Obamacare and the Affordable Care Act: policy overview

¶ … Affordable Care Act

Since its enactment in 2010, the Affordable Care Act (ACA) has transformed the way in which healthcare is provided in America. With its primary aim being to address "long-standing challenges facing the U.S. healthcare system related to access, affordability, and quality of care," the ACA has increased healthcare coverage for more Americans by mandating that health insurance be purchased and that insurance providers not discriminate against applicants (Obama, 2016). When considering the ACA, however, it is important to realize that this piece of healthcare legislation is far more impactful on the lives of Americans than simply in a healthcare context: in fact, the ACA affects lawmakers at both state and federal levels, workers, politicians and voters tasked with electing officials who will either pledge to carry the mantle of the ACA -- or repeal and replace it, as President-Elect Donald Trump has pledged to do. This paper will take examine the current progress of the ACA, its future, issues facing it, a state's policies regarding it and two career opportunities the ACA created.

Progress, Future and Issues Regarding the ACA

The current progress of the ACA is evident in the statistics associated with its aims: as Obama (2016) indicates, uninsured rates have decreased by 43% to below 10% of Americans in the 5 years that ACA has been in place. Accessibility has also improved for nonelderly adults, fewer bills have been sent to collections as a result of the expansion of Medicaid, and the percentage Americans reporting better health has risen by more than 3 points (Obama, 2016). Legal reforms have been adopted: for example, "30% of traditional Medicare payments [are] now flowing through alternative payment models like bundled payments or accountable care organizations" (Obama, 2016).

The future of the ACA, however, is uncertain -- as President-Elect Donald Trump has pledged to dismantle it by repealing and replacing. Whether any aspects of the law are retained, such as the ability of at-risk patients to find affordable coverage, remains to be seen. For now, the ACA's future is unclear. Goals and objectives that remain currently are for it to expand health insurance marketplaces by making marketplaces more competitive so that insurance is more affordable, and continue to reform the delivery system (Obama, 2016).

Issues facing the ACA currently are that while fewer are now uninsured, premiums and deductibles have risen over the years as insurance companies have taken on more risk without the projected number of young, healthy persons buying into the system. In other words, the penalty for not purchasing health insurance has not served as an adequate deterrent and insurance companies have pulling out of the exchanges in several states across the U.S., making the marketplace less competitive overall; thus, exchanges are one of the primary issues facing the ACA currently (Leflar, 2013). Cost control measures are another issue, as after just three years of the ACA being enacted it was noted that "among the first to feel a financial sting will likely be younger men" (Leflar, 2013). This issue is one that has raised the risk that healthy, young adults with abstain from buying insurance.

Career Opportunities

Two career opportunities that the ACA has created are related to the rising number of insured patients seeking medical care: thus, nurse practitioner jobs have been created and medical billing coders (information technology jobs) have been created. The nurse practitioner career is one that existed long before the ACA came into existence; however, the ACA has enabled the field to expand just as much as coverage of patients has expanded. Therefore, it stands to reason that with more patients coming to facilities for treatment, those same facilities will need to hire more nurse practitioners to care for the patients. Likewise, with more patients being treated and more facilities being created, billing codes for digital records and IT systems will need to be created; thus, careers in bill coding are being created by the ACA.

State Policy