The Instigator
Pro (for)
9 Points
The Contender
Con (against)
0 Points

The Affordable Care Act is Effective Legislation

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Post Voting Period
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after 2 votes the winner is...
Voting Style: Open Point System: 7 Point
Started: 10/17/2013 Category: Health
Updated: 3 years ago Status: Post Voting Period
Viewed: 1,614 times Debate No: 39056
Debate Rounds (4)
Comments (6)
Votes (2)





I will be arguing for the resolution, Con will be arguing that the Affordable Care Act is NOT good legislation. I had some trouble wording the title of the debate, so any questions make them clear.

This is an open challenge, I expect Con to be able to source and put considerable time into their arguments as I have opted for the 10000 character limit.I will be using Standard British English, Con may use American/British.

As this is such a contentious issue I hope voters will put personal beliefs aside and make judgement based on the quality of the debate.

Finally, good luck to whoever accepts! Looking forward to the first round of points, please remember your round one should NOT be your argument but rather acceptance.


1. Acceptance only
2. Opening arguments
3. Rebuttals
4. Closing arguments/rebuttals


The Affordable Care Act:' The Patient Protection and Affordable Care Act' (PPACA),[1] commonly called the Affordable Care Act (ACA) or "Obamacare": United States federal statute signed into law by President Barack Obama on March 23, 2010. Overhauling the current US healthcare system.

[1] - .gov record of the Act.


PPACA- The Patient Protection and Affordable Care Act
ACA- Affordable Care Act


I would like to think Pro for this debate. I will be showing him why The Affordable Care Act, is not an effective Legislative.
Debate Round No. 1


Initial Arguments

I would like to thank Con for agreeing to debate this much contested issue with me and to hopefully wade through some of the hot air and bellicose rhetoric that surrounds the Affordable Care Act(ACA). I notice that Con is relatively new to the site and I wish them a very warm welcome

My argument will be broken down into two dual sections, first dealing with the deficiencies of the current system of US healthcare and secondly the provisions the act contains to rectify these problems. In my first arguments I have chosen three

1) Large Numbers of Uninsured Low-Income Citizens

In the US, the consequence of no health insurance is no access to non-emergency healthcare and no treatment for long-term illnesses. This is undoubtedly an undesirable situation to exist in. So the question presses why do 48,000,000[i] Americans live with no health insurance? The answer is the inefficiency and unaffordability of a largely out-dated healthcare system.

The provisions of the ACA improve this in the following ways:

1.1) Expansion of Medicaid

‘The ACA creates new coverage options through Medicaid and new health insurance exchange marketplaces that, taken together, provide assistance to individuals with family incomes up to 400% of the federal poverty level (FPL). The ACA calls for the expansion of Medicaid eligibility to 138% FPL ($15,856 for an individual or $26,951 for a family of three in 2013) in 2014, which would make millions of adults newly eligible for the program. However, this expansion was effectively made a state option by the Supreme Court. If a state does not expand Medicaid, low-income uninsured adults in that state will not gain that new coverage option and will likely remain uninsured[ii]

This provision will increase the number of adults eligible to Medicaid programs, which will in turn reduce the number of uninsured Americans. This crucial fix will increase the healthcare provisions in the US and large numbers of people will now be able to receive treatment who were not before.

2) Pre-existing Conditions and Insurance

Under the current system those who have existing health conditions like severe asthma, leukaemia, heart problems and underlying diseases are either turned away by insurers or are offered very high, unaffordable premiums. This is one of the greatest defects because it means that those who are likely most in need of medical treatment are unable to access it.

The ACA fixes this as starting Jan. 1, 2014, no health insurance company will be allowed to deny patients coverage or charge you more because of your health status or pre-existing condition. This provision will help those most needy who are unable to access care and this is an irrefutable argument[iii].

The summary of changes from the White House is as follows:

‘A group health plan and a health insurance issuer offering group or individual health insurance coverage may not establish rules for eligibility (including continued eligibility) of any individual to enroll under the terms of the plan or coverage based on any of the following health status-related factors in relation to the individual or a dependent of the individual: Health status, Medical condition (including both physical and mental illnesses), Claims experience, Receipt of health care, Medical history, Genetic information, Evidence of insurability (including conditions arising out of acts of domestic violence), Disability, Any other health status-related factor determined appropriate by the Secretary’[iv]

This can only be seen as a good thing, helping many hard working people and tax payers access medicines to treat painful and expensive conditions.

