Introduction
The article by Steve Benen discusses the erroneous predictions that various people made about Obamacare five years after it was signed. The author notes that before its signing, the policy was described as a great success in transforming the American healthcare industry. However, few people expected the legislation to exceed expectations and lower the number of uninsured Americans by a third. The success of the Affordable Care Act (ACA) is proof that President Obama’s government made significant strides toward providing health security for all Americans. However, there were some skeptical people who predicted its failure. The Coronavirus crisis has compelled the government to make some changes in order to mitigate the health emergency. Although many of the waivers on testing, treatment, and telemedicine are temporary, plans are underway to make them permanent.
Article Summary
One of the predictions that turned out to be wrong was the argument that Americans would decline calls for enrollment in the ACA. Republicans argued that Democrats were misguided regarding their estimation of the demand for health coverage among Americans. They stated that people would not sign up for coverage under the policy because of their mistrust of the government. However, many families enrolled in the program in order to enjoy its numerous benefits. Furthermore, they argued that it would not meet its enrollment goals. On the contrary, for two years in a row, more people than the Obama administration had projected registered.
Conservatives opposed the policy because they were convinced that private insurers would refrain from working with the government. One of their predictions was that they would refuse to take part in the Act’s exchange marketplaces (Benen, 2015). However, since the implementation of the law, private insurers have worked together with the government in offering coverage to the uninsured. Certain members of the Republican Party believed that the ACA would affect the economy negatively as it would increase the rate of unemployment and alter job creation (Benen, 2015). However, analysts revealed that in 2014, the first full year for the policy’s implementation, more jobs were created in America compared to the 1990s. The rate of unemployment decreased, and no evidence could be found to show that the ACA had negatively affected the economy.
The success of the policy after its implementation angered individuals who had predicted its failure. Therefore, they downplayed the achievements by claiming that the number of enrolments was meaningless because Americans would not pay their premiums (Benen, 2015). They were wrong because the majority of those who registered submitted their payments in a timely manner. They further argued that even if people paid their insurance premiums, the payments would soar because the structure of the ACA was faulty. Five years after its implementation, the premiums have not increased, and more people are registering for coverage.
The issues of the overall coverage and the ACA’s impact on mitigating the high number of uninsured Americans were hotly debated. Opponents of the legislation downplayed its importance by claiming that it would only help people who were already insured (Wilensky & Teitelbaum, 2020). In that regard, it would not reduce the number of uninsured Americans. This prediction was wrong because surveys revealed that the uninsured rate dropped by approximately 33 percent during the first 5 years of the policy’s operation (Benen, 2015). There were claims that the ACA would be counterproductive because it would result in a “net loss” with regard to overall coverage. It would terminate coverage for more people than it would provide. This argument was flawed as the Act expanded coverage to many uninsured people.
Opponents of the ACA also predicted that the policy would cause higher deficits and destabilize America’s fiscal footing. The Obama administration had projected that the Act would reduce the USA’s deficit by billions of dollars after its implementation (Benen, 2015). However, Republicans were in disagreement and opposed it vehemently. They told the people that the Act would inflate the nation’s deficit and run the country into bankruptcy. However, the Congressional Budget Office revealed that Republicans were wrong because the ACA’s cost is less than the initial estimate (Benen, 2015). The rates of customer satisfaction surprised Republicans because they expected people to express their dissatisfaction. Polls have shown that people give positive reviews for the services that they receive through government exchanges. Only 9 percent of the people interviewed rated the services they received as poor (Benen, 2015). Opponents of the ACA were wrong about the majority of the predictions they made. Despite the policy’s success, Republicans who opposed it vehemently are yet to offer public apologies for their misleading predictions. They are spending time searching for ways on how to repeal the legislation that has increased insurance coverage among Americans.
Medicare and COVID-19
The government has implemented several changes to Medicare in response to the Coronavirus crisis. Trump’s administration and Congress have made several changes to Medicare regulations in order to enhance the system’s flexibility toward responding to COVID-19. They have taken place in several areas, including testing, treatment, telemedicine, extended medication supplies, and vaccines among others (Podulka & Blum, 2020). Regulations that have been waived play key public policy functions that are aimed at promoting the effectiveness of Medicare. They include deterring fraud and overuse, enhancing beneficiaries’ access to key items and services, shielding patients from serious harm, and guaranteeing that providers focus primarily on the safety of patients (Podulka & Blum, 2020). The regulatory changes are temporary. However, CMS announced that it was working on making some of them permanent.
Testing and Treatment
Any testing related to COVID-19 is covered under Part B, only if ordered by a health care provider or physician. In that regard, patients who receive the service are not required to pay any deductibles or co-insurance premiums (Podulka & Blum, 2020). The change eliminates the costs for services received in any form of testing. For example, visits to a physician or an outpatient facility are free (Miller, 2020). Moreover, if a Medicare patient is quarantined in a hospital, they will not be required to make additional payments for the services.
Telemedicine
An important change has been made in the provision of telemedicine services to the program’s beneficiaries within the United States. The Centers for Medicare and Medicaid Services (CMS) has scraped off a clause that required providers of telemedicine to offer services only to patients that they had served in the past three years (Podulka & Blum, 2020). Reimbursement for telehealth has been allowed temporarily for services like physician supervision and telephone visits. The legislation also allows hospitals to temporarily offer services in expansion sites, patients’ homes, and other facilities.
Other Changes
Other key changes include the creation of alternative care sites, waiver of participation conditions, expanded testing, safety requirements, as well as reporting and audit requirements. Alternative care sites have been established in order to create capacity for handling an increase in COVID-19 cases (Miller, 2020). Care is not limited to hospitals and designated healthcare facilities. Traditionally, patients were required to meet certain requirements in order to participate in Medicare (Wilensky & Teitelbaum, 2020). Currently, numerous requirements have been waived in order to improve access to Medicare services. Testing has also been expanded in order to improve diagnosis at the newly-created alternative sites. The government has also made changes to pause audit activity and provisionally stop the collection of certain information (Miller, 2020). The new reporting protocols will ensure that the healthcare system receives more information that will be useful in mitigating health emergencies.
Conclusion
The implementation of the ACA in 2015 was conducted amidst strong opposition from Republicans who claimed that the legislation would do more harm than good. They downplayed its importance, projected its failure, and claimed that it would have adverse effects on the economy. Their predictions were wrong because five years after it was signed into law, the uninsured rate dropped tremendously, Americans enrolled in large numbers, the economy grew significantly, and premiums did not soar as anticipated. The debate has morphed into a shouting engagement between proponents who give the reasons for the ACA’s success and opponents who continued to disparage it out of habit. The COVID-19 pandemic was unexpected, and the US government was compelled to make several changes to Medicare/Medicaid. The Trump administration and Congress implemented several temporary regulatory changes that were aimed at mitigating the health emergency. Critics have applauded the modifications that the CMS plans on making permanent. However, the risks that they pose have raised concerns with regard to their effectiveness.
References
Benen, S. (2015). 5 years later, “Obamacare” critics can’t believe their lying eyes. MSNBC. Web.
Miller, M. (2020). Medicare is updating coverage to help in the Coronavirus crisis. The New York Times. Web.
Podulka, J., & Blum, J. (2020). Regulatory changes to Medicare in response to COVID-19. The Commonwealth Fund. Web.
Wilensky, S. E., & Teitelbaum, J. B. (2020). Essentials of health policy and law (4th ed.). Jones & Bartlett.