Affordable Care Act. Critical Essay

It is astonishing how prices in the Affordable Care Act health exchange program have increased. I am in disbelief at the amount of pride a country has of being the best yet fails to acknowledge the needs of its people counting against their social determinants of health . With a twenty-five percentage increase in my premiums purchased through the Health Exchange Program, called Covered California, and as a woman-identifying individual, its devastating sacrifice I will be making on my needs and I prefer a better solution. I have overcome a variety of financial barriers and I am doing the best I can, but I still I rely heavily on my healthcare. Thus, a public option can be a feasible alternative solution for myself and others in my position.


Policies on a public option in the United States healthcare system has gained public and political attention for years. The public option refers to a government-run health insurance agency that would compete for consumers with other private health insurance companies within the US. The Health Affairs describes the public option by the 111th Congress as a way to transition toward single-payer insurance program, opposing the conversative view of government control an indication of allowing markets to sell and buy viewing the patients’ access to health access as a commodity thereby removing the idea of a patient to be healthy without the thought of going bankrupt. The University of California, Berkeley’s professor, Helen Halpin, and other authors developed the proposal of a state-based health insurance exchange called CHOICE designated to allow nonelderly Californias to enroll in the private managed care(,) or the new public option offered through the exchange during 2001-02. The idea of the plan illustrates the compromise between single-payer system and managed competition among private plans. In 2008 the public option rose in politics during Obama’s Health Reform, the bill passed by the Senate Health, Education, Labor, and Pensions Committee (HELP) yet did not gain enough support to pass through the reconciliation process. However, after more than a decade Californian Governor Brown signed a Public Option Study Assembly Bill No. 2472 in 2018 as part of the Care4All California package . The bill would require a feasibility analysis, reviewing the limitations of certain regions and financing at the end of 2021. On the other hand, Washington state has recently passed their public option, a state-sponsored plan to reduce both cost of premiums and deductibles capping the total provider and facility reimbursement rates at 160% of Medicare. 

The history of the public option has led to the current changes in states such as Washington and California. But, there are still many reviews on the overall outcomes. Thus, understanding what we have now the Affordable Care Act and their annual premium increase rate, the older you are companies may charge a higher premium and the local healthcare determines each cost and option for each consumer, is piling to a ridiculous amount of expenses for individuals like myself. The public option could potentially change the dynamic of charges, especially with establishing balanced risk pools. Since an imbalanced risk pool has been the result of the Trump administrative change to the Affordable Care Act penalty, it has led to people dropping out of their enrollments triggering a double-digit premium increase in the individual market. While there are many hurdles I face I cannot simply live without insurance, and having an option that would consistently have general payments allows for one less worry. 


I believe the public option would be helpful to me even though issues may arise. I feel confident many non-elder adults like myself could find benefits in this option. Even though, I may face rejection from providers due to their low reimbursement in which the government pays at lower rates as well as have less flexibility to choose treatments, drugs, and providers(this is not a complete sentence, if you get rid of the “even though” it is one). While this may be true, the government supervises the cost, competing with private insurances (and) could initially bring prices down due to bargaining with consumers. Hence, healthcare payments may fluctuate, but stay consistent by the options individuals encounter. (And this means I should buy it?)


The Public Option may lead to some short and long term effect(s) in our healthcare system. One long term effect is the indirect transition from public option to a single-payer system because the costs of the insurance market could plummet since private companies could not keep up. An alternative long term effect contributes to the improvements continuity in Californians staying in a healthcare program. Meanwhile, two short-term ramifications are in review of rural areas and the providers’ administrative burden. The rural areas would limit the ability to have necessary medical equipment, plus the survival of their hospitals since as Lauren Crawford Shaver points out is by the massive taxes. Lastly, providers’ administrative burden of receiving more patients and having to find ways to upkeep their clinics(incomplete sentence).