Government Role in Health Spending


GovernmentRole in Health Spending

TheObamacare is the biggest overhaul of the healthcare system of theUnited States since the 1960s. The aim of this plan is to expand thehealth insurance coverage to the individuals who are uninsured in thecountry. In accomplishing this objective, the law requires allAmericans to have health insurance but subsidies are provided toensure that the coverage is more affordable and mitigates the cost ofinsurance through bringing younger and healthier people into thehealth insurance system (Emanuel, 2015). The Obamacare has becomecontroversial, and there is a need to make changes to the healthpolicy to ensure that the Americans are confident with the issue. Thepurpose of this report would be to discuss the Obamacare, why it iscontroversial and changes that can be made to the healthcare policyto make it fit in the future.

TheAffordable Care Act (ACA) has been referred to as Obamacare. Thishealthcare policy has changed the manner in which health services aredelivered. The Act requires Americans to have health insurance for aminimum of nine months or be subjected to tax (Brill, 2015). Thepolicy creates marketplaces, where individuals are in a position tocompare prices as they buy their coverage. Also, the law prohibitsinsurance companies from denying health coverage to individualshaving pre-existing health conditions, and permits youths to remainon their parents’ health plans until the age of 26 (Brill, 2015).Furthermore, the policy expands the eligibility for thegovernment-run Medicaid health plans for the poor. The primary targetof the Act is to slow the growth of the United States healthcarespending. Although 40 hours a week emerges as the standard forfull-time work for the Americans, the ACA made a change to thestandard and claims that the average of 30 hours should be used whenconsidering whether workers should provide health coverage.

Acontroversy has emerged as a result of the changes proposed by theACA. The argument concerning the Obamacare has revolved arounddifferent issues. One of the major problems concerns the standardworking hours in a week. Because of the average working hoursproposed by the Act, the definition of full-time has varied.Employers usually offer benefits to full-time employees however, thenotion of full-time has problems. The Fair Labor Standards Act, whichhas the mandate of setting the requirement for overtime, considersfull-time to be 40 working hours. This is different according to theBureau of Labor Statistics which sets it at 35 hours. With the newrequirements of ACA, where it sets full-time hours to be 30 hours ina week, makes it difficult to define full-time hours that employersand workers should adhere to in order to possess a health cover.

Also,business groups are seeing it as an unfair burden to use the newstandard of 30 hours. These entities indicate that their membersshould comply with new record-keeping laws just to document whichemployees are on the job 31 hours, 29, or 28 hours. They argue thatthis makes it difficult to ask a worker to work an additional hour ortwo during busy seasons or weeks since that may prompt thehealth-insurance requirement (Pipes, 2010). Some small businessesargue that they are not in a position to afford providing thehealthcare benefits. Another problem that has stemmed from the 30hours standard is that employers may have an incentive of reducingthe hours of some employees who are close to the 30 hours threshold.

Anothercritical area where the controversy of the ACA revolves concerns thecost experienced by businesses. Individuals opposing the Obamacarehave argued that the policy inflicts too many costs on business,which may lead to killing of the operations of entities (Pipes,2010). Also, the law has been perceived as an unwarrantedinterference with the affairs of private individuals and businesses.This emanates from the reasoning that individuals are required tohave health cover once they accomplish the requirements whilebusinesses need to pay compensation following their ability to payfull-time employees. Therefore, there is a need to disclose whetherworkers are on a full-time or not. This goes against the privacy ofbusinesses and individuals.

Inorder to make the policy better in the future, there is a need ofrestructuring it so as to eliminate the controversies. One of theways of improving the law would entail removing the proposed 30 hoursstandard and let it remain as established under the Fair LaborStandards Act. Having this change would help businesses andindividuals have more confidence with the policy as it would notchange the average hours that they are used to. Also, another way isto allow employers to convert their health care costs from a distinctbenefits package to a definite contribution system. Furthermore,setting up a fair competitive bidding process would help inestablishing government payment in traditional Medicare programs.

Inconclusion, ACA requires Americans to have health insurance for aminimum of nine months or be subjected to tax. The policy createsmarketplaces, where individuals are in a position to compare pricesas they buy their coverage. The aim of this healthcare plan is toexpand the health insurance coverage to the individuals who areuninsured in the country. In accomplishing this objective, the lawrequires all Americans to have health insurance but providessubsidies to ensure that the coverage is more affordable andmitigates the cost of insurance through bringing younger andhealthier people into the health insurance system. The policy isfaced with controversies such as increasing costs on businesses and achange of the way full-time hours should be defined. However, thiscan be fixed by removing the proposed 30 hours standard and let itremain as established under the Fair Labor Standards Act and settingup a fair competitive bidding process that would determine thecontributions of the government towards Medicare programs.


Brill,S. (2015). America`sbitter pill: Money, politics, backroom deals, and the fight to fixour broken healthcare system.New York: Random House.

Emanuel,E. J. (2015). ReinventingAmerican health care: How the Affordable Care Act will improve ourterribly complex, blatantly unjust, outrageously expensive, grosslyinefficient, error prone system.New York, NY: PublicAffairs.

Pipes,S. (2010). Thetruth about Obamacare.Washington, DC: Regnery Pub.