"Harper's" Article on the ACA

While no expert at all, I've been interested in the development of the Affordable Care Act, since began to move through Congress in 2009. I devoted a few posts on this site to the topic, and we've discussed it in my college classes on contemporary moral issues. I believe that health care is a fundamental right, and that the Bible is concerned with physical as well as spiritual well-being. But is this act the way to go? How do we help provide proper and affordable health care in our contemporary time, when steep medical costs can make care out of reach for many? Does the act hurt small businesses, while attempting to provide justice for others?

A recent piece in Forbes discusses ways that the ACA can be improved: "The Supreme Court’s June 25 decision in King v. Burwell preserves federal health care subsidies under the Affordable Care Act (ACA) for Americans who reside in states that have opted not to create their own health insurance exchanges. In so doing, it removes an immediate uncertainty for those who would have been left without coverage if the federal exchanges had been declared unconstitutional. But it leaves untouched a more basic problem. The ACA’s reliance on mandatory participation in exchanges as the only way to obtain a health insurance subsidy is fundamentally flawed…"

That author suggests solutions: "The most important is to replace the ACA’s income-conditioned premium subsidies with a 'fixed dollar' refundable tax credit. This would be available to all Americans, with no income-based limitation. With the credit available to all, there would be no need for the unnecessary individual and employer mandates." Individuals could shop for coverage, and employers could enjoy more flexibility, including small businesses.

The current issue of Harper's Magazine (July 2015) includes an article by Trudy Lieberman, "Wrong prescription? The failed promise of the Affordable Care Act" (pages 29-38). I plan to read the article more closely this coming week. Lieberman regrets that the act is still poorly understood by Americans, has been ineffectively criticized by conservatives via misinformation, and has been barely criticized by liberals (p. 29). She makes numerous interesting points worth thinking about; she laments that the ACA has not at all fixed "our high-priced, unequal, and insanely inefficient system" but rather has "reinforced and accelerated many of the system's most toxic features" (p. 38). If the Supreme court rules favorably on the law (which it has, since the article's publication), it will be necessary to fix problems not only in the law but problems in our health care system prior to the law's passage.