The Implementation and Evaluation of the United States Affordable Care Act
In 2010 the United States Congress adopted the Patient Protection and Affordable Care Act (“ACA”), more commonly referred to as Obamacare. The ACA was proposed by President Barack Obama while running for president and it was passed with a near straight party-line vote of Democrats in the US House and Senate in 2010. The ACA was meant to address several problems with the American health care delivery system, including cost, access and outcomes. This article describes the major features of the ACA including the context of the US health care system, evaluates the ACA’s implementation history and assesses its fate and future reforms throughout the presidency of Donald Trump. The overall conclusion based on its implementation is that while the ACA made significant reforms in terms of access to health care, it is not clear that it addressed affordability or began to improve health care outcomes in the US.
Berchick, E. R., Hood, E. & Barnett, J. C. (2018) Health Insurance Coverage in the United States: 2017 (Washington, D.C.: U.S. Census Bureau).
Buchanan, L., Fairfield, H. & Yourish, H. (2014) Rating a Health Law’s Success, New York Times (May 19, 2014), retrived from https://www.nytimes.com/interactive/2014/05/19/health/rating-a-health-laws-success.html (December 19, 2018)
Congressional Budget Office (2010) H.R. 4872, Reconciliation Act of 2010 (Final Health Care Legislation), (March 20, 2010)
Goldman, A. L. et al. (2018) Out-of-Pocket Spending and Premium Contributions After Implementation of the Affordable Care Act, JAMA Internal Medicine, 178(3), pp. 347-355, doi: 10.1001/jamainternmed.2017.8060.
Hillstrom, K. (2012) U.S. Health Policy and Politics: A Documentary History (Los Angeles, CA: Sage).
Jacobs, Lawrence R., & Skocpol, T. (2010) Health Care Reform and American Politics: What Everyone Needs to Know (New York: Oxford University Press).
Kaiser Family Foundation (2011) Summary of the Affordable Care Act, retrieved from http://kaiserfamilyfoundation.files.wordpress.com/2011/04/8061-021.pdf (August 8, 2018.)
Kaiser Family Foundation (2018a) 6 Charts About Public Opinion On The Affordable Care Act, (December 19, 2018), retrieved from https://www.kff.org/health-reform/poll-finding/6-charts-about-public-opinion-on-the-affordable-care-act/ (January 17, 2019).
Kaiser Family Foundation (2018b) How Repeal of the Individual Mandate and Expansion of Loosely Regulated Plans are Affecting 2019 Premiums, (October 26, 2018), retrieved from https://www.kff.org/health-costs/issue-brief/how-repeal-of-the-individual-mandate-and-expansion-of-loosely-regulated-plans-are-affecting-2019-premiums/ (January 17, 2019).
Kaiser Family Foundation (2018c) Marketplace Enrollment, 2014-2019, retrieved from https://www.kff.org/health-reform/state-indicator/marketplace-enrollment-2014-2017/?currentTimeframe=0&sortModel=%7B%22colId%22:%22Location%22,%22sort%22:%22asc%22%7D (January 17, 2019)
Kaiser Family Foundation (2018d, March 28) The Effects of Medicaid Expansion under the ACA: Updated Findings from a Literature Review, retrieved from https://www.kff.org/medicaid/issue-brief/the-effects-of-medicaid-expansion-under-the-aca-updated-findings-from-a-literature-review-march-2018/ (January 17, 2019).
McCardle, M. (2014) Will Obama Ever Enforce His Health Law?, Politics in Minnesota, (March 10, 2014), pp. 5.
Pfiffner, J. P. (1994) President Clinton’s Health Care Reform Proposals of 1994, retrieved from http://www.thepresidency.org/storage/documents/President_Clintons_Health_Care_Reform_Proposals.pdf (August 8, 2014)
Schulte, M. F. (2009) Health Care Delivery in the U.S.A.: an introduction (New York: CRC Press).
Starr, P. (2011) Remedy and Reaction: The Peculiar American Struggle Over Health Care Reform (New Haven: Yale University Press).
Starr, P. (1982) The Social Transformation of American Medicine (New York: Basic Books).
Sullivan, K. (2006) The Health Care Mess: How We Got Into It and How We’ll Get Out of It (Bloomington, Indiana: Author House).
White, J. (2013) Cost Control After the ACA, Public Administration Review, 73(S1), pp. S24-S33, doi: 10.1111/puar.12108.
Weiner, J., Clifford, M. & Mark, P. (2017) Effects of the ACA on Health Care Cost Containment: What has the ACA done to "bend the cost curve"? Fourth and Final in a Series on the Impact of the ACA, retrieved from https://ldi.upenn.edu/brief/effects-aca-health-care-cost-containment (January 17, 2019)
Woolf, S. H. & Laudan, A. (2013) U.S. Health in International Perspective: Shorter Lives, Poorer Health (Washington, DC: The National Academies Press).
Copyright (c) 2019 University of Maribor, University Press
This work is licensed under a Creative Commons Attribution 4.0 International License.