Affordable Care Act: Driving Change in US Healthcare
This paper examines the key forces driving change in the United States healthcare system, with a focus on the Affordable Care Act (ACA), shifting social norms, and demographic shifts such as an aging and increasingly diverse population. It discusses how the ACA has improved care coordination, reduced insurance disparities—particularly for low-income and Latino communities—and enabled access to preventative care. The paper also presents three policy recommendations for further reform: expanding Health Insurance Marketplace funding, more strictly regulating the private insurance sector, and empowering nurses and healthcare workers as agents of change. The analysis draws on peer-reviewed literature and policy sources to argue that ethics-driven regulation is essential to achieving truly affordable, equitable healthcare in America.
- Forces Driving Change in US Healthcare: Policy, demographics, and social norms reshape healthcare
- Effects of the Affordable Care Act: ACA improves care coordination and reduces costs
- How the ACA Helps Lower-Income Families: ACA expands coverage and preventative care access
- Recommendations for Improving Access to Affordable Healthcare: Three steps to expand and strengthen ACA reforms
- Ethics, Regulation, and the Role of Healthcare Workers: Ethics-driven regulation and nurse advocacy as solutions
✍️ How to write this paper — guide, tools & examples ▾
What makes this paper effective
- Organizes a multi-factor analysis clearly, moving from broad systemic forces to specific policy effects and concrete recommendations.
- Grounds policy claims in peer-reviewed research and government sources, lending credibility to practical suggestions.
- Connects macro-level policy (ACA, insurance regulation) to real-world impacts on low-income and underserved populations, making the argument tangible and human-centered.
Key academic technique demonstrated
The paper effectively uses evidence synthesis: it draws on studies from health disparities research, government policy documents, and healthcare management literature to build a layered argument. Rather than relying on a single source, the author weaves multiple citations together to support each claim, a standard technique in health policy writing.
Structure breakdown
The paper opens with a broad overview of forces shaping healthcare change, then narrows to the ACA's specific effects, followed by a focused section on low-income family access. It concludes with three actionable recommendations and a discussion of ethics and professional advocacy. This funnel structure—from wide context to specific action—is appropriate for a health policy analysis paper.
Forces Driving Change in US Healthcare
Healthcare in the United States is driven by policy changes like those embedded in the Affordable Care Act, by shifting social norms and attitudes toward healthcare, and by demographic changes such as an aging population. The Affordable Care Act (ACA) was revolutionary in that it mandated universal coverage, but it still fell short of transforming the ethos of a market-driven healthcare system. As a result, the ACA did not lead to appreciable changes in insurance structuring. It did, however, instigate a new dialogue about the ethics, role, and function of healthcare in America.
Social norms also drive change in the healthcare system. In fact, the ACA itself helped change social norms and values, helping more Americans understand the importance of improved efficiency and reducing healthcare disparities. As social norms and values evolve, it may become possible to imagine a future in which Americans no longer tolerate the excessively high costs of healthcare that are directly attributable to insurance bloating. Finally, demographic changes—including an aging population and increased diversity throughout the country—mean that the nature of healthcare delivery is changing. Healthcare change is driven from the top down, through changes to fiscal and healthcare policy, and from the bottom up, by individuals, families, communities, and healthcare workers.
Effects of the Affordable Care Act
Two notable effects of the Affordable Care Act include improved coordination of care—aided by technology—and cost controls. According to Salmond and Echevarria (2017), the ACA's primary goals have been to reduce unnecessary spending at all levels of healthcare management and delivery, prompting strong self-assessment across the healthcare industry. The ACA has also led to changing values and norms, with more Americans recognizing the importance of accessible and fair insurance policies and easier means of accessing affordable healthcare services.
As more Americans recognize the ways Medicare and Medicaid already function as single-payer systems for seniors, it is also possible that the future of healthcare may include single-payer systems for all residents. The aging population and other demographic changes are additionally impacting the way nurses are trained, how healthcare is delivered across multiple levels of the system, and how costs are managed over time.
How the ACA Helps Lower-Income Families
The Affordable Care Act was designed in part to address the problem of millions of uninsured or underinsured Americans. Less than ten years after its passage, the ACA had already significantly reduced healthcare insurance disparities. One study found that disparities diminished particularly in Latino communities (Heintzman, Bailey, DeVoe, et al., 2016). Because it creates a government-based insurance program available to people who work in precarious or temporary jobs, those who are self-employed, and those who work only part time, all persons who cannot rely on employer-paid insurance plans stand to benefit from the ACA. While costs of insurance and healthcare services remain inflated for various reasons, the ACA nevertheless allowed countless Americans to have insurance for the first time.
Lower-income families were particularly at risk of having insufficient insurance, if any at all. As a result of being uninsured or underinsured, many lower-income families were not receiving annual checkups and went to the hospital only in emergencies. These patterns of usage lead to greater costs: it costs more to treat a major problem than to intervene earlier. Health promotion programs also need to become part of the healthcare system. With the ACA, lower-income families can access preventative care services including health screenings. Preventative care and early interventions can help reduce long-term costs for the individual or family, as well as for the entire system. When people spend less on healthcare, they can invest more in other important areas of life, including education.
References
Heintzman, J., Bailey, S. R., DeVoe, J., et al. (2016). In low-income Latino patients, post-Affordable Care Act insurance disparities may be reduced even more than broader national estimates: Evidence from Oregon. Journal of Racial and Ethnic Health Disparities, 4(3), 329–336.
Munro, D. (2014). U.S. healthcare ranked dead last compared to 10 other countries. Forbes, June 16, 2014. https://www.forbes.com/sites/danmunro/2014/06/16/u-s-healthcare-ranked-dead-last-compared-to-10-other-countries/
Obama, B. (2016). United States health care reform: Progress to date and next steps. JAMA, 316(5), 525–532.
Salmond, S. W., & Echevarria, M. (2017). Healthcare transformation and changing roles for nursing. Orthopedic Nursing, 36(1), 12–25.
Create your account
Always verify citation format against your institution’s current style guide requirements.