Table of Contents

The Obama Care and its Affect to the Nation

Abstract……………………………………………………………………………… 2

Introduction…………………………………………………………………………. 3

The Brief History of Affordable Care Act………………………………………… 4

National Federation of Independent Business Versus Sebelius…………………. 5

The Supreme Court’s Decision about the Obamacare…………………………… 7

Affordable Care Act and the IRS………………………………………………….. 9

Who Pays for Obamacare?........................................................................................ 11

The Effect of Obamacare to College Students……………………………………. 12

The Effect of Obamacare to Hawaii………………………………………………. 13

Conclusion………………………………………………………………………….. 16

Works Cited………………………………………………………………………… 18
 The Obama Care and its Affect to the Nation

Abstract

The Patient Protection and Affordable Care Act (PPACA) propose to take American

health care in an innovative direction by concentrating on preventative medicine and wellness-

based treatment. This article discusses how ACA will affect the lives of the unemployed,

uninsured, homeless population, and college students. It will also discuss about the benefits of

the Obamacare to the people in regards to accessibility, and affordability of the health reform.

The essay will discuss the effect of Obamacare to the Internal Revenue Services (IRS) and the

tax law. The essay will tackle U.S. Supreme Court decision in National Federation of

Independent Business v. Sebelius that upheld the constitutionality of the ACA. Together these

policy and funding mechanisms should help reduce U.S. healthcare costs and improve quality of

life.

2
 The Obama Care and its Affect to the Nation

Introduction

Healthcare insurance is very necessary that every individual should have in order to have

financial coverage during hospitalization. Our employers often offer healthcare insurance to us

so that we have something at hand in the case of emergency. A single hospitalization stay

usually cost hundreds of thousands of dollar because of the laboratory and radiological

examinations that the healthcare providers perform. Unfortunately not every one is privileged to

acquire healthcare insurance because of unemployment and financial problems. Most insurance

policies require high deductible money in our paychecks, high co-pays with each clinic visits,

and more out of pocket costs during hospitalization. The establishment of the Patient Protection

and Affordable Care Act ensures that every American regardless of their income or health status

is entitled to affordable and effective health insurance coverage.

Homeless and unemployed Americans are the majority of individuals that cannot afford

to purchase expensive health insurance. These individuals live on the periphery of society,

struggling in abject poverty. They must prioritize basic shelter, safety, and food and therefore

often forgo medical care until conditions become urgent or irreversible. Unmanaged and

worsening medical conditions can further extend the duration of homelessness and associated

economic problems. (Bharel, et.al, Vol. 103, No. 52). With all these circumstances compounded

together and the absence of health insurance coverage, sometimes access to medical care is often

challenging for these individuals. They are oftentimes disregarded in the emergency rooms and

care is often fragmented due to discrimination. The absence of individuals’ healthcare insurance

sometimes imposes costly hospital or emergency care visit. The Affordable Care Act proposed

by President Obama is one of the possible solutions that the government is seeing in order for

3
basic healthcare needs to be available to everyone. These will help assure the American people

that healthcare is accessible to everyone and is affordable to pocket.

The Brief History of Affordable Care Act

Countless people attribute healthcare reform to President Obama thanks in enormous part

to media coverage and pervasive misinformation. However, the concept of an individual

mandate under government-funded healthcare dates back to 1989 with the implementation of a

plan by conservative think-tank The Heritage Foundation. In fact, former governor of

Massachusetts Mitt Romney initiated a comparable idea in his state called “Romney Care,” after

which the current provisions of the ACA were modeled.

The Affordable Care Act is a result of decades’ worth of debates, bills, forums and

discussions from both sides of the congressional aisle. The Affordable Care Act or commonly

known as Obamacare is a federal statute signed into law by President Obama on March 23, 2010.

The purpose of the Affordable Care Act is to remedy these discrepancies in the American

healthcare industry and increase consumer rights and protections. By forcing insurers to offer

plans for people with pre-existing conditions and regulate the cost of insurance, Obamacare

opens up healthcare access to millions of people who otherwise wouldn’t have access. Even

those who already had insurance will benefit from Obamacare.

