US Health Care Reform Issues


In the past, United States has been one of the most expensive places for a person to get health care insurance. Due to this, the spending of people in the country has been affected, with much avoiding health care insurance, since it is too costly to afford. With the recession in the country, costs of health care soared and as a result a lot of people decided not take any health insurance. As a consequence, the number of affected businesses increased, being made not to give their employees any health insurance, since the cost was only increasing. The brief history of Health Care Insurance and Provision in the United States of America reveals the reasons for the New Health Care Reform Laws introduction. This paper looks at the history of health care in US that led to the formation of the new laws and a few provisions of the new laws (Kovner, Knickman, & Jonas, 2011).

Historical Issues in US Health Care Policies

The history of high cost health services with a low life expectance is one the past factors that led to the new health policy rules. Before the year 2010, America had the most expensive health care insurance policies. On the contrary, life expectancy was low, despite the costs of health care. To add to the problem of high costs, inflation has left many people with very little to spend, not to mention gaining an insurance policy. Businesses that gave their employees a health insurance package have had to re-strategize and drop this benefit. Without health insurance coverage that provides benefit for employees and with the increasing costs of living, it is virtually impossible to get insurance. For this reason, the government has created the new laws, which start to function in January 2014 (Lumpkin & Johnson, 2011).

Another important historical issue is a gap in health care insurance policies, which did not recognize dependents up to the age of twenty-six. In the year 1997, the federal government formed The State Children’s Health Insurance Program to provide insurance to children from poor families. There was the need to make a law that would focus not only on children from poor families but also on those from well-off families and those below the age of twenty-six, who start depending on themselves. The 2010 health policy takes into account this group and ensures they get insurance cover. It also covers every US citizen (Kovner, Knickman, & Jonas, 2011).

Provisions in the New Health Care Law

The Patient Protection and Affordable Care Act has numerous provisions. These provisions are aimed at eliminating all gaps in health care insurance provision and reducing the cost of insurance. Some of the provisions include guaranteed issues of health insurance cover, shared responsibility requirement, health insurance exchanges and expansion of medicaid eligibility (Lumpkin & Johnson, 2011).

The new law guarantees every person in US health care insurance cover. In the past, people with lifelong diseases did not get insurance cover, but with the new provision it is possible for them to get it nowadays. There will also be community rating which will require insurers to give the same premium to all applicants of the equal age and geographical region (Kaiser Family Foundation, 2010).

The second provision of this law is the sharing responsibility. Owing to this, all individuals without any form of cover from their employee, Medicaid, or Medicare are required to get health insurance cover from a public insurance policy provider. If they fail to do so, they will have to pay a penalty. However, there might be some exceptions if a person is a member of a legal cult or for some reason has received a waiver.

The third provision of the new law is Health Insurance Exchanges, which will be valid in every state. They will offer a trade area for small businesses and include earners to compare insurance policies and buy the best. Those who qualify for a government subsidy will buy the policy at a subsidized price. The law also expands Medicaid eligibility to incorporate all people and families living in poverty. For this provision, states that decide to ignore the government’s Medicaid policy can set their own thresholds (Kaiser Family Foundation, 2010).

Problems with the Current Health Policy

The first problem with the current health policy system lies in its cost. Many people agree that the cost of health insurance is too high to afford. To get insurance cover for a family it can cost up to fourteen thousand US dollars a year, which is a lot of money for average income earning families. With the inflation, the costs seem to be rising, and there is the need to eliminate this problem (Kaiser Family Foundation, 2010).

The second problem involves gaps in health care insurance programs. People who try to gain insurance policies on their own may reach a deadlock if insurance companies refuse to recognize the policy. Small businesses pay excessively much to secure health insurance policies for their workers. The other gap is the failure to offer insurance policies to those with lifelong diseases and limit of some insurance covers, which may leave others without insurance in the future (Kaiser Family Foundation, 2010).

Changes Taking Place and Big Change in January 2014

Currently, there is a limit of insurers’ spending of premiums. The insurance companies that spend much of the policy money have to give it back in term of rebates. This aims at ensuring that insurance firms spend policy money wisely. There are health services that are free. These are the basic and essential services such as prenatal health care services. Those over sixty-five can receive help in their medications. There is no lifetime limit on insurance covers and children are able to get it (Lumpkin & Johnson, 2011).

The big change in January 2014, Medicaid will cover all people despite the age. The government and employees will contribute to this health policy. If one is not doing any work for an employer, he or she can buy policies in the exchanges that the law will introduce in the year 2014. In the year 2014, health insurance providers will not bar anyone from receiving a health care insurance policy (Kaiser Family Foundation, 2010).

Personal Experience

From personal experience as a health professional, the current health policy discourages many people from getting insurance policies. The cost factor and limitations in the insurance policy are the two main barriers of taking health insurance policies. Owing to this fact, many patients were forced to spend high amounts on health care, since they do not have any cover; others cannot afford medication. Without health insurance, it is extremely difficult for one to get health care, since the costs are too high to pay. As a result of this, many unprecedented deaths has happened. The reason is that these people choose not to visit hospitals because they are aware that the costs are already too high for them to afford.

In conclusion, the new health policy law aims at eliminating gaps in the health insurance sector and reducing high costs of health insurance in US. In the past, people have lived without health policies because they could not afford them. With the new health law, it is possible for all people in US to access health insurance.


Kaiser Family Foundation. (2010, September 7). Healthcare Reform Hits Main Street [Video file]. Retrieved from [youtube] WEB

Kovner, R., Knickman, J., & Jonas, S. (2011). Health Care Delivery in the United States. New York: Springer Publishing Company.

Lumpkin, J, & Johnson, R. (2011, April 11). Health Care Reform: Overview of Access to Care [Video file]. Retrieved from [youtube]

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