Social Issue 1 - Healthcare in the USA
How do Americans access healthcare?
There are different ways Americans access healthcare. The way in which healthcare is organised in the US has been divisive.
Unlike the UK, there is no free at the point of use national health care provision in the US.
Most Americans are expected to provide for their own health care through private medical insurance. Many people receive their private health insurance through their employer. One of the providers is the Blue Cross Blue Shield Association, which provided health insurance for 115 million members as of 2023.
Health programmes
The US government has health programmes that cover those who cannot afford private medical insurance.
These include:
- Medicare 鈥 mostly for people over 65 years of age and administered by the federal government. In 2022, Medicare covered 65 million people and cost $905 billion.
- Medicaid 鈥 covers people on low incomes including children, pregnant women and people with disabilities. It is administered by individual states. In 2023, over 88 million individuals were enrolled in Medicaid costing the US government $805 billion.
- Children鈥檚 Health Insurance Program 鈥 covers those children who do not qualify for Medicaid. CHIP is administered by states. In 2023, nearly seven million children were enrolled in CHIP.
Black and Hispanic Americans are more likely to have lower incomes or to be unemployed. This means that they are less likely to have private medical insurance and are more likely to depend on Medicare or Medicaid to be uninsured (not covered by government health programmes and without private medical insurance). In 2023, 26 million people or 7.9 percent of the population were uninsured.
What is the Affordable Care Act (ACA)?
Often referred to as Obamacare鈥, the act was passed in 2010 to give Americans better access to healthcare by putting in place comprehensive health insurance reforms which:
- expanded healthcare coverage
- held insurance companies accountable
- delivered lower health care costs
- guaranteed more choice
- enhanced the quality of care for all Americans
- required all Americans to have health coverage
Repealing the ACA
Why is the affordable care act controversial?
The Affordable Care Act has been divisive. Republicans are against it and believe it is unaffordable, that it has led to hundreds of thousands of jobs losses and represents excessive government interference in private lives.
Many Democrats have embraced the ACA. It has led to higher insurance premiums for some, but it has widened access to health insurance. The number of Americans who are uninsured has fallen since the ACA was passed from about 15.5% of the population in 2010 to 7.9% of the population in 2022.
There were attempts to repeal and replace ACA during the Trump Presidency, but these failed. In 2017, despite the Republicans holding a majority in Senate, they were unable to repeal ACA or bring in an alternative.
Covid-19 has led to many Americans losing their jobs and the health insurance that came with them. In response, some Republican politicians have openly suggested they look to ACA providers to find replacement insurance.
Does Biden support the ACA?
President Biden supports the ACA. As vice president to Obama between 2008 and 2016, Biden was fully behind ACA鈥檚 introduction.
Since becoming President, Biden has looked to expand the ACA through increased government support.