Under the new law, insurance now has to cover a lot of basic treatments and situations

that your insurance may not have covered before. As it was contested and proposed in the court,

ACA promised the goals of increasing quality and affordability of health insurance, lowering the

uninsured percentage by enlarging public and private insurance coverage, and reducing the costs

of healthcare for the people. On the article “Surviving and Thriving with the Affordable Care

Act” written by Mark Terry on the Podiatric Economics magazine last September, 2014, he

4
stated that “the ACA introduced a number of mechanisms such as subsidies, insurance exchange,

and mandates” to increase the individual’s coverage and affordability (72). This law disregards

discrimination because it offers the same rates regardless of the individual’s pre-existing

debilities and conditions or gender. On the article “Obama’s Health Care Reform and the

Economic Principles of a Constitutional Issue”, it discussed the aim of the reform to “reduce

expenses and improve medical services outcomes by shifting the system to quality over quantity

through increased competition and incentives in the delivery of health care services” (Esteban

and Dickinson, 42). According to American Journal of Public Health published by Bharel, et al.,

“the Affordable Care Act provides a framework for reforming the health care system to improve

the coordination of care and outcomes for vulnerable populations. However, improved health

care coverage alone may not be enough, health care must be integrated with other resources to

address the complex challenges presented by inadequate housing, hunger, and unsafe

environment.” (Bharel, et.al, Vol. 103, No. 52).

Despite the nearly thousand pages of terms and conditions, the Affordable Care Act is

sure to provide better and more effective healthcare to Americans. However, only few people

have read the massive law in its entirety and confusion arises with the provisions of the law.

Actually, there was so much upheaval about the law and its provisions that the Supreme Court

had to rule on its constitutionality or its legality according to the U.S. Constitution. Under this

law, millions of uninsured people now have access to healthcare opportunities that they may not

have been able to acquire in the previous years. Moreover, the law provides for the protection of

patient rights and guarantees that insurers and healthcare providers to provide accessible

healthcare to those who may have been refused prior to the implementation of the law.

National Federation of Independent Business Versus Sebelius

5
 In a case known as National Federation of Independent Business versus Sebelius, the

United States Supreme Court upheld the constitutionality of two major provision of the

Obamacare: individual mandate and the Medicaid expansion. On the article published by Kaiser

Family Foundation, it state, “individual mandate can be satisfied by obtaining coverage through

employer-sponsored insurance, an individual insurance plan including those to be offered

through the new health insurance exchanges, a grandfathered health plan, government-sponsored

coverage such as Medicare or Medicaid, or similar federally recognized coverage (Kaiser, 2).

The Obamacare provides increase access to affordable health insurance through the creation of

health insurance exchange depending on the income of the individual applying for the insurance.

Kaiser Journal devised an example in order to explain the individual mandate, “a person with

income between 100% and 133% FPL is responsible for paying premiums up to 2% of her

income (adjusted for family size) toward her premium and is eligible for a tax credit for the

remaining amount. The tax credit is based on the premium of the second lowest cost silver plan

in the exchange, and a person enrolling in a plan that costs more than the second lowest cost

silver plan must pay the entire difference in premiums. Legal immigrants with incomes below

100% FPL who are ineligible for Medicaid based upon their immigration status also are eligible

for premium tax credits. The ACA also provides cost-sharing assistance to people with incomes

between 100% and 250% FPL, between $23, 050 and $57, 625 per year for a family of four in

2012.” (Kaiser, 2).

Medicaid is a program that provides health insurance coverage to least fortunate people

with low incomes and is financed together by the federal and state governments. Prior to the

ACA, federal law mandated coverage for the following principal eligibility groups: pregnant

women and children under age 6 with family incomes at or below 133% FPL, children ages 6

6
through 18 with family income at or below 100% FPL, parents and caretaker relatives who meet

the financial eligibility requirements for the former AFDC program, and elderly and disabled

people who qualify for Supplemental Security Income benefits based on low income and

resources. Federal law prior to the ACA excluded non-disabled and non-pregnant adults without

dependent children from Medicaid, unless states obtained waivers to cover them. (Kaiser, 3).

