The Affordable Care Act (also known as Obamacare or the ACA) of 2010 was the largest and most controversial piece of United States healthcare reform legislation since the creation of Medicare in 1965. As a means to increase access to healthcare services for American citizens, the Affordable Care Act mandated that all small business owners with 50 or more full-time employees must provide health insurance coverage benefits for their full-time staff. Employers who opted out of the policy would be obligated to pay a substantial financial penalty per full-time staff member left uninsured.
Understandably, the passage of the Affordable Care Act created unease among small business owners nationwide. Many of these entrepreneurs do not have access to the labor pools and loans that larger corporations utilize, so their ability to absorb additional costs from employee health insurance is limited. The Affordable Care Act’s online marketplace, including the Small Business Health Options Program, is designed to help these small business owners directly compare regional health insurance plans available from local providers. As of January 1st, 2014 (the date when the health insurance mandate activated), however, we have yet to see the long-term effects that the Affordable Care Act will have on small business owners.
In order to address the costs previously incurred by uninsured citizens, the Affordable Care Act also contains a mandate requiring all citizens to purchase one of the ACA’s public option plans or pay a penalty of $95 (or 1% of their income in 2014, whichever is greater). This means that healthcare providers will receive compensation for services rendered to uninsured citizens that will help offset the costs of both providing the services themselves and the expenses associated with collecting the medical debt. Under the Affordable Care Act, individual citizens who elect to pay the financial penalty rather than obtain public option health insurance will also be completely liable for their own medical expenses. This will help hospitals recoup their costs, but patient advocates have raised the question of the medical debt prison: how would such a citizen generate the funds necessary to repay his or her debt?
Despite these measures, many members of the general public (and some in Congress) are still quite vocal about their desire to see the Affordable Care Act repealed. Prior to its inception as a law, the United States House of Representatives voted to repeal the Affordable Care Act 45+ times. The law was eventually passed, however, and upheld by the United States Supreme Court. Whether or not we see significant amendments (some of which may address the individual mandates) remains to be seen.