The Affordable Care Act, referred to as Obamacare, was signed into law about one year ago in March 2010. In the time since Congress passed the legislation, many tweaks and modifications have been suggested, ranging from changes that will have minimal impact on the overall effect of the bill to a full repeal. Here are five proposed changes and a brief overview of each:
Medical Malpractice Reform
Tort reform, or legislation focused on changing how medical malpractice influences health care in the U.S., was not included in the health care reform bill. Both sides of the aisle have ideas for medical malpractice reform, and so does the Obama administration.
Obama included in his budget $250 million in grant money for the Justice Department, along with the proposed task of helping states analyze and rewrite their medical malpractice laws. The goal would be to limit the liability of doctors and, in turn, limit the number of tests ordered and medications prescribed as defensive medicine.
Both the American Medical Association and Republicans have pushed for this type of modification to medical malpractice laws, but have been unsuccessful thus far, with the exception of damage caps in some states and various requirements to reach litigation intended to weed out frivolous suits. A recent poll revealed that a majority of Americans, 54 percent, are in favor of limiting medical malpractice awards.
1099 Tax Reporting Requirement
Most of the proposed changes are rather partisan, with one party or the other attempting to use health care reform as a vehicle to push its agenda. However, the repeal of a 1099 reporting requirement has bipartisan support, primarily due to the burdensome effect the provision would have on small businesses.
Senator Robert Menendez (D-N.J.) is proposing an additional amendment to the repeal amendment that would require investigation into the effects of the repeal of the 1099 reporting requirement before it is put into effect. Basically, this would give lawmakers a chance to keep the 1099 reporting requirement at some point in the future if further investigation revealed that repealing the requirement would have an overall negative impact on businesses. Sen. Menendez unsuccessfully attempted to rally support against the repeal amendment, and, if that serves as any indication, it appears support will be thin for this amendment as well.
Abortion Funding at the State Level
State legislatures have gotten involved in modifying the health care bill as well by proposing laws that would affect the bill's influence on health care. Several states have already passed legislation that would prevent state exchanges from funding abortions, except for cases of rape or incest.
The state exchanges are part of the Obamacare bill that will be set up as an option for both individuals and small businesses. The exchanges will go into effect in 2014 and, without these laws, may be able to fund abortions due to loopholes in Obamacare and the fact that an anti-abortion provision was left out of the original bill. In order to rally the necessary support for the original bill, President Obama issued an executive order profiting funding for abortion, but the order does not have the legal effect a provision in the legislation would, thereby leaving the door open for possible abortion funding.
Prevention and Public Health Fund
Republicans have gone on the offensive against a provision of the health care bill that establishes a $15 billion Prevention and Public Health Fund. The fund is intended to improve and expand measures aimed at preventing medical problems before they arise. Some Republicans are against the measure, calling the money nothing more than a "slush fund."
A recent letter to President Obama, signed by multiple health care advocacy groups, urges the president to fight back against Republican attempts to eliminate or reduce the funding for preventative health. The Republicans against the measure take issue with the fact that the funds are considered mandatory as opposed to discretionary, and therefore do not require congressional approval each year.
Oversight of Waivers
Various businesses and organizations such as unions have received waivers in which, for one year, they will not have to provide at least $750,000 in annual benefits. Through March, over 1,000 waivers have been granted, which is being taken as sign that Obamacare is flawed by legislators such as Rep. Fred Upton (R-Mich.).
Upton has recently used his oversight power to look into the waivers, but despite his ongoing investigation, he has not proposed legislation to limit the waivers. Rep. Mike Rogers introduced a bill that wouldn't limit the number of waivers, but would make the waivers available to individuals. His argument is that if businesses like McDonald's or organizations such as the SEIU receive waivers, the average individual should be able to do the same.
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