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The Affordable Care Act, more commonly known as “Obamacare” was a comprehensive healthcare reform law enacted in 2010 with the aim of increasing access to affordable healthcare coverage, improving the quality of care, and reducing healthcare costs.  The ACA focused on three major goals, including making healthcare available and affordable to more people, expanding the Medicaid program, and supporting innovation and technology to deliver quality care at a minimal cost. While the Affordable Care Act has accomplished many of the goals it set out to achieve, there have also been some critical drawbacks of the plan for many Americans.

One of the primary goals of the ACA was to expand healthcare coverage, and there can be no doubt that this goal was met. By 2016, the uninsured rate in the US had dropped to its lowest level in decades. There has also been a slow down in the increase of healthcare costs. Positive effects on the economy include improved productivity and reduced absenteeism of workers due to greater preventative care, as well as the expansion of Medicaid resulting in stimulated economic activity (Rapfogel et. al, 2021). Many of these economic benefits had subsequent positive effects, including; benefits of tax credits which helped to pay insurance premiums, increasing the demand for goods and services due to the ACA’s ability to make it easier for families to meet other needs, and reducing unemployment because of the need for more workers (National Archives and Records Administration, 2014).

Perhaps the greatest criticism of the ACA was that as a result of minimum coverage requirements, many individuals experienced cancellation of their existing health plans, despite the initial “keep your plan” promises. These requirements for individuals, businesses, and healthcare providers resulted in increased compliance costs, which were then passed on to employees. Employees who already had health insurance coverage were forced to pay higher premiums due to the restrictions of the ACA, additionally, employers were forced to ensure coverage in businesses maintaining 50 or more full-time employees, which, as a result, cut employee hours and resulted in job loss and minimum growth in small businesses (Blase, 2022). In the four years before the ACA, every age group and family type experienced a premium decrease, or an increase of 9.2% or less. In the first four years of the ACA, however, every age group and household type experienced an increase between 56-63%. Also, individuals are now required to pay more out-of-pocket and prescription costs before benefits kick in, and individuals who do not meet the requirements for subsidies are subject to skyrocketing costs for care (Book, R., 2017).

Although I do think that the list of disadvantages to the ACA is intensive, there is no denying that greater insurance coverage for many of the lower-income individuals and families in our country is commendable. The dissolution of the pre-existing conditions clause of many insurance companies, allowing young adults to stay on their parents’ insurance plans until the age of 26, and ensuring the coverage of preventative care are all portions of the ACA that have benefited our citizens at large. The expansion of Medicaid in many states has been both beneficial and negative. Providing greater low-cost coverage is beneficial, but many doctors and healthcare systems have chosen to exclude themselves from these programs, making medical care choices more limited. The affordability of healthcare is a complex issue and is likely viewed very differently by those with varying experiences and perspectives.