The ACA expands the Medicaid program’s mandatory coverage groups by requiring that

participating states cover nearly all people under age 65 with household incomes at or below

133% FPL ($14, 856 per year for an individual and $30, 657 per year for a family of four in

2012) beginning in January, 2014. To fund this expansion of Medicaid coverage, the ACA

provides that the federal government will cover 100% of the states costs of the coverage

expansion in 2014 through 2016, gradually decreasing to 90% in 2020 and thereafter. According

to Congressional Budget Office, the ACA’s Medicaid expansion would cover an estimated 17

million uninsured, low income American. (Kaiser, 3).

The Supreme Court’s Decision about the Obamacare

The Supreme Court agreed to decide the constitutionality of two of the ACA’s major

provisions, the individual mandate and the Medicaid expansion. The Court has decided,

“Individual mandate is a constitutional exercise of Congress’ power to tax”. Based on Article I,

Section 8 of the U.S. Constitution in pertinent part provides that “Congress shall have power…

to lay and collect taxes, duties, imposts, and excises, to pay the debts and provide for the

common defense and general welfare of the United States.” The majority on the taxing power

issue observed that the shared responsibility payment that is triggered by the failure to comply

with the individual mandate “looks like a tax” even though Congress did not label it as such: its

collection is administered by the IRS, it is reported on and paid when filing federal tax returns, it

7
does not apply to people who are not required to file tax returns because their income is too low,

and it is calculated based on factors such as the amount of taxable income, number of

dependents, and tax filing status. In addition, the shared responsibility payment “produces at

least some revenue for the Government” (the Court noted that the Congressional Budget Office

estimates that the shared responsibility payment will raise $4 billion per year by 2017), which the

Court observed is the “essential feature of any tax.” (Kaiser, 4). Because a majority of the Court

found that the individual mandate is constitutional under the taxing power, the question of

whether the mandate would be severable from the rest of the ACA did not have to be decided.

However, the four dissenters -- who did not find any constitutional basis to support the individual

mandate -- would have held that the individual mandate was not severable and thereby

invalidated the entire ACA. (Kaiser, 5).

Another major provisions that were discussed in the Supreme Court were the expansion

of Medicaid. It was proposed that the “Medicaid expansion is unconstitutionally coercive with

states because states lacked notice to voluntarily consent and the secretary could withhold all

existing Medicaid funds; the appropriate remedy is to circumscribe the secretary’s enforcement

authority.” A group of three justices including Chief Justice Roberts joined by Justices Breyer

and Kagan, found that the Medicaid expansion is a “gun to the head” because “the threatened

loss of over 10 percent of a State’s overall budget… is economic dragooning that leaves the

States with no real option but to acquiesce.” (Kaiser, 6).

The Court’s decision is the first time that Spending Clause legislation has been

invalidated as unconstitutionally coercive of states. And, the Court does not set out a test to be

applied to future coercion challenges; instead, the Roberts plurality simply observes, “wherever

the line may be, this statute is surely beyond it.” However, the Court’s decision leaves the

8
Medicaid expansion provision of the ACA intact and instead restricts the Secretary’s

enforcement authority. The Court’s decision leaves all other provisions of the ACA intact as

well. As a result, all other changes to the Medicaid program contained in the ACA, such as the

increase in primary care provider payments, the new options to expand home and community-

based services, the gradual reductions in disproportionate share hospital payments, and the

requirement that states maintain the eligibility standards in place as of March 23, 2010, until the

Secretary certifies exchange readiness, continue to have full force and effect. (Kaiser, 6).

