INTS3350_GroupProject_ACA_Inequality

Running Head: ACA INEQUALITY 1
Affordable Care Act and its Impact on Socioeconomic Inequality
Dane Arnold
Luz Charles
Tyler Conway
Vincent Cowan
Marlyn Garcia
Jason Lapiska
Texas Tech University
May 2015

Introduction
The most complex issue facing Americans in present time is the Affordable Care Act or
ACA which is also known as Obamacare. Contrary to popular belief, the Affordable Care Act
was signed into law in March of 2010 according to the U.S. Department of Health & Human
Services, Office of the Assistant Secretary for Planning and Evaluation. This problem with the
ACA is interdisciplinary as it is very complex and affects society at all levels within the United
States.
The ACA is affecting our nation in numerous ways. Starting from an economic
standpoint, an emotional and a moral approach, no one wants to have to purchase health care if it
is not one of their necessities (economic inequality). There are some responsible people out there
who when faced with a medical need will actually set up a payment plan and pay off their
medical expenses as agreed. From an emotional standpoint, millions of people are losing their
healthcare benefits because they are being told that their income is above the allotted amounts
even though they cannot even afford money for food in their current situation. Above all, from a
moral perspective people feel as though it is unconstitutional to be forced to do something they
are not comfortable with; even going against religious beliefs such as those which affect most
Jehovah’s Witnesses (Examiner Editorial, 2012).
An interdisciplinary approach should be taken to solve this problem as quickly and
effectively as possible. There is no room for trial and error when it comes to problem solving.
Problem solving and research includes the usage of brainstorming, deferring judgment, using
affirmative judgment, seeking quantity, considering novelty and interdisciplinarity. These
guidelines can be applied to the Interdisciplinary Research Process by incorporating proper

problem solving and goal attainment while embracing diversity and innovation by generating the
alternatives to move from a current state to a preferred state (Harris, T., & Sherblom, J.,2011).
The interdisciplinary research process (IRP) is the “how” part of the definition of
interdisciplinarity. Interdisciplinarity refers to the process used to study a complex
problem/issue/question, not to the problem/issue/question itself” (Repko, 2012 pp.24). This is
why interdisciplinary research is the best method for solving such a complex issue, like the ACA
which is affecting our nation during present times. “Each interdisciplinary research project
involves drawing on a different combination of disciplines, insights, and theories because
knowledge and problems are contextual and contingent” (Repko, 2012 pp.25).
Literature Review
The ACA is a government implemented federal health reform that is intended to,
according to Affordable Care Act (2011), “expand access to insurance, increase consumer
protections, emphasize prevention and wellness, improve quality and system performance,
expand the health workforce, and curb rising healthcare costs.” This act that is estimated to give
coverage to over 30 million Americans that do not currently have insurance has of course been
criticized by the public and highly controversial between those that it will not positively benefit
and those that it will. The concerns that most people are having with the ACA is that according
to ACA.org (2013), “other provisions that are taking effect will significantly increase the cost of
coverage, such as health insurance tax, minimum essential benefits, and restrictions on age
rating. The cumulative impact on all of these provisions increases the likelihood that some
individuals will choose to purchase insurance only after they become sick or injured, further
increasing the cost of coverage for everyone else with insurance.” Not only does the ACA have a

significantly high cost for coverage but it also affects others who already do have insurance
coverage. This is one of the main problems we are seeing involving the ACA and its terms.
Throughout this project, we will determine the main focus on areas of issues in the following
most relevant disciplinary perspectives: Economics, political science and communication. These
three disciplines prove to be the most relevant regarding the issues that come along with the
Affordable Care Act because from an economic standpoint the ACA will most likely increase the
deficit instead of reduce it as well as increase insurance costs and reduce employment as a
consequence of that. The problem that stems from this issue is that health insurance is being
made unaffordable and if insurance is bought, there is no room to pay for the medical bills that
are left over. From a political science perspective, according to Haeder (2013), the ACT relies
extensively on the cooperation of states for its implementation, offering opportunities for both
local adaptation and political roadblocks. Despite significant financial support from the federal
government, many governors and legislatures have taken action that have blocked or delayed
significant progress in developing their exchanges.” This is portraying a deconstruction within
the system and makes the public question the act in full. Communication seems to be extremely
relevant to the issues regarding the Affordable Care Act. Complaints from the public are being
made that their understanding of the provisions and stipulations are unclear.
From what we have gathered throughout this research process, young adults have an
advantage by being allowed to be dependents on their parents insurance until the age of 26.
Contrary to popular belief, the ACA has benefited millions of young adults that fall into this
category. The communication is not adequate for this Act as there are many questions regarding
access to care. According to Sommers (2012), “Analysis of the timing of the policy impact

