What are the effects of the affordable care act?

Answer 1

Log Term - Answer

As the program is just starting now, it will likely take at least a half-decade to see the actual economic and health effects on the population.

Employers Answer

Employers with 50 or more full time employees will have to provide an "affordable" healthcare plan that's qualified by the government.

The effect that I'm seeing on this, especially for that "affordability" part, is that companies will need to gather more private information and incur additional administrative expenses. They will have to do that because the employee contribution cannot exceed 9.5% of household income.

Poor Pro - Answer

Many of he poor who previously could not afford health insurance may be able to obtain qualified coverage through the the Social Security Medicaid/Medicare systems in certain states, or may qualify for financial assistance in the form of tax credits to purchase coverage whether through an employer or individually through an exchange.

Poor Con - Answer

The effect for many poor people who can't afford health insurance and will not qualify for financial aid or Social Security is that they will be even deeper into poverty and will now be guilty of a federal misdemeanor offense to boot because they are too poor. Now, they are not just poor, but they owe a fine (declared an additional TAX by SCOTUS) to the government. This makes these poor even more poor than before ACA by imposition of what is essentially a "Poor Tax".

Additionally, the law declares that the fines collected by the I.R.S. are to be used to "enforce" the law. The fines do not provide health care to anyone, rather, the fines are to be used to root out and prosecute those others who are too poor to buy health insurance.

For the first time in history, America has crminalized poverty.

Enforcement and Administration

In order to enforce and track the above requirements, there has been an expansion of both state and federal health department bureaucracies. In addition, certain information sharing between the IRS and DHHS is required to insure that employers and individuals are complying with the coverage requirements.

ACA requirements

In plain language, the primary requirements of the ACA are:

• All US citizens and permanent residents much obtain medical insurance coverage from some source. This can be from a government-sponsored program, through an employer, directly from a health insurance company, or from a healthcare insurance company via individual states' "healthcare exchange" systems.
• Failure to obtain health insurance incurs a fine on your tax form, which starts at $95 in 2014 and rises to up to 2.5% of gross income by 2016.
• People purchasing insurance through the state exchanges may qualify for an income-adjusted subsidy from the Federal Government.
• All states must expand Medicaid insurance to all people under the Federal Poverty Level, the cost of which is paid by the Federal Government.
• States may choose to expand Medicaid to all persons up to 133% of the Federal Poverty Level, the majority of that cost being borne by the Federal Government, and the rest by the State.
• All insurance plans must meet minimum coverage and feature standards - things like free Birth Control and allowing family plans to cover children up to age 26. In addition, no plan can cover less than 60% of costs of healthcare, and there are maximum limits to deductables and total out-of-pocket expenses.
• Insurance companies must pay out a minimum of 85% of premiums in coverage to their subscribers (i.e. limits on profits and administrative fees for the insurance companies)
• Insurance plans cannot deny or discriminate coverage based on any pre-existing condition
• Companies employing 50 or more full time people (counting all part-time people as the appropriate fraction) must provide a qualified plan to their employees. If they do not, and the employee must seek coverage on the state exchanges, companies pay a $3000 fine per employee. In addition, employer-sponsored plans cannot force the employee to spend more than 9.5% of their gross wages on them (the employer must cover the rest of the costs).
• There are a laundry list of fees and taxes levied against various parts of the medical industry (from medical suppliers, to hospitals, to parts designers).