Affordable Care Act and the IRS

The Affordable Care Act or ACA impacts nearly every American and every arena of

work. The health reform or Obama Care Act requires all U.S. citizens to obtain sand buy

insurance beginning this year (2014). The United States Supreme Court has ruled that the ACA

is constitutional as a tax, not as a matter of interstate commerce. So, the lion's share of policing

compliance with the ACA will be up to the IRS. (Watkins, 1). The ACA provisions provide

incentives and tax breaks to individuals and small businesses to offset health care expenses. They

also impose penalties, administered through the tax code, for individuals and businesses that do

not obtain health care coverage for them or their employees. The ACA represents the largest set

of tax law changes in more than 20 years and represents a significant challenge to the IRS.

(Duncan, 2).

However, the ACA outlaws many of the traditional methods the IRS uses in tax

enforcement. The IRS cannot initiate civil or criminal penalties, file liens or levy (garnish) a

taxpayer's bank accounts or wages or otherwise seize property to satisfy any unpaid ACA

tax. Also, no interest can accrue on these tax penalties. The only practical way for the IRS to

collect on penalties is to capture or withhold tax refunds from year to year until satisfied. So, in

9
summary, you can't go to jail for failure to comply, but you could lose your refund. The IRS will

also oversee many tax breaks and incentives to allow taxpayers to afford health insurance and

penalize those individual that are not in compliance. Future employment of thousands more IRS

agents and more changes to the already complex tax code are anticipated. (Watkins, 1). The

federal subsidy for people who earn between 100% and 400% of the FPL is designed to help

reduce the monthly cost of health insurance, or the monthly premium as it is commonly referred

to. There is a second subsidy offered under the ACA, which is called the tax credit. Any person

or family who earns less than 250% of the FPL and who enrolls in a silver-level plan is eligible

for a tax credit. The tax credit is reimbursed to the person on their yearly tax returns and is

designed to help reimburse a person for their insurance-related out-of-pocket costs from that

year, which may be from annual deductibles, co-pays or coinsurance payments. (Obamacare.net).

Under the law, you must obtain health insurance or face a fine imposed by the Internal

Revenue Service on your annual tax returns. For 2014, the deadline to enroll was March 31st. In

2015, the deadline to enroll in February 15, 2015. If you fail to enroll in a government plan or

acquire health insurance through an acceptable source, then you will owe a penalty fee for each

month that you did not have healthcare. This fee varies and may be waived in certain

circumstances by claiming exemption status. While the fee for non-compliance is sometimes

referred to as the “individual mandate” provision of the ACA, it was actually considered a tax by

the Supreme Court in its June 2012 ruling and therefore subject to collection by and interest

assessed by the IRS. (Obamacare.net)

However, Obamacare only works properly if everyone contributes. Thus, the individual

mandate and employer mandate work to protect uninsured Americans. If you don’t obtain what

10
the government calls “minimum essential coverage,” then you will be charged a fee for every

month that you lack this essential coverage. In 2015, the individual mandate requires that non-

compliant citizens pay a fine equal to two percent of their total adjusted gross income or $325

per uninsured adult and $162.50 per uninsured child, whichever is greater. The fine goes up in

2016 and 2017. People who are eligible for an exemption will not have to get health insurance

under the ACA. Any person who is without health insurance for three months or less is

considered exempt from the penalty tax; however they must get a health insurance policy that

complies with the law before they reach their 4th month of being uninsured. (Obamacare.net)

Whether you buy insurance from your employer, a private company or the government,

you are entitled to what the ACA considers “ten essential benefits” designed to keep people

healthier and prevent major issues that could overwhelm the cost of healthcare. Essential benefits

include the following: access to prescription medication, emergency services, hospitalization or

surgery, laboratory services, mental health services such as behavioral therapy, counseling,

substance abuse treatments and psychotherapy, outpatient care, which is also referred to as

ambulatory patient services, pediatric care pre-natal and post-natal care, preventative care in the

form of general wellness checkups along with management services for chronic diseases and

rehabilitative care and the use of devices necessary for rehabilitative recovery. (Obamacare.net)

Who Pays for Obamacare?