suggested that early gains in coverage were greatest for people in worse health. We found strong
evidence of increased access to care because of the law, with significant reductions in the
number of young adults who delayed getting care and in those who did not receive needed care
because of cost.” This information is crucial because it brings to light the negative effect it has
on the people without serious sickness or injury. The Act is proving true to the biased opinion on
how it is negatively impacting those that are healthy at the time of registration versus those that
were already deemed ill or injured.
An interesting tidbit by Dr. Butler (JAMA, Jan, 2015) sheds some positive light on a very
controversial program. Should the ACA survive to the year 2017, currently dormant regulations
in the ACA will allow for a dynamic change in the way healthcare coverage is currently operated
and open the pathway to a single-payer system. A single-payer system eliminates many of the
bloated areas in insurance including elimination of premiums, deductibles and opens the option
for patients to choose who to go to for healthcare. This is very different from HMO programs
today where you have to visit a primary care physician and then referred to specialists for further
care. Dr. Butler refers these new regulations under Section 1332 as unleashing “state innovation
on steroids.” This allows states to custom tailor their healthcare coverage to the extent that best
suits their plans to achieve parity and meet the required coverage quality without causing an
increase in costs to the federal government. There is a focus currently on the immense increase
in costs for personal insurance, which is not unfounded. Ultimately, this is a change in policy
that many hope it will actually benefit the community by decreasing the financial burden
especially on those in the struggling lower class.

In a political science basis, there is a large racial bias in regards to healthcare and its
availability to minorities and especially undocumented citizens. One article on the ACA
(Ortega, Rodriguez, Bustamante. p. 527) explains that there are dynamic challenges even in
providing coverage for families that might have a mixture of citizenship under one roof.
Children might have been born here in the United States, while maybe one parent has a work
visa and another may not be a documented citizen or not working for a business that is able to
offer health care options. Therein exists a challenge because people will not seek health care,
with some groups suffering from a higher mortality rate due to this or from living so remotely
that proper health care is not easily accessible. By having an open health care program, the
burden can be offset by promoting options for naturalisation and becoming a citizen. Currently,
if you visit an emergency care center and are uninsured or an undocumented citizen, they cannot
deny giving you of care. This is not the same as if you tried to visit a regular doctor’s office.
With further improvements to the ACA, this will also encourage the use of primary care
physicians which come at a lower cost and tax burden than that of large numbers of
undocumented citizens using an emergency care center and opening up their use for truly
necessary emergency cases.
Connections
Insights on Economics:
Economics is typically seen as a major discipline around the world. When we deal with
the Affordable Care Act, economics is seen as the most prominent perspective to help figure out
this crisis. The perspective of economics in America has been a troubling issue lately when it
comes to trying to figure out the problems with the ACA. Many things affect the economy of the

United States, but the Affordable Care Act is a major factor. One of the biggest economic
uncertainties is the hurting of businesses. When you have 50 or more people employed by your
business and need them to work over 30 hours a week they will be forced to receive health
benefits. These benefits could cause monetary troubles for said business due to the high expenses
it costs to turn all these part time workers into full time workers. The economy of some of these
businesses can't afford to pay the price for these health plans so instead of giving them full time
status they end up just hiring twice as many people and keep them under the 30 hour a week
maximum before having to receive these health plans. What this also costs is the people who
work for these businesses can't afford to pay for their own health plans now because they do not
get enough money from their paychecks since their hours were cut down. So by fixing the
economic problem with the ACA could become a very vital operation to making it into a
successful plan that President Obama and his supporters plan on keeping it in effect indefinitely.
Insights on Political Science:
Political Science emphasizes relationships of power and the legitimacy of power.
Traditional political science includes an analysis of regime types of forms of government as well
as the influence of political principles in shaping these realms (Taylor, 2012, p. 13). When
applying political science to the ACA, you have to realize that we have a Republican party and a
Democratic party that have different opinions and ideals on how the ACA should be run. Right
now the Republicans are trying to repeal the Affordable Care Act. They plan to set up a
provision similar to last year’s GOP plan that will help people who have pre-existing conditions
before being denied by the new health plans. Jamelle states that, “For Americans who don’t
have insurance, the plan would provide a one-time enrollment period. Like the ACA, the

