The Affordable Care Act (also known as Obamacare or the ACA) is the most significant piece of healthcare reform legislation in the United States since the creation of Medicare (a socialized form of health insurance available to all US citizens over the age of 65) in 1965. During the course of its passage, the Affordable Care Act created massive political controversy due to its mandate that small business owners with 50 or more full-time employees would be required to provide health insurance benefits for their full-time staff. Companies can presently opt out of this particular ACA obligation by paying a substantial financial penalty per full-time employee left uninsured.
Understandably, many small business owners were apprehensive about changing their employee health insurance plans, given that most small businesses operate with a much smaller profit margin and fewer capital reserves than larger corporations. The Affordable Care Act also established the Small Business Health Options Program (SHOP), an online marketplace designed to help small business owners directly compare regional health insurance packages for their employees. Since the insurance mandates’ activation as of January 1st, 2014, millions of US citizens have signed up for individual health insurance coverage through the ACA website, healthcare.gov.
After a rocky initial reception, the Affordable Care Act seems to be succeeding in what it was originally designed to do: provide millions of previously uninsured US citizens with access to health insurance and healthcare services. With such controversial legislation, however, it’s difficult to predict what long-term repercussions the Affordable Care Act might have on the US healthcare delivery system. Some public health advocates have expressed concern that the ACA’s mandate regarding small business owner-provided health insurance may cause a surge in part-time labor, given the costs associated with compensating for full-time employees’ health insurance.
Proponents of the Affordable Care Act, on the other hand, paint the law as the first step toward universal coverage in the United States. Universal coverage, a system in which all citizens of a given nation receive health insurance regardless of age or income, is typically funded through public taxation. Most developed nations now utilize some form of universal coverage to supplement their healthcare delivery system. As the Affordable Care Act ages and new legislative changes are made, we may see calls for it to be expanded (as well as similar calls to expand Medicare’s universal coverage). The individual and corporate mandates requiring purchase of public health insurance may also be repealed as universal coverage gradually becomes a reality.