeit necessary to provide more affordable health care to lower income families, most high income households see this as an unfair way to “balance the scales” so to speak. However the health care act will change overall amounts in how much upper class Americans will pay. Tax hikes for all American individuals making $200,000 and families making $250,000 or more will experience a 0.4% increase to cover Medicare offsets. This in turn will make health insurance more widely available to lower class Americans. Public opinion surrounding this is generally negative. It is also heard more widely than from lower class America. Now to turn the focus toward lower class America. This new bill will really help lower class America on various factors. Even though it will require everyone to have health insurance there are still some stipulations. There is an annual penalty for those who opt to take it and it will equal $695 for individuals and a maximum of $2250 per family but if insurance coverage would cost more than 8% of the household income they won’t pay the annual penalty. Therefore low income families don’t have to stress about having to have insurance. To make matters better for poorer families if they make within 133% of the national poverty line they can qualify for Medicare, Medicaid, or CHIP. Public opinion on this is very repressed and not seen on the media but its there. Based on the above data and opinions it is obvious that due to public opinion this new health care proposal will be seen in both a positive and negative light. Only time can tell if the new Heath Care and Patient Protection Act will succeed or fail. Regardless, America, both upper and lower class citizens, will maintain differing opinions on whether this Act is fair or even constitutional. What is clear is that low income families will receive a break and richer Americans will be paying more in the long run. Vanessa Rogers

Ronald Vavra: Provisions of Final Bill "Taxes"

Now that the $848 billion ”Patient Protection and Affordable Care Act” has been signed in to law by President Obama, many Americans are wondering how the country can afford such a law. Some Americans will argue that the law was needed no matter the cost, while others will argue that even though some type of health insurance reform was needed, this law puts too much of a burden on the American people. No matter what the argument was, the fact is that the bill is now a law and the monies needed to put the law into action must be fronted by the American people. All Americans will be required to have insurance or face a fine. //(Individual Health Insurance Mandate 1501, 10106; Reconciliation bill 1002) imposes a penalty tax on individuals not maintaining minimum essential coverage, beginning in 2014. The penalty is generally the greater of a flat-dollar amount ($95 for 2014, $325 for 2015, and $695 - indexed for inflation - for 2016 and after) or a percentage (1.0 percent for 2014, 2.0 percent for 2015, and 2.5 percent for 2016 and after) of the taxpayer’s household income.// As an example, a married couple who make $40000.00 per year ($20000.00 each) with no children will be fined $400.00 in 2014, $800.00 in 2015, $1000.00 in 2016. After 2016, the fine will raise based on cost of living. This fine will be imposed on top of any other local, state or federal tax that is owed by the couple. It is not stated in the law if this fine is per person, per couple or per family. The penalty tax would not apply to those with incomes under the tax return filing threshold for that year. There are also rebates in the form of tax credits. “I f your yearly income is higher than 133% of the federal poverty level but less than 400% of the poverty level (about $43,000 for an individual), you will get a tax credit to help you pay your health plan’s premiums and out-of-pocket expenses. This will come to you as a tax rebate even if you do not owe any income taxes. And, the lower your income, the higher the tax rebate.” [|http://healthinsurance.about.com] The new law also put new requirements on employers. (Employer Responsibility 1513, 10106) requires an employer with more than 50 full-time employees that does not offer coverage and has at least one full-time employee receiving the premium assistance tax credit, to make a payment of $2,000 per full-time employee. An employer with more than 50 employees that does offer coverage but has at least one full-time employee receiving the premium assistance tax credit will pay the lesser of $3,000 for each of those employees receiving a tax credit or $2,000 for each of their full-time employees total. Another way to raise revenue will be to place a 2.9 percent excise tax on manufactures and importers of medical devices. This will raise $20 billion over ten years. Manufacturers and importers of name brand drugs will also be taxed and are expected to raise $27 billion. An excess tax on indoor tanning services is expected to rise over $2.7 billion. [|http://www.opencongress.org]