3) Individual and Employer Mandates

Under provisions of the act every individual will be mandated to buy health insurance or face a small penalty. This step towards universal healthcare is a good thing because it makes being insured the norm and eliminates the complacency among young people who stipulate they don’t need insurance because they are young.

Employers of more than 50 people will be mandated to provide employer coverage of its employees or lose tax breaks and subsidies. This provision will make again widen the provision of healthcare[v].

4) Poor Quality of Coverage

Under the current insurance program, insurers are allowed to offer very low levels of coverage, which barely constitute health care: no access to cancer drugs, long term treatments, good prosthetic limbs etc.

The ACA introduces minimum requirements of standards that insurers must provide to patients that may increase the minimum cost of care slightly but increases the quality of care for all Americans.

5) Cost

Cost to the federal government of implementing the ACA is an often misunderstood area. The act is seen as a white elephant spending more and more money on entitlements, but this is not the case

Federal spending will be reduced by the implementation of the ACA. Read this source from the non partisan Central Budget Office(CBO)

Assuming that H.R. 6079 is enacted near the beginning of fiscal year 2013, CBO and JCT estimate that, on balance, the direct spending and revenue effects of enacting that legislation would cause a net increase in federal budget deficits of $109 billion over the 2013–2022 period. Specifically, we estimate that H.R. 6079 would reduce direct spending by $890 billion and reduce revenues by $1 trillion between 2013 and 2022, thus adding $109 billion to federal budget deficits over that period.

This, their latest estimate, calculates that revenues will increase under the ACA more than net spending, reducing the budget deficit.

My Case

The debate on the ACA has become a highly partisan issue where reason is thrown out the window in a tempest of anti-Obama fury. The ACA is seen as a bad thing mainly because it was Obama who created it and pushed it through.

My case is simply: that the current healthcare system is highly inadequate and that it is in urgent need of reform. Obamacare begins down the track of reforming the system through several thought at strategies. It is a realistic solution to a problem, which will only get worse.


These are my initial arguments for Obamacare. May I remind Con that in his round 1 he is expected to lay out his case that the ACA is not effective legislation, and in round 2 we will begin to refute eachothers points. Good Luck!



Here, I am going to list some facts for the downside of The Affordable Care Act a.k.a. Obama-care.

1. Employer mandate. Most companies will have to provide and pay for expensive government-determined health insurance for their employees or face federal fines.

2. Anti-conscience mandate. Religious organizations will be required to provide free sterilization, contraceptives, and abortion-inducing drugs to their employees, even if it violates their religious beliefs.

3. New and higher taxes the law contains at least 20 new taxes totaling $500 billion that will hit medical innovators, health insurance, and even the sale of your home.

4. The Independent Payment Advisory Board. IPAB will still stand, with its rationing power over Medicare.

5. State exchanges. States will be compelled to set up vast new bureaucracies to check into our finances and families so they can hand out generous taxpayer subsidies for health insurance to families earning up to $90,000 a year.
6. Medicare payment cuts. $575 billion in payment reductions to Medicare providers and Medicare Advantage plans will cause more and more physicians to stop seeing Medicare patients, exacerbating access problems.

7. Higher health-care costs. The Kaiser Family Foundation says the average price of a family policy has risen by $2,200 during the Obama administration. The president promised premiums would be $2,500 lower by this year. Hospitals, doctors, businesses, and consumers all expect their taxes and health costs to rise under Obamacare.

8. Government control over doctor decisions.Value-based payments, quality reporting requirements, and government comparative-effectiveness boards will dictate how doctors practice medicine. Nearly half of all physicians are seriously considering leaving practice, leading to a severe doctor shortage.

9. Huge deficits. The CBO has raised its cost estimate for the law to $1.76 trillion over ten years, but that is only the opening bid as more and more people lose their job-based coverage and flood into taxpayer-subsidized insurance. At this rate, the cost will be $2 trillion, not the less than $1 trillion the president promised.

