Various factors impact the capacity of the population to receive medical care. One may consider politics as one of the most influential factors. Affordable Care Act (ACA) is a federal law that has significantly affected the American health care system, seeking to make insurance more affordable, promote Medicaid expansion, and encourage innovation in medicine (U.S. Department of Health & Human Services, 2022). The current paper examines the impact of this law on access, equity, cost, quality, and choice of care. While most researchers find that the ACA has positively affected public health, others question its effectiveness and significance.
The availability of health services to more citizens is one of the critical goals of the ACA. The law allowed young people to join their parents’ insurance plans until they were 26, expanded Medicaid coverage for people with small incomes, created special insurance policies for low-income citizens, and added an insurance mandate (Soni et al., 2020). As a result, about 5.5 million people under 26 took the opportunity to be part of their parent’s plan, and 12 million received Medicaid coverage (Soni et al., 2020). Moreover, according to Buchmueller and Levy (2020), ethnic and racial minorities who could not previously access health services could obtain insurance thanks to the law. The ACA promoted equity by reducing the gap in coverage between different groups, but it is still strong, so further measures are needed (Buchmueller & Levy, 2020). Consequently, the ACA has significantly increased access to care for the population, including marginalized groups.
The goal of making health care more affordable affected the cost of care and also its quality. Buntin and Graves (2020) analyzed the situation and compared it with a potential scenario if the ACA was not adopted. Researchers are confident that the law dampened health care cost growth (Buntin & Graves, 2020). Moreover, the ACA has pushed providers to adopt Alternative Payment Models promoting value-based payment (Chernew et al., 2020). These models link cost to service quality, encouraging its enhancement (Chernew et al., 2020). Studies prove quality improvement by testifying the better health outcomes (Soni et al., 2020). As a result, the ACA has improved the quality of care without significantly increasing its costs.
One should consider that the slowdown in cost growth occurred at the national level, but at the individual level, the situation is different. According to Slagle (2021), the cost of health insurance for citizens has increased significantly and even doubled in some states. At the same time, the market is not competitive enough, which reduces the possibility of choosing care plans for the people (Slagle, 2021). Therefore, although the ACA created opportunities to receive the necessary medical services for a part of the population compared to its absence, it also limited the care choice.
Thus, the ACA sought to make medical services more affordable to the population. The measures taken within this law allowed insurance coverage for a more considerable number of people, making care more accessible to low-income households. At the same time, groups that earlier had no opportunities to obtain insurance could afford it. Therefore, the law promoted equity though the gap is still serious among the population. The ACA also facilitated the acceptance of alternative models of payment that slowed down the speed of national healthcare cost growth and raised the quality of services. However, at the individual level, the cost of health insurance considerably increased, which negatively affected the competitiveness of the market and the opportunities for the choice of care.
References
Buchmueller, T. C., & Levy, H. G. (2020). The ACA’s impact on racial and ethnic disparities in health insurance coverage and access to care: An examination of how the insurance coverage expansions of the Affordable Care Act have affected disparities related to race and ethnicity. Health Affairs, 39(3), 395-402. Web.
Buntin, M. B., & Graves, J. A. (2020). How the ACA dented the cost curve: An analysis of whether or not the Affordable Care Act reduced the annual rate at which total national health care costs increased and brought per capita health spending growth rates down. Health Affairs, 39(3), 403-412. Web.
Chernew, M. E., Conway, P. H., & Frakt, A. B. (2020). Transforming Medicare’s payment systems: Progress shaped by the ACA: A narrative review of Affordable Care Act payment reforms. Health Affairs, 39(3), 413-420. Web.
Slagle, A. (2021). Obamacare’s side effects: Higher costs, lower choices. The Heritage Foundation. Web.
Soni, A., Wherry, L. R., & Simon, K. I. (2020). How have ACA insurance expansions affected health outcomes? Findings from the literature: A literature review of the Affordable Care Act’s effects on health outcomes for non-elderly adults. Health Affairs, 39(3), 371-378. Web.
U.S. Department of Health & Human Services. (2022). About the Affordable Care Act. Web.