The Affordable Care Act: Protecting the Rule on Pre-Existing Condition Coverage

Posted: March 27th, 2020

The Affordable Care Act: Protecting the Rule on Pre-Existing Condition Coverage

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The Affordable Care Act: Protecting the Rule on Pre-Existing Condition Coverage

The Patient Protection and Affordable Care Act (ACA) of 2010 has proven instrumental in the distribution of healthcare services to most populaces across the nation. Elements of the law such as Medicaid have ensured the availability of these resources to millions of people who were uninsured before its implementation. Despite this, the Trump administration has advocated for a repeal of the law, arguing that some of its features are unconstitutional and costly. A particular issue involves the coverage that the Act offers to individuals with pre-existing conditions. Insurance firms had often refused to cover people that suffered from ailments such as asthma and chronic illnesses. Resolving the concern necessitates an emphasis on attaining mandatory coverage and imposing legislation that seals the loopholes insurance companies use to evade the directive.

The underlying principle establishing the Affordable Care Act’s provision on pre-existing conditions is that the directive is unconstitutional. The lack of a legal requirement that authorizes the possession of health insurance for most Americans establishes the law’s undemocratic nature (Goodnaugh, Pear, & Savage, 2018). As such, the stipulation, which restricts insurance firms from barring covers for people with pre-existing ailments, is inapplicable and void as far as the argument is concerned. Since the absence of an individual mandate generates the current issue, a probable resolution may involve the application of mandatory coverage. Accordingly, mandatory coverage will ensure that all American citizens attain the most basic insurance covers. The obligatory nature of the prerequisite will also guarantee that most individuals purchase health insurance by using the law as a deterrent for evading.

Aside from mandatory coverage, the implementation of rules that disrupt vulnerabilities in the corresponding provision will fix loopholes used to avoid covering pre-existing illnesses. Irrespective of the directive, insurance firms usually engage in antics such as high pricing for medications needed by patients ailing from conditions such as multiple sclerosis and HIV/AIDS (Amadeo, 2018). The imposition of significant expenses on the acquisition of these drugs influences persons to switch to plans that apply cheaper levies. Insurance firms also deny coverage for specific medications, forcing individuals to access other platforms (Amadeo, 2018). While both solutions may rectify the situation, mandatory coverage is the most feasible alternative since it will reinforce the constitutional position of the ACA and secure it from repeal. The end outcome will involve the protection of the pre-existing conditions provision from nullification.

The federal government will be responsible for effecting the proposition. Through mechanisms such as funding and facilitation, the federal government will finance state and local governments with the resources needed to provide coverage to all citizens such as subsidies (Larrat, Marcoux, & Vogenberg, 2012). Consequently, the branches of the government, especially the legislative, have the task of ensuring that all citizens attain insurance coverage. Through legislation, all citizens will be required to buy health insurance or incur financial penalties if they fail to comply. The executive will ascertain the proposed bill by signing it into law, hence establishing its application across states. The judiciary, through the Supreme Court, will be responsible for determining the constitutionality of the ACA and its provision by assessing whether mandatory coverage qualifies as an individual mandate.

However, the argument for mandatory coverage is objectionable due to ethical concerns, specifically pertaining to autonomy. Even though health is essential for the public, a person bears the right to choose whether to obtain insurance or not. In this respect, mandatory coverage stifles this right by forcing all persons to attain coverage or face the consequences. While the argument resonates from a moral perspective, it fails to note the extent to which the provision will create a larger insurance pool that satisfies the needs of most Americans from a health standpoint. To this end, since the objective involves ensuring ease of access to health care, the proposed solution may facilitate increased wellbeing, reduced levels of mortality, and morbidity at the expense of privileges linked to autonomy.

References

Amadeo, K. (2018). Obamacare pre-existing conditions: How Obamacare protects those with pre-existing conditions. Retrieved from https://www.thebalance.com/obamacare-pre-existing-conditions-3306072.

Goodnaugh, A., Pear, R., & Savage, C. (2018, June 8). Trump’s new plan to dismantle Obamacare comes with political risks. The New York Times. Retrieved from https://www.nytimes.com/2018/06/08/health/obamacare-pre-existing-conditions-mandate.html.

Larrat, E. P., Marcoux, R. M., & Vogenberg, F. R. (2012). Impact of federal and state legal trends on health care services. Pharmacy and Therapeutics, 37(4), 218-220.