The Affordable Care Act: The Value of Systemic Disruption (original) (raw)
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The Affordable Care Act: Dispersing the Fog of Misinformation
Poverty & Public Policy
Editor Max J. Skidmore provides a concise history and political analysis of the attacks on American efforts to achieve near universal health care, and also reviews an innovative history of the 2010 Patient Protection and Affordable Care Act.
Health Care for All: An Overview of the Affordable Care Act's Medicaid Expansion in the USA
One of the most significant health care reforms since the implementation of Medicare and Medicaid, the Affordable Care Act (ACA) enacted into law in 2010, was met with widespread criticism. The expansion of Medicaid eligibility was a specific focus of these critiques as sceptics believed the long-term effects would be primarily negative for both the physical and fiscal health of the population. This article provides a brief history of the ACA along with the role of political and public opinion. This is followed with an analysis of initial criticisms and concerns surrounding the eligibility and expansion—with a brief discussion of the constitutionality of the law. Finally, while the long-term effects of the ACA upon health care access and service in the USA are yet to be seen, preliminary results indicate positive effects, contrary to the negatives originally assumed. The article concludes with a summary of current health care reform and a prospective on the future of health care reform in the USA.
The Sustainability of the ACA: Legal Challenge and Legislative Opposition
Universal health care coverage has long been seen as an unattainable goal for Americans. With the Affordable Care Act, the Obama administration addressed the issue with a complex system of mandates, subsidies, and state marketplaces. The implementation of the reform encountered many obstacles including legal challenges, a congressional shut down, system failure, and, recently, a growing number of state legislatures (23 to date) enacting measures to nullify or opt out of the reform. This paper examines the resistance to the Act in two interrelated dimensions: legal challenges and state legislative opposition. These two dimensions of resistance are explored in order to speculate on the legal and political sustainability of the reform. Ultimately, the discussion on the sustainability of health care reform sheds considerable light on the broader sustainability of federal intervention in social policies (gun control, abortion, immigration, death penalty, drug control).
International Journal of Sciences: Basic and Applied Research (IJSBAR), 2019
The changing political climate of Congress and the dilemmas of the Affordable Care Act (Obamacare) in reforming the U.S. health care system is the focus of this work. The author is with the view that most barriers that led to the denial of previous health care reform bills were as a result of the role played by Congressional caucuses and the continuous health care malpractices perpetrated by health care industries in the United States. Healthcare policy making in the United States therefore, owns its hegemonic past from a long standing institutional and ideological politics beginning with Theodore Roosevelt's failed proposal for a national health care system in 1912. The work further examines Congressional path dependency on health care reform and its role in health care policy adoption and implementation. The obstacles faced by Americans in having a relatively rational type of health care coverage system in the United States will also be discussed. The paper argues that the invisible hands of Congressional caucuses and health care industries continue to play integral parts in health care policy making in the U.S. thereby, frustrating government's efforts in order to uphold the privileges and profits enjoyed at the expense of tax payers. The puzzle the work seeks to unravel is to showcase whether the fight to repeal the Affordable Care Act by Congress, States and individual plaintiffs will hold in the light of the unprecedented health care burden on Americans. The work explores John Kingdon's Multiple Streams Framework in public policy making with particular reference to the health care policy reforms in the United States. The author concludes that in order to achieve an efficient market outcome in the case of the prevailing health care externalities in the U.S., the implementation of a policy where mostly everyone is expected to be better off is deemed necessary.
Assessing the New Health Care Law
Congressional Quarterly Researcher , 2012
Will it improve care and reduce spending? I n June, the Supreme Court upheld most of the Obama administration's 2010 health care law, allowing the government to fine people who decline to buy medical insurance. But the court barred cutting off Medicaid funds for states that refuse to participate in a new program expanding health care for the poor. Some Republican governors have balked at the expanded coverage, undermining the administration's goal of adding 30 million people to the health insurance rolls. Meanwhile, GOP presidential nominee Mitt Romney, along with many congressional Republicans, vows to repeal the entire Affordable Care Act, arguing it is too costly and abridges individual freedoms. The law's supporters, however, say its benefits already are evident, as children with pre-existing illnesses can no longer lose coverage and young adults can enroll in their parents' health plans.
United States Health Care Reform
Journal of Neuro-Ophthalmology, 2014
Care Act is the most important health care legislation enacted in the United States since the creation of Medicare and Medicaid in 1965. The law implemented comprehensive reforms designed to improve the accessibility, affordability, and quality of health care. OBJECTIVES To review the factors influencing the decision to pursue health reform, summarize evidence on the effects of the law to date, recommend actions that could improve the health care system, and identify general lessons for public policy from the Affordable Care Act. EVIDENCE Analysis of publicly available data, data obtained from government agencies, and published research findings. The period examined extends from 1963 to early 2016. FINDINGS The Affordable Care Act has made significant progress toward solving long-standing challenges facing the US health care system related to access, affordability, and quality of care. Since the Affordable Care Act became law, the uninsured rate has declined by 43%, from 16.0% in 2010 to 9.1% in 2015, primarily because of the law's reforms. Research has documented accompanying improvements in access to care (for example, an estimated reduction in the share of nonelderly adults unable to afford care of 5.5 percentage points), financial security (for example, an estimated reduction in debts sent to collection of 600−600-600−1000 per person gaining Medicaid coverage), and health (for example, an estimated reduction in the share of nonelderly adults reporting fair or poor health of 3.4 percentage points). The law has also begun the process of transforming health care payment systems, with an estimated 30% of traditional Medicare payments now flowing through alternative payment models like bundled payments or accountable care organizations. These and related reforms have contributed to a sustained period of slow growth in per-enrollee health care spending and improvements in health care quality. Despite this progress, major opportunities to improve the health care system remain. CONCLUSIONS AND RELEVANCE Policy makers should build on progress made by the Affordable Care Act by continuing to implement the Health Insurance Marketplaces and delivery system reform, increasing federal financial assistance for Marketplace enrollees, introducing a public plan option in areas lacking individual market competition, and taking actions to reduce prescription drug costs. Although partisanship and special interest opposition remain, experience with the Affordable Care Act demonstrates that positive change is achievable on some of the nation's most complex challenges.
Repeal and Replace of Affordable Care: A Complex, but Not an Impossible Task
Pain Physician
The Affordable Care Act (ACA), signature legislation of President Obama, was arguably the most consequential and comprehensive health care reform since Medicare was introduced as part of President Lyndon B. Johnson’s great society. It has been claimed that many of the law’s reforms are now so integrated in the health system that full repeal would be impractical, while others including President Elect Trump have rejected that idea and called for full repeal and replacement claiming ACA law cannot be fixed. A tsunami of increasing regulatory burden over the past 8 years, the current health care milieu has moved independent practitioners towards hospital employment in great numbers. In addition, public opinion has been slowly climbing against ObamaCare with 54% of Americans now opposing the law. President Obama has indicated that the law has accomplished many of its goals, including increasing accessibility, affordability, and quality of health care. However, others have contradicted t...