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Katelyn Watters

Professor Jennifer Santiago

UWRT-1102-027

7 February 2017

Topic Proposal

As a student pursuing a career in healthcare, I am intrigued by the way in which

Americas healthcare system functions, the social issues that arise from Americas healthcare

system, and how healthcare policy affects real people. This interest has led me to the question

that will be what I attempt to answer in my inquiry paper, which is as follows: If the Affordable

Care Act were to be repealed, how would this impact the American public? While I knew

initially that I wanted my papers focus to be on the healthcare system, the recent discussion of

policy changes regarding the Affordable Care Act, or ACA, by the Trump administration have

influenced me to adjust the direction of my paper. I will be focusing specifically on the ACA, its

history and why it was implemented, the impact its implementation has had on various

populations, and how America would be affected if it were annulled. I will be discussing the

current healthcare system in less detail due to the unpredictable political climate and

impending policy changes.

The Affordable Care Act, commonly referred to as the ACA or Obamacare, is a

comprehensive healthcare reform law passed under former President Obama in March 2010 with

three key objectives in mind (ACA, Healthcare.gov) The primary goal was to make healthcare

more affordable and accessible, particularly for low income populations (ACA, Healthcare.gov).

The act also planned to expand Medicaid in most states to cover adults with income below the

federal poverty level, and support inventive healthcare delivery methods intended to increase
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quality of care while lowering costs (ACA, Healthcare.gov). Beginning primarily in the 1970s,

multiple attempts have been made to establish federal healthcare reform by several presidential

administrations throughout the years, including Carter, Clinton, and Obama (Westmoreland, 98)

Prior to when the ACA took effect in 2012, it was estimated that 55 million Americans under the

age of 65 were uninsured, according to estimations done by the Congressional Budget Office

(American Public Health Administration). Many of these uninsured Americans were low income,

yet did not qualify for Medicaid due to the specific requirements, leaving them without an

alternative (Westmoreland, 98). When the uninsured were to seek treatment in the case of an

emergency, it resulted in astronomically high costs (American Public Health Administration).

40% of these high costs would then be delegated to consumers with health coverage in the form

of higher premiums (American Public Health Administration). Many health professionals,

democratic politicians, and citizens voiced their concerns and advocated for a policy that would

help cover uninsured individuals (Westmoreland, 99). Advocates claimed that increased

coverage for these uninsured individuals would diminish health inequalities and allow better

access to preventive care (American Public Health Administration).

This policy has been riddled with controversy, as a significant portion of the American

public has not been in favor of it since its implementation (Tucker). Critics often argue that it

allows the government to have an excessively dominant role in peoples healthcare (Tucker).

This reaction is mainly in response to the individual mandate policy in the ACA that requires

individuals to obtain the minimum health insurance or they will face a penalty at the time ones

federal tax return is filed (Individual, Healthcare.gov). Citizens are being coerced into

purchasing a product, in this case health insurance, which critics of the ACA believe to be an

infringement of individual rights (Tucker). Twenty-six states have objected to the mandate,
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bringing it to the Court of Appeals (Tucker). Not only are certain states not in favor of the

mandate, but disapprove of the ACAs expansion of Medicaid, arguing it to be unprecedented in

scope and a threat to withhold federal funding (Tucker). The controversial ACA has been

battled since its beginnings, and will likely remain this way due to the complexity of the issue. It

affects a vast number of people in the U.S., and all these people have conflicting perspectives as

to how they are and should be affected by this policy.

Research regarding health care policy, particularly the ACA, is crucial, as policy

changes affect such an enormous portion of Americas population (American Public Health

Administration). It can be difficult for the public to garner accurate, unbiased information,

regarding how policy changes will impact them. The press, as well as many other media outlets,

sometimes have their own specific agendas. This makes credible, factual research designed for

the average American incredibly significant. Without this information, many Americans will not

know how to prepare for upcoming policy changes, or which officials running for public office

will vote for policy changes that benefit them.

I plan to tailor this paper to a widespread audience that is concerned with how changes in

healthcare policy will affect them, and those around them. I will include a wealth of information

from credible sources that provide reasons for the implementation of the ACA, government

expenditure, who are and arent benefitting, and the effect that a repeal would have on the

healthcare system. An individual with little to no knowledge about health care will be able to

read and comprehend this paper, as I will be carefully defining the vocabulary that I will use,

breaking down facts, and introducing a multitude of varied perspectives.

From here, I plan to do more extensive research. I plan to gather scholarly information

from a diverse set of perspectives regarding how the ACA has or has not been beneficial. I want
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to focus mainly on the outcomes the ACA has had on the average consumer, those of low

income, as well as healthcare professionals and administrators. Americas healthcare is an

incredibly multifaceted issue, and I will reflect that. To produce a factual claim as to how a

repeal would affect the American public, it is necessary that I collect more data regarding how

the healthcare system functioned before the ACA was implemented, and the changes in America

that have occurred since the ACAs implementation. Currently, I need to focus my research on

gathering quantitative data and statistics regarding the ACA and its impact on the public.

Additionally, it is necessary that I research more about Medicaid and its relationship with the

ACA. In some time, I will begin outlining the main topics that I wish to cover and the facts that I

have researched regarding those topics, not only to ensure I include all the information necessary

to support my claims, but that an orderly flow is present in my paper. To remain focused and

organized, I must plan ahead carefully.

Bibliography

Alcala, Hector E., et al. Impact of the Affordable Care Act on Health Care Access and

Utilization Among Latinos. Journal of the American Board of Family Medicine, vol. 30,

no. 1, 2017, pp. 5262. PubMed.gov, doi : 10.3122/jabfm.2017.01.160208.

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Affordable Care Act (ACA) - HealthCare.gov Glossary. HealthCare.gov, U.S. Centers for

Medicare and Medicaid Services, www.healthcare.gov/glossary/affordable-care-act/.

Dalen, James E., et al. Why Do So Many Americans Oppose the Affordable Care Act? The

American Journal of Medicine, vol. 128, no. 8, 2015, pp. 807810. PubMed.gov, doi :

0.1016/j.amjmed.2015.01.032.

Fox, Jared, and Wanda Barfield. Decreasing Unintended Pregnancy Opportunities Created by

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3159&vol=19&page=E1109.

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Nowak, Sarah A., et al. Alternatives to the ACA's Affordability Firewall. Rand Health

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Tucker, Charlotte. Health Reform Law to Have Its Day in Nation's Highest Court Next

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gov.librarylink.uncc.edu/pmc/articles/PMC5007056/.

Westmoreland, Timothy M. The Affordable Care Act in the United States and HIV Disease:

Past, Present, and Future. Topics in Antiviral Medicine, vol. 24, no. 2, 2016, pp. 98102.

PubMed.gov, http://www.iasusa.org/sites/default/files/tam/24-2-98.pdf.

Why Do We Need the Affordable Care Act? The American Public Health Association, Aug.

2012, www.apha.org/~/media/files/pdf/topics/aca/why_we_need_the_aca_aug2012.ashx.
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