The Obamacare Reform, also described formally as the Patient Protection and Affordable Care Act, is a legislation that attempts to modify the American healthcare system by enhancing the quality of the delivery of healthcare services in healthcare institutions. Passed in 2010, the reform attempts to protect consumers by putting security measures that augment the access to healthcare without incurring any form of malpractice or abuse from insurance firm practices. At one point, insurance companies had the capability of restricting children with heart defects or diseases such as asthma from receiving coverage for healthcare services. However, the reform’s Patient’s Bill of Rights has provided measures of curbing this form of discrimination by insurance organizations. In addition to this, the legislation has also allowed the occurrence of novel benefits as well as increased value for expenditures on healthcare, especially for Americans possessing health insurance. However, Obamacare also possess several impacts with the most notable bearing on its political implications and costly expenditures.

Overview of Obamacare

In overview, Obamacare focuses on augmenting the affordability and eminence characterizing health insurance. Accordingly, the reform also attempts to decrease the rate of the uninsured by extending private and public coverage of insurance. In addition to this, the coverage also plans on decreasing healthcare costs for the people as well as the government. In order to endorse affordability as well as the extent of coverage, the PPACA plans on introducing a range of measures. These measures comprise subsidies, insurance coverages and subsidies in order to accomplish this purpose. The legislation also attempts to necessitate insurance organizations to provide coverage for every applicant within novel minimum standards as well as grant similar rates irrespective of pre-subsisting conditions or gender. Supplementary reforms within the law aim at decreasing expenses and enhancing healthcare outcomes by modifying the healthcare structure towards a system that emphasizes more on quality rather than quantity.

Early Implementation of Obamacare

The Affordable Care Act comprises a set of stipulations that will modify the healthcare structure of the country. By extending coverage, the health modification legislation alleviates insurance markets by making health insurance accessible and affordable. This is because insurance offers imperative economic advantages to registered households. Undeniably, it covers unprecedented medical expenses. This enables people to receive compulsory medical treatment without gaining probable destabilizing financial consequences. Accordingly, the Act also comprises significant provisions aimed at deceasing ineffectual spending, endorsing competition and augmenting the sophistication of healthcare.

Expenditure Estimates

Accordingly, the expenditure involved in the implementation of the Affordable Care Act is in accordance to the increases on Medicaid expenditure. Indeed, the novel reform will focus on covering 27 million uninsured American individuals. Moreover, the Act will ascertain the accessibility of affordable comprehensive coverage via conventional employer-sponsored insurance and novel health insurance exchanges or markets (“The Affordable Care Act” 1). Based on this, it is apparent that the legislation comprises a range of provisions that necessitate increased government spending. However, such costs are equalized by other reform stipulations that will either provide novel revenue or reduce the present spending. Nonetheless, in sum, the Act is expected to decrease budget discrepancies by $210 billion in the next decade. Consequently, the Congressional Budget Office (CBO) approximates the total expenditure incurred by the legislation to be $1168 billion within the respective decade.

Technical Issues Facing Obamacare

Eligibility of Medicaid Provisions

Even though the Obamacare reform stands to provide insured healthcare for most Americans, certain technical issues are evident with respect to its implementation. One of these issues involves determining the eligibility of Medicaid provisions. Accordingly, the Affordable Care Act comprises several provisions devised to extend and restructure Medicaid eligibility. Specifically, the Act plans to widen coverage to young and non-disabled civilians with income below the Federal Poverty Level’s (FPL) 133 percent requirement (Camillo 3; Gruber 6). Nonetheless, the issue that arises from this involves the utilization of novel suitable methods required for ascertaining eligibility. Therefore, in order for the program to undergo successful implementation, it needs the institution of a new streamlined procedure that enables state Medicaid schemes to coordinate flawlessly with other affordable health and reasonably insurance programs. In addition to this predicament, the efficiency of this novel archetype will rely on the ability of the states to apply it successfully.

Financial Burden on States

Another technical issue arising from the adoption of the Affordable Care Act comprises the financial implications it imposes on states. As stated, in order for states to approximate the expenditure involved in the expansion of the Medicaid program, they have to ascertain the amount of individuals who, presently, are eligible for the program but are not registered. Accordingly, the Obamacare legislation does not augment funding to states especially in economic slumps. In times such as these, Medicaid registration usually increases. For instance, the recent economic crisis saw Medicaid cover a supplementary 3.3 million between June 2008 and 2009 (NCSL 2). Regardless of this realization, the Act does not offer a countercyclical prompt for Medicaid. Based on this, states will face higher costs due to increases required to cater to the boosts in access to the Medicaid program (NCSL 2).

