Editor’s note: The following is a brief abstract of a chapter appearing in the book, “The Trillion Dollar Revolution,” edited by Ezekiel Emanuel of the University of Pennsylvania and Abbe Gluck of Yale University. The book provides a look back at the first ten years of the Affordable Care Act (ACA), which was enacted in March 2010.
Abstract: The Affordable Care Act (ACA) was enacted in an environment of deep partisan division. The law did not completely remake American health care as some hoped and others feared. Although it adopted some of the trappings of market competition, the ACA increased federal regulatory control over the insurance market, backed up by billions of dollars in new or expanded subsidies for health coverage. Insurance became affordable for many because of those subsidies and the law’s new rules protecting patients with expensive conditions. But insurance also became less affordable for others, who were not allowed to keep their less-expensive health plans.
The next reform must move decisively toward a better-functioning marketplace that reduces unnecessary spending by bringing more discipline to the way patients receive care. Although the ACA did not meet all of its objectives, the public strongly supports the law’s provisions that reduce costs for people with expensive health conditions and subsidize private coverage for lower-income households. Republicans failed to reach agreement on a replacement plan for the ACA, but there may be Republican support for market-oriented reforms that are missing from the ACA.
Read the full chapter here.
Joseph Antos
Senior Fellow and Wilson H. Taylor Scholar in Health Care and Retirement Policy
