Pros and Cons of the Affordable Care Act

The Affordable Care Act (ACA) was passed into law under the Obama Administration and was responsible for reshaping the health care system in many different ways. From overhauling procedures regarding how health care providers deal with patients and practice quality care to providing more people with coverage, the ACA was meant to make fix many of the problems that Americans had with health care. While some have found the ACA to be highly positive, others have found it to be a complete disaster.

Obama noted that the aim of the ACA was to address “long-standing challenges facing the US healthcare system related to access, affordability, and quality of care” (525). Those three points—access, affordability and quality—were the main selling points of the ACA. The legislation was supposed to provide more access to care for people. It was supposed to make care more affordable, and it was supposed to increase the quality of care by promoting preventive medicine, as Obama noted in his article for JAMA.

Critics of the ACA have stated that it actually fails in every single one of its aims: healthcare access is limited thanks to the Accountable Care Organizations (ACOs) that place restrictions on what providers can and cannot do (Alpert). As Alpert shows, while the ACA has helped to ensure that millions more Americans have coverage, the Affordable Care Act has also tightened the screws on providers by establishing ACOs, which have placed a variety of restrictive conditions on providers, such as how they must work to ensure that patients do not keep returning for the same problem over and over again. Though the ACOs mean well, the regulations they enforce under the ACA can handcuff providers and keep them from actually giving quality care to patients. So even if the ACA has allowed millions more Americans to obtain coverage and have access to care, the quality of care that they would normally expect to find may not actually be there thanks to regulatory acts of the ACOs. This is especially true, as Eckstein points out, in the case of emergency medical services (EMS) responsible for transporting patients to health care facilities. New guidelines from ACOs limit the number of options that EMS crews have when attempting to deliver patients to care providers in an emergency situation, as not every facility will be willing to accept them for fear of violating the terms of the ACA and the regulations of the ACOs.

Likewise, while the Affordable Care Act has aimed to promote preventive care, as Obama pointed out, the reality is that preventive medicine is still taking a backseat to treatment, which the federal government continues to subsidize. This subsidization of treatment incentives specialists and health care providers to order more and more treatments and tests for patients, as they know the government will pay for them. Instead of working prevent illness, disease and disorders, health care providers focus instead on ordering tests and waiting till patients are sick and then treating them (Sommers, Gawande & Baicker). Plus, the costs of care have gone up too, with premiums and deductibles skyrocketing for people with insurance.
As I have seen premiums and deductibles rise among my own family, I can say that the ACA has failed in at least this aim. However, when it comes to ensuring quality care and greater access, this will depend upon individual experiences as there are some for whom one side of the story is true, while for others it is very likely that the opposite story is the case. Perspective and personal experience will make all the difference in this case.

Works Cited

Alpert, A. et al. “Giving EMS flexibility in transporting low-acuity patients could generate substantial Medicare savings.” Health Affairs, 32,12 (2013), 2142-2148.

Eckstein, M. “The ambulance industry struggles to go the distance.” Health Affairs, 32,12 (2013), 2067-2068.

Obama, Barack. “United States Health Care Reform Progress To Date And Next Steps.” JAMA, 316, 5 (2016), 525-532.

Sommers, B. D., Gawande, A. A., & Baicker, K. “Health insurance coverage and health—what the recent evidence tells us.” New England Journal of Medicine, 377 (2017), 586-593.