The Political Situation

Consequently, the Obamacare reform also poses impacts on the current political situation. Foremost, the opinions regarding the Act fall exclusively within party borders. Accordingly, public opinion surveys indicate that Americans generally favor healthcare reform. However, the public’s perception has become gradually negative in retort to particular plans. With respect to politics, a large number of Democrats favor the legislation. In contrast, Republicans express dissent towards the Act. Nonetheless, particular aspects of the law are significantly accepted athwart the political continuum. For instance, the enactment of provisions such as the reduction of Medicare qualification age, the importation of Canadian prescription medicines and the Public Health Insurance Option saw a large number of Democrats favor the Act (Blendon and Benson 3-4). These polls illustrate the political influence that the Act imposes on the country based on the coverage of its provisions as well as the financial effect it imposes disparately in states throughout America.

Further political influence concerning the legislation is in respect to its implementation. Accordingly, the influence of Republicans in Republican-run states has created significant challenges regarding the implementation of certain provisions within the Act. Accordingly, some states have challenged the reform’s constitutionality. Indeed, the Act restricts the allotment of Medicaid funding to states, which refuse to engage in the extension of the program. Based on this, political opponents have resorted to initiating an opposing stance against the Act referring to this specific proviso as a limitation towards the constitutionality embedded in all the laws of the United States. In other instances, Republican-administered states have focused on rejecting the extended Medicaid coverage offered by the legislation. This illustration portrays the political predicament facing the Affordable Care Act due to political influence. Accordingly, states under the control of Republicans have opted out of the coverage based purely on political reasons as well as party boundaries.

In addition to the political situation facing the Affordable Care Act, Republican bureaucrats within a number of states have settled on opposing aspects of the implementation of the legislation. This is because they possess significant diplomacy over these elements. For instance, some states have declined the establishment of a health insurance market as well as the extension of the Medicaid program. In addition, Republican-run states have also enacted laws that forbid the provision of funding not particularly required by law concerning the operation of the Affordable Care Act. In addition to these restrictive efforts, Republicans within the Congress have also limited amendments to the provisions of the legislation that may be helpful to the individuals it covers. Accordingly, most of partisan politicians argue that amendments to the Act will only weaken the arguments presented for repeal of some of the provisions within the law.


In conclusion, the Affordable Care Act offers a number of provisions aimed at improving access and delivery of healthcare in the United States. It aims at doing this by offering insurance coverage for more than 20 million previously uninsured Americans. Based on this, the Obamacare reform stands to utilize a significant amount of expenditure in order to ensure that every aspect of its anatomy is fulfilled to the required extent. Nonetheless, the legislation is not free from criticism from lobby groups and political opponents alike. However, this does not necessitate any partisan innuendos or retrogressive ideologies towards the implementation of the law. Instead of focusing on political stakes, it is imperative to focus on the positive points of the law and ensure that it undergoes successful implementation throughout the country.



















Works Cited

“The Affordable Care Act and Trends in Health Care Spending.” (2013): 1-30. Web. 9 Nov. 2013. <http://www.whitehouse.gov/sites/default/files/docs/fact_sheet_implementing_the_affordable_care_act_from_the_erp_2013_final1.pdf/>.

Blendon, J. Robert, & Benson, M. John. “Public Opinion at the Time of the Vote on Health Care Reform.” New England Journal of Medicine 362.16 (2010): 1-6. Web. 9 Nov. 2013. <http://www.nejm.org/doi/pdf/10.1056/NEJMp1003844/>.

Camillo, A. Cheryl. “Implementing Eligibility Changes under the Affordable Care Act: Issues Facing State Medicaid and CHIP Programs.” State Health Access Reform Evaluation (2012): 1-6. Web. 9 Nov. 2013. <http://www.mathematica-mpr.com/publications/PDFs/health/eligibilitychangesstateissues_brief1.pdf/>.

Gruber, Jonathan. “The Impacts of the Affordable Care Act: How Reasonable Are the Projections?” NBER Working Paper Series 17168 (2011): 1-23. Web. 9 Nov. 2013. <http://economics.mit.edu/files/6829/>.

National Conference of State Legislatures. “States Implement Health Reform: Medicaid and the Affordable Care Act.” (2011): 1-3. Web. 9 Nov. 2013. <http://www.ncsl.org/documents/health/HRMedicaid.pdf/>.

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