replacement proposal includes subsidies for low- and middle-income Americans, but in the form
of tax credits instead of a payment to the insurer. But these would be much less generous, with a
threshold well below the one established by the ACA. The Republican plan eliminates the
federal exchanges and ends regulation of insurance benefits, allowing, for example, an insurer to
offer a comprehensive plan that didn’t include maternity coverage” (2015). This could bring a
conflict between the democratic and the republican parties. With this rift between the two parties
it could be seen as a major conflict. The ACA could completely change the aspect of the
upcoming election.
Insights on Communication:
Communications is a broad spectrum field in itself including other aspects such as Data
Science and Information Technology. All revolve around the necessity of Communications and
the technology that makes mass communication possible. According to the current census
(census.gov, 2015), the U.S. population is over 320 million people, which is quite a large amount
of information to log and keep track of whether they are insured as well as what programs or
insurance coverage they are using. This could mean text or photo documentation in servers for
storage and quick access through the marketplace or other locations. We have moved into the
era of “Big Data,” which is the presence of large amounts of data that is very hard to manipulate,
requires extensive computational power, bandwidth and other expansions in logistics to manage.
If every person’s medical information and history in the U.S. was distilled down to just one file
each with 100 megabytes of information or around 50 pictures from your camera phone, this
would equate to 32 petabytes of information or around 300,000 new iPhone 6’s full of
information. As you can imagine, storing this information as well as dealing with the traffic load

for the millions of people, organizations and health care providers accessing this information on
a daily basis is very expensive to set up and maintain. With this last year’s push for insurance
and enrollment through the healthcare marketplace, complaints were abundant regarding slow
servers, downtimes and other errors that caused lost information or users had to log in again and
start from the beginning. From personal experience, the Graphical User Interface (GUI) or how
the website was designed and interconnected was not very streamlined and had some limitations
in selecting specific healthcare packages. There is not very much in variety for insurance
selections especially in the lower income market with mostly HMOs to choose from. This
proves to be a challenge as many doctors and clinics that are on the insurance lists for the
network have actually stopped accepting that coverage. You can spend a few days searching for
a local clinic that would take your coverage which, for some, still feel it has some limitations as
it has to be performed by referral, thus delaying health care for some.
A Communications expert will prove crucial in aiding the Economist and the Political Science
specialist in understanding the vastness of the program at hand as well as having technical depth
necessary to help the team reach the most effective options available for streamlining the data
and communications portion of the ACA.
Conflict:
Conflict in the same perspective and different perspectives will always happen. There
will always be people in the same perspective that will have different ideals no matter what.
“Conflicts occur between insights within a perspective and between perspectives. Possible
sources of conflict are the underlying assumptions, constituent concepts, and theories that are
express as disciplinary insights” (Repko, 2012).

Common Ground:
Those that are in Economy and Political Science are more and more often involved in
accessing large swaths of data. Those in Communications are able to streamline, and break
down these chunks of data into relevant statistics to help the rest of the team better understand
patterns in user behavior, common trends in healthcare as well as identify potential hot spots or
problem areas before they actually become an actual crisis. Those in Economy and Political
Science know what they are wanting out of the data and what they need whereas
Communications knows where to look, how to organize the data and how to break it into easily
understandable sets.
Integrative Framework
Evaluating the Affordable Care Act through the perspectives of economics, political science, and
communication have concluded that the healthcare industry is still in need of a solution. The
analysis from an economic standpoint revealed that employers are finding loopholes in order to
save money on insurance costs spent on their employees. Companies are capping hours at 30
hours per week in order to ensure that employees are not categorized as full time, therefore
saving the company from insurance costs. This cut in hours has resulted in lower wages for
individual employees. Ultimately the employee is not insured by their employer and cannot
afford an insurance plan on their own due to the decrease in hours.
Results from the perspective of political science conclude that healthcare is in danger due
to indecisiveness or an inability to compromise. The battle between republicans and democrats
continue to hold back health care reform. Once one party develops a plan the opposite party
blocks the progression by attempting to deconstruct and delay the reorganization. This struggle