10. 159 new boards, agencies, and programs: The Obama administration will work quickly to set up as many of the law"s new bureaucracies as fast as it can so they can take root before the election.
Debate Round No. 2


Opening Remarks

Thanks to Con for posting so quickly, although I am a little disappointed that the whole argument came form that one source. Below, quotations from Con are coloured red(or should be if this reformats properly).

‘Employer mandate. Most companies will have to provide and pay for expensive government-determined health insurance for their employees or face federal fines.’

In my arguments above I detailed the employer mandate. Employers should have some responsibility for the welfare of their employees in the place of the government. Packages are cheaper when bought through employer schemes and often are more comprehensive. Your source’ stipulation that this new coverage will be ‘expensive’ is entirely wrong. The new mandate will be accompanied by both a carrot and stick: the carrot in the form that if the employers follow the new guideline they will be rewarded with tax breaks and other incentives[i]. For many companies, employer coverage will become cheaper because of the new incentives.

The provision limits this new expansion to companies with 50+ employees, and companies will have time to prepare for the new rules. Rather than ‘government determined’, new coverage will be bought in the same way but will be easier to buy because of the new insurance exchanges being created.

The main opposition to this rule has not been from the American people but rather from big business that employ many very cheaply such as mass food chains and factories. What hurts about making these companies a little more responsible for those that they employ? Will this not usher in a new era of ethical practice with companies in relation to their employees.

‘ Anti-conscience mandate. Religious organizations will be required to provide free sterilization, contraceptives, and abortion-inducing drugs to their employees, even if it violates their religious beliefs.’

I found it quite difficult to find reliable information on this, much of the writings on the web were from the tea-partiest Heritage Foundation, a darling of Koch industries and a host of other interested parties. I eventually found a source detailing exactly what this claim means[ii].

‘…the Health and Human Services (HHS) Mandate which requires nonexempt employers/insurers to provide eligible women with coverage for contraceptives, sterilizations, and related patient education and counseling.’

It seems like the provision is closely related to the Employer Mandate, making clear that coverage for women on employer programs must include contraceptives. First of all notice that the provision covers ‘non-exempt’ employers- not churches, community groups or faith groups. It covers for-profit companies, of which very few are explicitly religious.

So baring in mind these companies are a tiny minority, is it right that they should limit who they employ on religious grounds or limit their coverage because of religious objections? It sounds very much like discrimination, and these companies should have to pay for contraceptives to women who want them.

This source excellently stipulates a modern day Jefferson view on the provision:

‘The First Amendment was meant to create a wall of separation between Church and state.[1] However, this does not prevent civil government from regulating economic activity.[2] It seems to me that requiring health insurance providers to cover certain medical benefits has nothing to do with man’s natural rights to hold religious beliefs free from government interference. This is not about religious opinion. This is about providing health care to women.[iii]

Therefore bearing in mind that the provision is constitutional, to please concerned groups the federal government made a compromise that looks goes like this…

‘Under this [compromise], a nonprofit religious employer must notify its insurer that it objects to contraceptive coverage. The insurer must then notify people in the health plan that it will arrange or pay for contraceptive services as long as they remain in the health plan.[iv]

Using these sources, I find it difficult to find what the argument from Con intends to make. Not only is the provision small, fair and constitutional, but also the provision has been altered to provide a compromise to worried religious non-exempts. I ask Con to concede this point to me.

‘New and higher taxes the law contains at least 20 new taxes totaling $500 billion that will hit medical innovators, health insurance, and even the sale of your home.’

The area of these new taxes is highly complex and unsuitable to be put into the debate in its entirety. Despite this I will make an effort to outline what some of the main taxes are, why they are being introduced, and why they are necessary.

For the majority of the 85% of Americans with health insurance the percentage of income paid in taxes won't change much, if at all. However, some of the changes may directly or indirectly affect specific groups[v].

Second, the ACA contains many tax breaks to help businesses cope with the cost of new healthcare:

Advanced Premium Tax Credits (tax break): Low-to-middle income Americans are eligible for tax credits which reduce the upfront cost of premiums on health insurance purchased through their State's "Health Insurance Marketplace".

Small Business Tax Credits (tax break): Small businesses may be eligible for tax credits of up to 50% of their cost of employee premiums through the Small Business Health Options Program.

