Patient Protection and Affordable Care Act

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Patient Protection and Affordable Care Act (Obamacare) are a set of health insurance and industry reforms that aim to expand access to health insurance and change the way the federal government pays doctors. The expansion of people with insurance can be attributed to three main provisions in the law – The expansion of Medicaid, the creation of insurance exchanges and the individual mandate (Kliff, 2017). While Obamacare relies on insurance companies and federal government, single – payer healthcare relies on government (single payer) and covers the cost of essential healthcare for all residents through publicly funded taxes.

The first provision under Obamacare is the expansion of Medicaid, a federal program that provides health care coverage to low income Americans. Before the expansion of Medicaid, residents of states such as Massachusetts and New York qualified for Medicaid based on income, household size, disability, family status and other factors. However, after the expansion of Medicaid in these states, residents can quality based on income level alone. If their income level is below 133% of the federal poverty level, they are eligible (HealthCare.gov). The second provision under Obamacare is the creation of health insurance marketplaces or health exchanges through which people can purchase and choose from a range of government – regulated and standardized health care plans. Before Obamacare, health insurance companies could deny coverage or charge higher prices for people with pre – existing conditions.

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However, under Obamacare, one’s health, medical history and gender can’t affect their premiums. Insurance companies are only allowed to account five factors while setting premiums which are Age, Location, Tobacco use, Individual vs family enrollment and Plan Category (HealthCare.gov). The third and the most controversial provision under Obamacare is the individual mandate that requires most Americans to purchase health insurance coverage.

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