between parties results in the public being confused and frustrated with new reformations. The
confusion and frustration leads to setbacks that can be addressed and thought through by an
expert in communication.
The discipline of communication is vital to reforming health care. Communication skills
need to be applied to health care reformists from both political parties. Once a compromise has
been reached communication experts can explain the reform to the public in layman’s terms. If
needed, technology can be utilized in order to efficiently store information in order to increase
the speed of communication between patient and insurance provider. The successful use of
communication will lead to solutions from all other disciplines involved in tackling the issue of
health care reform.
Through improvements in communication, the issues mentioned from the political
science perspective can be ironed out. Communicating the demands of each party can result in a
brainstorming session in order to create common ground. Once common ground is established
between republicans and democrats then perhaps a compromise can be constructed.
Communication skills will greatly assist both parties in meeting their demands while remaining
flexible on the national issue of healthcare reform. With a compromise from both parties the
public will be more likely to accept the collective decision that has been agreed upon.
Communicating the benefits to the public in a clear and concise manner will assist in
transitioning to the new healthcare plan. The discipline of communication will also assist when
combing over the policies in search of possible loopholes that may arise. In an ideal situation, the
plan will be accepted by employers and they will not attempt to cheat the system.
Communicating the benefits of the health care reform as well as creating the technology to

successfully interact with users will create a smoother transition for both the government and the
people. Combining the successful utilization of communication with perspectives from
economics and political science will increase compromise, effectively educate the public, and
insure the people of the United States that a solution is in sight.

References
Bouie, J. (2015, February 5). Republicans talk about getting rid of Obamacare. But are they
capable of hashing out a real alternative? Retrieved April 30, 2015.
Butler, Stuart M., PhD (2015, January 13). States Are the Key to Both Strengthening and
Replacing the Affordable Care Act. JAMA, Vol. 303, No. 2
Examiner Editorial. (2012, January 31). Obamacare regulation tramples on religious freedom |
WashingtonExaminer.com. Retrieved from
http://www.washingtonexaminer.com/obamacare-regulation-tramples-on-religious-
freedom/article/209086
Harris, T., & Sherblom, J. (2011). Small group and team communication (5th ed.). Boston:
Pearson Education/Allyn & Bacon.
Ortega, A.N., Rodriguez, H.P. & Bustamante, A.V. (2015, January 7). Policy Dilemmas in
Latino Health Care and Implementation of the Affordable Care Act. UCLA
Repko, A. (2012). Defining Interdisciplinary Studies. In Interdisciplinary research: Process and
theory (2nd ed., pp. 24-25). Thousand Oaks, California: SAGE Publications.
Sommers, B., Buchmueller, T., Decker, S., Carey, C., & Kronick, R. (2013). The Affordable
Care Act Has Led To Significant Gains In Health Insurance And Access To Care For
Young Adults. Health Affairs, 32(1), 165-174. Retrieved April 30, 2015, from
http://content.healthaffairs.org/content/32/1/165.short
Tayler, M. R. (2012). Jewish marriage as an expression of Israel’s conflicted identity. In A. F.
Repko, W. H. Newell, & R. Szostak (Eds.), Case Studies in Interdisciplinary Research
(pp. 23-51). Los Angeles: Sage.

The Affordable Care Act: A Brief Summary. (2011, March 1). Retrieved April 29, 2015 from
http://www.ncsl.org/portals/1/documents/health/hraca.pdf
U.S. Department of Health & Human Services, & Office of the Assistant Secretary for Planning
and Evaluation. (2012). The affordable care act research briefs. Retrieved from
http://www.aspe.hhs.gov/health/reports/2012/ACA-Research/index.cfm
United States Census Bureau (Population Clock)
http://www.census.gov/popclock/

Group Project Grading Rubric
Criteria
Points
Possible
Points
Earned
General
Paper adheres to APA formatting (title page, citations, references page,
etc.). Filename is correct. This rubric pasted at the end of the assignment.
Peer evaluations submitted from all group members.
10
Writing is clear with appropriate grammar, spelling, and punctuation.
Headings are appropriately labeled
10
Introduction (1-2 pages)
Group clearly identifies a complex problem or issue. It is clear from the
writing that the problem is interdisciplinary. The group provides a clear
rationale for the use of interdisciplinary research process.
20
Literature Review(3-4 pages)
Group provides a brief background for the problem/issue. The group
identifies and discusses meaningful interdisciplinary questions that should
be asked about the problem/issue. Group identifies and discusses at least 2
(no more than 3) disciplinary perspectives for addressing the
problem/issue. The rationale for choosing those disciplinary perspectives
is clear. Group provides a discussion of previous research and findings.
20
Connections (2-3 pages)
Group identifies the common ground between the disciplinary
perspectives. Group discusses how this common ground will address the
problem in a more precise way than disciplinary research might.
20
Integrative Framework (1-2 pages)
Based on the common ground, group discusses a new, holistic, integrative
framework for understanding the problem/issue.
20
Total 100
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