Social Problems Essay – Affordable Care Act

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SOCIAL PROBLEMS ESSAY – OPTION B
Health Care and the Affordable Care Act
This paper focuses on the “Patient Protection and Affordable Care Act” (or ACA), which was
the result of heated debate in our society. (NOTE: The final version of the ACA included
some amendments from the Health Care and Education Reconciliation Act passed a few
days after ACA in 2010. Also, please note that the ACA is often referred to as “Obamacare.”
However, this is politically charged term so avoid using it in your essay.)
Tasks To Do Before Selecting Your Topic and Writing: Become familiar with the ACA
In order to become knowledgeable about the ACA, please do the following and then
proceed on to the actual assignment below.
First, please watch the 17-minute video “Obamacare – The Affordable Care Act Explained”
by Keith Hughes to get an overview of the ACA. This is a broad, but very good, summary of
the law. Also, watch the 9-minute video “Health Reform Hits Main Street,” which provides
some additional overview information. Feel free to pause the videos frequently so you can
jot down a few notes for yourself. These videos are a useful summary of some subjective
concerns about health care in the U.S. that our society is trying to address with the ACA.
Video by Keith Hughes

This “Health Reform Hits Main Street” video is useful to help understand what the
health care insurance situation was like BEFORE the ACA

Second, spend 5-10 minutes examining the “Implementation Timeline” of the ACA provide
by KFF. This is VERY important. In particular, I encourage you to scan through the 2010
items and the 2014 items. The law first took affect in 2010 and was (for the most part) fully
implemented in 2014: http://healthreform.kff.org/timeline.aspx.
Please note how you can “Customize By Topic” on the left. This is VERY useful in
narrowing the focus of your paper. For example, if you are mostly interested in the
ACA’s affect on “Employers” you can “deselect all” then re-click just this area to see
what is in the ACA under this narrower topic. When I did this, and then clicked on
the year 2010 I got:
• the “Small Business & Tax Credit,”
• the “Reinsurance Program for Retiree Coverage” and
• the “Therapeutic Discovery Project Credit”
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When I click on the year 2014, I got:
• In the year 2014, I got “Employer Requirements”.
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Any one of the above sub-topics would be a useful topic for your paper. This is VERY
helpful for identifying your focus in question #1 below! Note: you will need 2
narrowly focused topics like the above from the ACA for this essay so please spend
some time with this timeline and the above process!!
Third, spend 5-10 minutes scanning through the “Summary of New Health Reform Law”
provided by the non-partisan Kaiser Family Foundation (KFF). This may add a bit more
detail to the two topics you select via the timeline above.
Kaiser Summary of ACA:
http://kff.org/health-reform/fact-sheet/summary-of…
Fourth, to get a sense of some additional perspectives and data, scan some of the
following. You are, of course, always welcome to do independent research but that is
not required for this essay.
Centers for Medicare and Medicaid Report (March, 2017) on ACA Marketplaces
enrollment:
https://www.cms.gov/Newsroom/MediaReleaseDatabase/Fact-sheets/2017-FactSheet-items/2017-03-
15.html?DLPage=1&DLEntries=10&DLSort=0&DLSortDir=descending
Kaiser Family Foundation (January, 2017) ACA Data Bank
http://kff.org/state-category/health-reform/
New York Times – The Upshot (October, 2016) A Quick Guide to Rising Obamacare
Rates
https://www.nytimes.com/2016/10/26/upshot/rising-o…
United States Census (September, 2016) “Health Insurance Coverage in the U.S.”
https://www.census.gov/library/publications/2016/d…
Kaiser Family Foundation (September, 2016) “Key Facts About the Uninsured
Population”
http://kff.org/uninsured/fact-sheet/key-facts-abou…
The American Journal of Public Health (August, 2016) “Effect of the Affordable Care
Act on Racial and Ethnic Disparities in Health Insurance Coverage”
http://oaktonlibrary.oakton.edu:2077/10.2105/AJPH….
New York Times article “Is The Affordable Care Act Working?”:
http://www.nytimes.com/interactive/2014/10/27/us/i…
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CNN article “House sends Obamacare repeal bill to White House”:
http://www.cnn.com/2016/01/06/politics/house-obama…
Non-Partisan CBO report (June, 2015) “Budgetary and Economic Effects of
Repealing the Affordable Care Act”
http://www.cbo.gov/sites/default/files/114th-congress-2015-
2016/reports/50252-Effects_of_ACA_Repeal.pdf
Non-Partisan CBO report (April, 2014) on costs and deficit reduction (or savings)
derived from implementing the ACA:
http://www.cbo.gov/publication/45231
Washington Post article (August, 2014) documenting declines in federal budget
deficit due to ACA:
http://www.washingtonpost.com/blogs/plum-line/wp/2…
For a brief review of the 2012 Supreme Court decision upholding the ACA’s
constitutionality, see the following:
http://www.nytimes.com/interactive/2012/06/28/us/h…
If interested, here is the link to the full Supreme Court decision:
http://www.supremecourt.gov/opinions/11pdf/11-393c…
Feel free to examine other more recent articles in the reputable periodicals if
desired. These are just some examples.
NOTE: As you write the paper, you may use additional resources. However, this is not
required. Rather than spending your time searching for information, I want you to spend
your time thinking about and understanding the ACA.
Paper Instructions
The social problem of “health care” in the U.S. is complex. There is a great deal of objective
data available about costs and numbers of people securing coverage (or not), as well as a
wide variety of subjective concerns being expressed by members of society. People seem to
want coverage, but our past arrangements left many without protection or access. Drawing
from the material above, please write a 5-6-page essay addressing the following*:
1) In a short opening paragraph, please identify 2 specific areas of the ACA that
interest you and that you will write about in the essay. To select your topic, please