The main new taxes follow as:

• 2.3% Tax on Medical Device Manufacturers 2014R32;R32;

• 10% Tax on Indoor Tanning Services 2014R32;

R32;• Blue Cross/Blue Shield Tax HikeR32;

R32;• Excise Tax on Charitable Hospitals, which fail to comply with the requirements of ObamacareR32;R32;

• Tax on Brand Name DrugsR32;R32;

• Tax on Health InsurersR32;

R32;• $500,000 Annual Executive Compensation Limit for Health Insurance ExecutivesR32;R32;

• Elimination of tax deduction for employer-provided retirement Rx drug coverage in coordination with Medicare Part D R32;R32;

R32;R32;• Medicare Part A Tax increase of .9% over $200k/$250k

So there is a fairly comprehensive list. What you will notice is that many of these new taxes are highly unlikely to affect the average tax-paying citizen. Many of these taxes are on insurance companies and manufacturers. This will raise large amounts of money for the federal government that will offset the cost of Medicaid Expansion and new subsidies. So could Con please detail what he objects to with the new array of taxes and the specific tax he means when he writes ‘even on the sale of your home’.

‘The Independent Payment Advisory Board. ’

First, allow me to make clear what IPAB is:

‘The Independent Payment Advisory Board, or IPAB, is a fifteen-member United States Government agency created in 2010 by sections 3403 and 10320 of the Patient Protection and Affordable Care Act which has the explicit task of achieving specified savings in Medicare without affecting coverage or quality.[vi]

IPAB is just a steering committee tasked with making savings in Medicare without affecting coverage or quality. Despite what Con says, it is mandated against ‘rationing’ and is just tasked with making appropriate savings within an enormous government program. It seems an unusual anti-ACA argument to make against a committee trying to reduce the federal deficit.

‘State exchanges...’

Rather than ‘vast new bureaucracies’ the exchanges are a) optional, the state is not ‘compelled to set up’ anything and b) as vast as the state chooses them to be. The exchanges are online platforms that allow families to compare health care packages and make it easy to select coverage. A family earning $90,000 dollars a year is certainly a taxpayer so could Con please explain what they meant about the handouts? The subsidies are designed to help families deal with the cost of healthcare, what is the objection?

‘159 new boards, agencies, and programs...’

As we are now past the election where the American people voted for the ACA I stuggle to see how the point stands. Could Con elaborate?

‘Huge deficits...’

I have saved this argument for last because it is the most misleading, read this source on the actual cost of the ACA:

What is the cost of ObamaCare? ObamaCare, Obama's new health care law, has a massive impact on health care costs. ObamaCare's cost is estimated at up to net cost of $1.36 trillion dollars by 2023. Although Obamacare's net costs are in the trillions, the law actually reduces the growth in health care spending by tens of billions each year, reduces health care costs for many Americans, helps to insure tens of millions and is estimated to result in an overall net decrease of the deficit[vii].

So lets make this clear, the ACA reduces the deficit. Obamacare's net cost is estimated to be $1.1 trillion. This number is an updated estimate by the Congressional Budget Office (CBO) 2012. However, a number of factors including taxes, fees and penalties will reduce the federal deficits by $210 billion over the 2012-2021 period.

Closing Remarks

May I remind Con that their round two should be refuting the points I made in my round one arguments! I wish Con the very best of luck and look forward to posting for round 3.

[1] Letter from Thomas Jefferson to the Danbury Baptist Association (Jan. 1, 1802), available at (last visited July 20, 2012).

[2] Id.


[ii] The Affordable Care Act and Religious Freedom: The Next Battleground. by. Terri Day* and Leticia Diaz

[iii] The Affordable Care Act and Religious Freedom: The Next Battleground. by. Terri Day* and Leticia Diaz



Unfortunately I will have to forfeit, as something came up. I am sorry Pro for doing this last minute. Although, I would like to just sum up my main thoughts on the A.C.A. The AC.A'.s main issue may not be taxes, as my opponent pointed out in round 2, but the main issue I see is: Socialism. More importantly Socialism in Health Care. This is very important for all Americans because If the Government decides certain medical treatments for diseases/illnesses; then that means people can not decide the best treatment their doctor suggests or provides for them.