You might be wondering how Obamacare gets funded. After all, with such a large

increase in the way that benefits are distributed the cost of Obamacare could skyrocket if not

funded through various means. Nothing in life is free, and the ACA makes sure that affordable

healthcare stays affordable through the following payment sources such as personal income

11
taxes, a tax on Medicare of 0.9 percent, unearned income tax on people who earn more than

$200,000 per year, spending cuts in other government departments, a tax levied against insurance

companies, and taxes levied against businesses of more than 50 full-time workers that don’t

comply with the law.

In essence, taxes pay for Obamacare. Many have expressed concern or even outrage

about a healthcare system that depends on tax support. However, almost 97 percent of small

businesses and 99 percent of families will be able to take advantage of the ACA’s new

provisions. Taxes also don’t affect people who can’t afford to pay them. In other words, the more

money you make the more taxes you’ll pay to support this program. Regardless of how much

individuals earn, more than 70 percent of Americans will benefit in some way from Obamacare

and healthcare reform. As of the end of open enrollment period in 2014, an additional three

percent of Americans who previously lacked coverage now have health insurance and can

benefit from everything Obamacare currently has to offer. (Esteban and Dickinson, 6).

The Effect of Obamacare to College Students

The new health care system will definitely affect most Americans, but in various ways.

If an individual has an employer-sponsored health care, they may or may not recognize the

changes to their health care coverage, based on costs and coverage options. As a college student,

having a health insurance is very important, especially if your parents no longer cover your

health care expenses. As it was discussed in the ACA, one of the many changes that the act

introduced was “the ability of the parents to keep their adult children on their family health

insurance policies until the age of 26” (Trusted Choice, 2014). In many cases, if a parent moves

to the ACA plan, a full-time enrolled college student is likely to maintain coverage in the same

12
way he or she received it previously, such as through their parents' employers. If the student does

not enroll in a college-provided health insurance plan or a parent's plan, the student can elect to

obtain health insurance through the Affordable Care Act marketplace. If young people enter the

workforce rather than college and begin earning income, they will be required to maintain health

insurance under the ACA either through their employer or the marketplace. (Trusted Choice,

2014).

The healthcare system developed under Obamacare does multiple things according to

Maloney. “This plan gives the lower class health insurance, which there will be subsidized plans

and access by expansion of Medicare. However, the middle class may be stretched. Maloney

explains that, according to Obamacare, full time employment is 30 hours, which is making small

business employers cut hours so they can avoid paying for health insurance so now they are

paying for health insurance with less revenue. The goal of Obamacare is to give access to health

care. The objective of Obamacare is “if you make it accessible and affordable, people will go get

care earlier”. (Orlando, 2013). As you enter the hospital premises to obtain medical help, the

nurse would automatically ask your healthcare insurance. If an individual does not have health

insurance they are either placed at the end of the physician’s lists to check or goes home in a

critical condition. If only every individual is able to purchase affordable healthcare insurance,

then accessing medical help would not be that difficult. College students even though they are

the least consumer for health care, it is necessary that they are insured under their parents so that

in case of emergency they have something at hand to use. Although most college students are

involved with car accidents, alcohol intoxication, and drug use, they are prone to having

critically ill conditions. In response to avoiding devastating illnesses and critical medical

problems, the colleges are educating the students for safety and in preventing most of the

13
avoidable health issues. There are some college students that are full time students and

unemployed, making them uninsured with healthcare plans. They are the ones that are depending

into their parents’ healthcare benefits and insurance if they have to visit their primary care

physician for a physical examination, for example. However, they can only be under their

parents’ health insurance if they are full time students. There are sets of students as well that are

part time student at the same time part time workers, making them qualified to obtain their own

healthcare insurance plan to their employers. With the presence of their own health insurance,

their visits to the hospital or the physician’s office covers mostly all the expenses and under

Obama care they could end up paying less in yearly visits, checkups, and other healthcare visits.

With this in mind, the discrimination and the problem of inability to access the Affordable Care

Act, in some extent, has solved healthcare due to underinsurance and unemployment.

