2. The Affordable Care Act  AKA, “Obamacare”  Goals:  Increase the quality affordability of health insurance  Decrease the number of uninsured people  Reduce the overall cost of healthcare in the country  Mechanisms:  Mandates  Subsidies  Insurance Exchanges

3. Obamacare Mechanisms/Provisions  1) The Individual Mandate  Individuals who are not covered by an employer plan or government program must purchase their own health insurance or pay a fine  How does this bring down the average cost of insurance for all Americans?  2) Employer Mandate  Businesses with at least 50 full-time employees must offer health insurance to their full-time workers or pay a fine  What might be an unintended effect of this provision?  3) Government Subsidies  Individuals and families earning 100% to 400% of the federal poverty level receive subsidies from the federal government to help them purchase insurance on an Exchange  4) Insurance Exchanges  Individuals and businesses can compare and purchases insurance policies within their state  5) Expansion of Medicaid  Now available to individuals earning up to 133% of the federal poverty level  In states that accept the additional federal funds

4. Single-Payer Plans: An Alternative System  Bernie Sanders characterizes this system as “Medicare for All”  System in which the government, rather than private insurers, pay for all healthcare costs  “Single payer” refers to the government—the single source of payments for healthcare costs  Where would the government get the money?  Senator Sanders refers to this system as “Medicare for All” because it would function much like the current Medicare system, but would be provided to all Americans, not just those 65 and older

5. Examples of Single Payer Systems  Some type of single payer health insurance system is employed by most Western democracies  Canada: Preserves the private health insurance industry by having the government contract with private insurers  Great Britain: Government owns and employs healthcare resources and personnel  Australia: A government insurance option (named “Medicare”) is offered to all citizens, but individuals may also elect to purchase insurance from private companies

6. Class Debate: Obamacare vs. Single Payer  Question for Debate: Should the next U.S. President support the Affordable Care Act, and attempt to expand its coverage to additional families and individuals, or advocate repeal of the ACA, replacing it with a single-payer system?  Decide which side of this question you support, and go to the appropriate side of the room.  Work in small groups to brainstorm arguments for your position.  Write a 30-second Opening Statement, and determine the order in which you will present additional arguments.  Debate!