Wednesday, March 12, 2014

What is....?

So what is the PPACA, more exactly the ACA section of the bill.  I mean we hear it called Obama-care by detractors, we hear it called unconstitutional by other detractors, but what is it, what is it's history?  Well, lets jump in our way back machine, and find out shall we?

Welcome ladies and gentlemen to 1993.  The Nintendo was still hanging around but had largely been replaced by Super Nintendo.  Meatloaf was topping the charts, and Howard Sterns biography was a bestseller.  Yeah, times have changed haven't they?

Healthcare reform was a hotly contested item for everyone in politics.  And the GOP, unlike its modern counterpart had a plan.  HEART, yeah, the Health Equality and Access Reform Today act.  A plan written by the conservatives of the day, and they were heavy hitters.  Basically imagine the Affordable Care Act, minus the the Medicaid/Medicare expansion, employers were mandated to offer not pay for insurance, and there was medical malpractice tort reform in the HEART bill, they are identical.  This is not going as well as expected.  Obamacare as it is called, is basically the same as HEART, and while that bill didn't make it past the written stage, it was written by the GOP.  At that time the mandate was better than what they called Hillarycare.  Oops, looks like your party just shot itself in the foot on that one.  See, not listed in the differences was a mandate that forced everyone to purchase medical insurance.

Lets jump a head a few years shall we?  Well 13 to be exact, and rather than appear on the national stage, we will just drop down to the state level, specifically Massachusetts.  Romney, then governor of the state said that something needed to be done about the unemployed and dragged out HEART.  The state legislature went to work, and sent him the An Act Providing Access to Affordable, Quality, Accountable Health Care.  What did Romney's proposed and signed plan do?  Created a state based exchange, provided subsidies for lower income families, had both individual and employer mandates, and expanded the states medicaid program for children, parents, pregnant women and the long-term unemployed.  Key differences?  The ACA is larger, keep in mind 6.5 million people for Romney's plan, 300 million for the ACA.  The ACA covers preventative costs, and states have the option to expand their medicaid programs to ensure people are able to comply with the mandates. 

So, if the HEART and Romney-care, plans were constitutional why is Obama-care not?  You might say that it is because of it's scope.  I hear people talking about car insurance, but that isn't federal, that is state mandated.  But do you know what has existed for years that is federally mandated?  Flood Insurance.  Yeah, that is right.  If you live in an area that is high risk, your lender is required by mandate to carry flood insurance on your home, or property that can become flooded.  And who do you think pays for that?  You do.  Go figure, we now have the scope covered, and the precedent set, even if the Supreme Court reaffirmed Obama-care is constitutional.

So there you have it, Obama-care is really based on two other plans, one of which was national.  While it is not identical to the first, it is identical to the second, with a slight change in wording.  So, if you were going to vote for Romney, you really cannot say anything about it.  If you voted for people like Dole, or the list of over 20 GOP leaders in the 90's, you really cannot say anything more than you got what you wanted.  But the question is, did you really want it.  But before we go, lets hope back into the way back machine once more, and lets look at one possible outcome.

We will go a few decades into the future, and we see that Obama-care is gone, it left us several years ago.  What replaced it was truly better, it was replaced by a single-payer option or maybe an outright single payer system.  Thats right, if you want to keep your privately held insurance, you could.  If you wanted it taken out of your taxes, it is.  But more likely everyone has the same system, because we learned that everyone deserved decent medical insurance, no matter their socioeconomic class.  Just saying.