use the Kaiser Foundation timeline identified and explained earlier and below
(http://healthreform.kff.org/timeline.aspx). Be sure to drill down on a particular
topic and year to narrow your focus.
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SELECTING YOUR TOPICS, EXAMPLE A. If you use the following click-path, you
will end up with the topic “Annual Fees on the Pharmaceutical Industry”:
• Under “customize by topic” click “deselect all”
• Click the box for “prescription drugs”
• Click on the year “2012”
• You should see the ACA provisions being implemented in 2012 for “Annual
Fees for the Pharmaceutical Industry”
SELECTING YOUR TOPICS, EXAMPLE B. If you use the following click-path, you
will end up with the topic “ Adult Dependent Coverage to Age 26”:
• Under “customize by topic” click “deselect all”
• Click the box for “insurance”
• Click on the year “2010”
• Click on “Adult Dependent Coverage to Age 26” to see the ACA provisions for
this topic
Using the above example “click-paths,” please select 2 topics of your own choosing for the
paper. You will focus on these two areas when answering the remaining questions. In the
opening paragraph be sure to briefly explain what the 2 topics are about. Be sure to select
something narrow and “doable”; remember that you have just 5-6 pages for this essay. The
opening paragraph should be roughly a half-page or less.
2) In at least two separate paragraphs, and drawing upon the web sites made available
to you in this assignment, or other credible resources, please:
a. Identify and explain a specific subjective concern related to each of the 2
areas you selected in #1. In other words, what was it that people were
concerned about that these 2 areas of the ACA attempt to address? Why were
these two areas included in the ACA? What problems were they trying to
solve?
b. Next, identify one subjective concern for each of your 2 areas that is
expressed by those who oppose the assistance being provided by the ACA.
What are they worried about? Feel free to use a quote (if needed) followed by
an in-text citation like: (CNN, 2016). A bibliography is NOT required unless
you use outside sources.
3) In a separate paragraph, please briefly identify what cultural value (or values) is/are
reflected in the debate in #2. Remember, cultural values are standards of what is
“good,” “fair” or “just” in a society. There are particular American values that
underpin the ACA debate and I expect you to connect the debate to at least one. This
discussion of values may relate directly to your two narrow topics selected above, or
if you prefer, you can discuss what American values that underpin the overall
debate about the ACA in our society.
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4) In a separate paragraph or two, identify 2 specific pieces of objective data (i.e., a
measurable statistic from a reliable source) related to the ACA. Often, people
express subjective concern about a social problem, but the available objective data
doesn’t support it. Again, a simple in-text citation like (New York Times, 2016) or
(CBO, 2015) should be used following the data. Also, if possible, please state how
these data relate to the debate surrounding at least one of your topics. If these data
don’t relate directly to your selected topics (and they don’t have to), please briefly
state how the information you selected is useful in understanding the social
problem of providing health insurance/care via the ACA overall.
5) In a separate paragraph (or two, if you feel that it is useful in terms of organization
and clear writing), please briefly contrast how a functionalist and a conflict theorist
would approach the social problem of health care and the proposed solution – that
is, the ACA – in the U.S.? Be sure to apply each approach to the problem, rather than
simply re-state the basic perspective for each without connecting it to health care
and the ACA debate. How might a conflict theorist think through the ACA? How
might that differ from a functionalist?
6) In a separate paragraph, please tell me your general thoughts about the ACA. Are
you in favor, opposed, somewhere in the middle? Why? Also, please tell me how
your social location likely affects your perspective. Remember, social location
includes your gender, racial-ethnic background, social class, religious affiliation, and
other aspects of identity and culture. Be specific with your social location and how it
may influence your perspective.
* Please CAREFULLY read the Grading Rubric and the Writing Requirements
document for more details. If you have questions, please email me. Spelling,
grammar, and cogent writing matter so please think carefully about what you are
trying to say in each paragraph and proofread carefully.
NOTE: If you know that you struggle with clear, effective writing, please contact the
Learning Center (http://www.oakton.edu/studentservices/learning_center/index.php) or
me for assistance. If you want assistance from me, please schedule an appointment (either
phone or in-person) with me at least 5 days before the paper is due. Please plan ahead!
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THE FOLLOWING IS JUST FOR YOUR INFORMATION. IT IS NOT A REQUIRED PART OF
THIS PAPER ASSIGNMENT.
Recently, the Republican majority in the House of Representatives proposed a bill to
“repeal and replace” the ACA. It was call the American Health Care Act (AHCA). Here is
some information on this proposal. As I’m sure you know, the bill was never called for a
vote because the Republican leadership realized they didn’t have the votes needed for
passage.
Kaiser Summary of the American Health Care Act (AHCA)
http://files.kff.org/attachment/Proposals-to-Repla…
Kaiser Side-By-Side Comparison of ACA and AHCA:
http://kff.org/interactive/proposals-to-replace-th…
CBO (non-partisan Congressional Budget Office) Estimates of Costs for the AHCA:
Summary 3/17/17: https://www.cbo.gov/publication/52486
Full Report 3/17/17: https://www.cbo.gov/sites/default/files/115thcongr…
Updated Summary and Report 3/23/17 to reflect amendments:
https://www.cbo.gov/publication/52516
New York Times article on the CBO estimated costs of AHCA:
https://www.nytimes.com/interactive/2017/03/13/us/…