Jennifer Mishory, deputy director at Young Invincible, says the online marketplace will

affect students in three significant ways: (1) Students can enroll in plans without the threat of

being denied coverage because of a pre-existing condition. (2) Students who earn less than about

$46, 000 or families that earn less than $94, 000 annually may be able to access free coverage

through Medicaid or discounted coverage through monthly tax credits depending on the state and

their exact income level. (3) New plans will provide free preventative services, annual checkups,

prescriptions, and substance use disorder services. (Sand, 2013).

Under the new law, young people will pay more for insurance coverage while older

people will pay less. However, young people may stay on their parents’ insurance plans until

they’re 26. In addition, the government allows people under the age of 30 to purchase low-cost

catastrophic plans that help in the event of an emergency in lieu of more extensive coverage.

14
Obamacare also ensures that people with pre-existing conditions get the coverage they need

without being unfairly treated by insurers or providers. (Obamacare.net).

The Effect of Obamacare to Hawaii

According to Senator Daniel Akaka, “the Affordable Care Act may now fulfill its full

promise to bring quality health care to millions more Americans, combat skyrocketing costs, and

lower the burden of uninsured patients on our hospitals and doctors.” The Affordable Care Act

has already helped thousands of young adults in Hawaii stay on their parents' plans, helped over

24,000 Hawaii seniors afford their prescription drugs, and helped over 100 Hawaii residents with

pre-existing conditions get insurance coverage. Now that the Affordable Care Act is without

question the law of the land, many more Hawaii residents will gain new coverage options over

the next two years. Senator Akaka is proud that Hawaii is ahead of the curve as the first state to

announce plans to develop a state-based health insurance exchange. Hawaii is again proving

itself as a national leader in quality health care coverage, and today's ruling clears the way for the

Hawaii Health Connector to succeed- says Senator Akaka. As it was discuss in today's news, we

cannot forget about the minority populations in our nation that continue to face serious health

disparities, including higher rates of diabetes, cancer, and heart disease and lack of access to

culturally competent health care services. We must do all we can to ensure quality health care for

all Americans, and today's ruling is a big step in that direction." (Hawaii News Now, 2012).

As we look around each day at Waikiki Park or streets, we observe hundreds of homeless

individuals that are maybe uninsured. The grandiosity and lively Waikiki streets sometimes

hides the current problem of the nation which is homelessness and unemployment. As I was

walking one night at one of the busy streets at Waikiki, I came across to a man with gigantic

15
bilateral lower extremities wrapped in a Kerlix and was oozing with brownish drainage. This old

man was sitting down at one of the benches near the beach carrying his children on his lap while

they are sleeping soundly. The children were wrapped with thin white blanket while enduring the

cold night. Hundreds of thoughts bombarded my mind with that scenario that I witnessed. Even

though I did not have a chance to spoke with the old man and asked him the questions that I have

in mind, I realized how lucky I was to have a stable job and healthcare insurance to use when I

have to visit my primary care physician. Based on what I have observed, the old man might be

suffering from a serious condition and is probably unemployed. With the recent passing of the

affordable healthcare insurance or Obamacare, I hope that less fortunate people, underinsured,

and unemployed individuals suffering from serious health condition can have access to the health

care system. Every individual has the right to access the health care system as well as to have

affordable health care insurance that cover their hospital visits in order to have a healthier nation.

Hawaii is one of the most expensive nations across the globe, in terms of costs of living

and access to healthcare. However, with the government’s program of providing the low-income

population with EBT on a monthly basis, they can be able to purchase their primary needs such

as food and water. Health for me is considered one of the basic needs that every individual

should maintain. Hawaii’s population are at increase risk for many chronic health issues such as

obesity, heart disorders, diabetes mellitus, and cancer due to lack of health promotion and

preventative measures. With the approved Affordable Care Act, I think Hawaii would benefit a

lot with its aforementioned benefits to healthcare access.