I see this as a train wreck waiting to happen. Back in 2011, a survey was done to see how many doctors disagreed with Obama-care. Almost 70 percent of all doctors said no. Unknown to the public; the AMA represents only about one fourth of the nation’s doctors. A startling 43 percent said the health care reform itself would likely lead them to retire over the next 5 years, and only 37 percent said that was an unlikely consequence of this law. Now let's think about this for a minute. If these doctors decide to quit practice that means that they'll end up going out of business, and there won't be enough doctors to treat patients, or doctors will quit and start their own firm, and Obama-care will not pay for them because they are a private firm.
Look at this passage here below
"Perhaps America’s doctors know about the scandalous deficiency of access in centralized systems, countries where government’s officials themselves circumvent restrictions when their own personal care is at stake. Like when England’s NHS spent more than 1.5 million pounds to pay for thousands of its own staff members to leapfrog their own waiting lists in 2009; or when Italy’s Prime Minister Berlusconi chose to have his heart pacemaker surgery at the Cleveland Clinic in 2006, rather than in Italy; or perhaps when the Canadian Prime Minister of Newfoundland and Labrador, Danny Williams, traveled to the US in 2010 to circumvent Canada’s restrictive system for his own heart valve procedure, because, as he explained, “This was my heart, my choice and my health,” and “I did not sign away my right to get the best possible health care for myself when I entered politics.”

I mean I think many people see the point here. If we allow the government to start intervening in our health care and select treatments (which they have little knowledge of compared to a doctor), then patients will suffer from malpractice or worse death. America's Medical Systems trumps almost any other nation. We have the some of the most advanced medical equipment, and up-to-date diagnostic testing machines, the most sophisticated surgical techniques, the most innovative medical therapies, the newest drugs, and the best doctors in the world. We are going to jeopardize our Health Care system, and our patients by doing this. The Government has too much intervention in some things. What they are doing is micro-managing our health care system.
Debate Round No. 3


OK, I accept your forfeit. If you have time to debate this properly with me, just initiate another one or send me a message. Hopefully that will happen as I amtrying hard to understan the anti-ACA camp and this is very much what I need.


janetsanders733 forfeited this round.
Debate Round No. 4
6 comments have been posted on this debate. Showing 1 through 6 records.
Posted by Quatermass 2 years ago
Gladly in England we possess free healthcare (for the moment).

The question behind 'Affordable Healthcare' is to whom is it affordable? Affordability is relative to the income bracket you're in. If the highest income bracket view something as 'affordable', it does not automatically follow that it will be affordable to the lowest income bracket.
Posted by airmax1227 3 years ago
Pro really does an excellent job of going through several key points in his R2. Arguments like expansion of medicaid, cost and the employer mandate do a decent job in establishing benefits of the ACA. Con doesn't rebut these in his R2, opting instead to list 10 numbered points. Some of these are valid enough points, but Con should have addressed at least some of Pro initial assertions. Pro does an excellent job of responding to Con in his R3, going down the list point by point to rebut Cons arguments. Rebuttals to the "state exchanges" and "deficits" arguments were especially well made and Con would have had his work cut out for him responding to these rebuttals. Con unfortunately concedes at this point, leaving those rebuttals open while also leaving Pros R2 still mostly untouched. Con does a decent job making some good arguments in his R3, making the case about a reduction in the quality of care and the potential problems with government getting involved in HC, but without having replied to Cons R2 or R3 and ultimately the concession, it's not enough to negate the resolution which Pro did enough to establish. So argument points go to Pro.
Posted by janetsanders733 3 years ago
@Ignopius LOL
Posted by Ignopius 3 years ago
I would have turned the debate and said ACA doesn't go far enough lol.
Posted by janetsanders733 3 years ago
Sorry, next round I will think it through.
Posted by smoothpoints 3 years ago
A little disappointed that your round one is just copy-pasted from the source...but I will refute
2 votes have been placed for this debate. Showing 1 through 2 records.
Vote Placed by bsh1 2 years ago
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Total points awarded:60 
Reasons for voting decision: FF. Pro had more sources that Con, evidencing the great time he put in to researching and warranting his claims. Conduct and Sources to Pro. Additionally, Con failed to rebut many of Pro's points, giving Pro clear offense that allows him to win the round. Arguments to Pro. Thus, I vote Pro.
Vote Placed by airmax1227 3 years ago
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Total points awarded:30 
Reasons for voting decision: RFD in comments.