Conclusion

16
 Healthcare insurance is very necessary that every individual should have in order to have

coverage with medical emergencies and healthcare visits to physician’s office. Unfortunately,

not everyone is privileged to acquire healthcare insurance because of unemployment and

financial instability. Oftentimes, underinsured individuals are disregarded in the emergency

rooms and care is often fragmented due to discrimination. The absence of individuals’

healthcare insurance sometimes imposes costly hospital or emergency care visit. The

establishment of the Patient Protection and Affordable Care Act ensures that every American

regardless of their income or health status is entitled to affordable and effective health insurance

coverage. Despite of all the issues that are associated with the recently approved healthcare

reform, the ACA still poses questions and concerns to most people because of individual

mandate and the Medicaid expansion provisions. The new health care system will definitely

affect most Americans, but in various ways. The ACA provisions provide incentives and tax

breaks to individuals and small businesses to offset health care expenses. They also impose

penalties, administered through the tax code, for individuals and businesses that do not obtain

health care coverage for them or their employees. Students are affected as well due to the law

that they must be fulltime in school in order for their parents to cover them under their health

insurance. At the end of the day, Affordable Care Act still remains a fulfillment of most

Americans, especially the low-income individual, because healthcare system will become

accessible and affordable for them. Above all, healthcare access should be available to everyone

for the reason that every person has the right to obtain medical attention with no regards to

gender, financial status, social strata, religion, and race.

17
 Works Cited

"Affordable Care Act Information & Healthcare Agent Network." What Is Obamacare?

Obamacare.net, 5 Oct. 2014. Web. 4 Dec. 2014. <https://obamacare.net/what-is-

obamacare/>.

Baker, Sandy. "How Does Obamacare Affect Me?" How Will Obamacare Affect College

Students Age 18 to 26? Trusted Choice, 11 Apr. 2014. Web. 4 Dec. 2014.

<https://www.trustedchoice.com/insurance-articles/life-health/how-does-obamacare-

affect-me/>.

Bharel, Monica, Wen-Chieh Lin, Jianying Zhang, Elizabeth O’Connell, Robert Taube, and

Robin Clark. "Health Care Utilization Patterns of Homeless Individuals in Boston:

Preparing for Medicaid Expansion Under the Affordable Care Act." RESEARCH AND

PRACTICE Vol 103.No. S2 (2013): 311-13. Print.

Esteban, Roberto, and Szederkenyi Dickinson. "OBAMA’S HEALTH CARE REFORM AND

THE ECONOMIC PRINCIPLES OF A CONSTITUTIONAL ISSUE." Universidad De

Chile, 1 Dec. 2013. Web. 4 Dec. 2014.

Duncan, Alan. "“ACA – INFORMATION TECHNOLOGY READINESS AND DATA

SECURITY”." Review of Systems Development Activities for the Premium Tax Credit

Project Under the Affordable Care Act Program (2013): 1-8. Print.

"Hawaii's Congressional Delegation Supports Ruling."

Http://www.hawaiinewsnow.com/story/18909952/hawaiis-congressional-delegation-

supports-ruling. Hawaii News Now, 28 June 2012. Web. 4 Dec. 2014.

18
Kaiser, Henry. "A Guide to the Supreme Court’s Affordable Care Act Decision." Focus on Helth

Reform (2012): 2-7. The Kaiser Family Foundation. Web. 4 Dec. 2014.

<http://kaiserfamilyfoundation.files.wordpress.com/2013/01/8332.pdf>.

Orlando, Christopher. "How Will Obamacare Affect Students?" The Outlook. Monmoth

University, 2 Oct. 2013. Web. 4 Dec. 2014.

<http://outlook.monmouth.edu/index.php/politics/1220-how-will-obamacare-affect-

students>.

Sand, Dana. "Will College Students Use Affordable Care Act Insurance?" USA Today, 26 Sept.

2013. Web. 4 Dec. 2014.

<http://www.usatoday.com/story/news/nation/2013/09/26/college-students-affordable-

care-act/2877193/>.

Terry, Mark. "Surviving and Thriving with the Affordable Care Act DPMs Can Adapt, Change,

and Be Successful under Obamacare." Podiatric Economics (2014): 72. Print.

19