{"id":38403,"date":"2021-06-08T08:24:00","date_gmt":"2021-06-08T12:24:00","guid":{"rendered":"https:\/\/www.shortform.com\/blog\/?p=38403"},"modified":"2021-06-18T11:08:16","modified_gmt":"2021-06-18T15:08:16","slug":"affordable-healthcare-act","status":"publish","type":"post","link":"https:\/\/www.shortform.com\/blog\/affordable-healthcare-act\/","title":{"rendered":"Affordable Healthcare Act: Achievements and Pitfalls"},"content":{"rendered":"\n<p>Under what president was the Affordable Healthcare Act enacted? And what is the main reason it failed to live up to its promises?<\/p>\n\n\n\n<p>One of Obama\u2019s hallmark achievements was passing the Affordable Care Act. While it made good progress in some areas, it ultimately fell very far from its original sweeping vision.<\/p>\n\n\n\n<p>Here\u2019s an overview of its achievements and its pitfalls.<\/p>\n\n\n\n<!--more-->\n\n\n\n<h2 class=\"wp-block-heading\"><strong>Achievements of the Affordable Care Act<\/strong><\/h2>\n\n\n\n<p>Here\u2019s how the Affordable Care Act succeeded:<\/p>\n\n\n\n<ul class=\"wp-block-list\"><li>It barred insurers from denying coverage to people with preexisting conditions.<\/li><li>It banned lifetime limits on insurance payouts.<\/li><li>It defined essential health benefits that insurers had to cover, like maternity care and screening procedures<\/li><li>It allowed adult children to stay on family health insurance until age 26.<\/li><li>It capped annual out-of-pocket spending per person (to around $7,000) as long as the patient stayed in-network. The aim was to limit bankruptcy caused by healthcare.<ul><li>(Shortform note: this doesn\u2019t directly constrain costs. Even if patients can only pay a certain maximum, the extra cost just gets pushed onto higher premiums.)<\/li><\/ul><\/li><\/ul>\n\n\n\n<h3 class=\"wp-block-heading\"><strong>Pitfalls of the Affordable Care Act<\/strong><\/h3>\n\n\n\n<p>Here\u2019s how the Affordable Care Act failed:<\/p>\n\n\n\n<ul class=\"wp-block-list\"><li>It didn\u2019t directly control rising costs. Its measures tried to achieve this in roundabout ways, with unclear efficacy.<\/li><li>As healthcare costs rise, insurers can push expenses to the patient through higher co-pays and deductibles.<ul><li>Higher prices for drugs meant patients avoided getting any medicine, which raises the cost of later care once complications result.<\/li><li>Insurers also narrowed networks, often to less experienced doctors and second-tier hospitals.<\/li><\/ul><\/li><li>It did not create a \u201cpublic option\u201d that allowed anyone to choose a national health insurance plan or get on Medicare. This would have created a large payer with large <a href=\"https:\/\/www.shortform.com\/blog\/negotiating-power\/\">negotiating power<\/a> over providers and pharmaceutical companies. However, the insurance industry fought this provision since it threatened their businesses.<\/li><li>The public option\u2019s successor, non-profit health insurance co-operatives, largely failed. These had started as small startups without the size to get enough negotiating leverage.<\/li><li>Some incentives created by the ACA were easily gamed.<ul><li>For example, the ACA promoted free screening for certain conditions. But in some cases, providers could code procedures as a diagnostic instead of a screening procedure. For instance, if there was a benign polyp discovered 10 years ago, a colonoscopy could be a diagnostic instead of a screening.<\/li><li>Furthermore, the screenings themselves could be free, but providers could charge for the room rental or anesthesiology.<\/li><\/ul><\/li><\/ul>\n\n\n\n<p><strong>It\u2019s not clear to patients that their lives have improved with the Affordable Healthcare Act.<\/strong> Healthcare spending doesn\u2019t seem to have been strongly controlled, and premiums have risen for many patients. This has led many to call for the repeal of the ACA.<\/p>\n","protected":false},"excerpt":{"rendered":"<p>Under what president was the Affordable Healthcare Act enacted? And what is the main reason it failed to live up to its promises? One of Obama\u2019s hallmark achievements was passing the Affordable Care Act. While it made good progress in some areas, it ultimately fell very far from its original sweeping vision. Here\u2019s an overview of its achievements and its pitfalls.<\/p>\n","protected":false},"author":7,"featured_media":34410,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_jetpack_memberships_contains_paid_content":false,"footnotes":""},"categories":[16,39,275],"tags":[380],"class_list":["post-38403","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-health","category-history","category-politics","tag-an-american-sickness","","tg-column-two"],"yoast_head":"<!-- This site is optimized with the Yoast SEO Premium plugin v24.3 (Yoast SEO v24.3) - https:\/\/yoast.com\/wordpress\/plugins\/seo\/ -->\n<title>Affordable Healthcare Act: Achievements and Pitfalls - Shortform Books<\/title>\n<meta name=\"description\" content=\"One of Obama\u2019s hallmark achievements was passing the Affordable Healthcare Act. 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Here\u2019s a discussion of its achievements and its pitfalls.\" \/>\n<meta property=\"og:url\" content=\"https:\/\/www.shortform.com\/blog\/affordable-healthcare-act\/\" \/>\n<meta property=\"og:site_name\" content=\"Shortform Books\" \/>\n<meta property=\"article:published_time\" content=\"2021-06-08T12:24:00+00:00\" \/>\n<meta property=\"article:modified_time\" content=\"2021-06-18T15:08:16+00:00\" \/>\n<meta property=\"og:image\" content=\"https:\/\/s3.amazonaws.com\/wordpress.shortform.com\/blog\/wp-content\/uploads\/2021\/05\/barack-obama-photo.png\" \/>\n\t<meta property=\"og:image:width\" content=\"830\" \/>\n\t<meta property=\"og:image:height\" content=\"698\" \/>\n\t<meta property=\"og:image:type\" content=\"image\/png\" \/>\n<meta name=\"author\" content=\"Darya Sinusoid\" \/>\n<meta name=\"twitter:card\" content=\"summary_large_image\" \/>\n<meta name=\"twitter:label1\" content=\"Written by\" \/>\n\t<meta name=\"twitter:data1\" content=\"Darya Sinusoid\" \/>\n\t<meta name=\"twitter:label2\" content=\"Est. reading time\" \/>\n\t<meta name=\"twitter:data2\" content=\"2 minutes\" \/>\n<script type=\"application\/ld+json\" class=\"yoast-schema-graph\">{\"@context\":\"https:\/\/schema.org\",\"@graph\":[{\"@type\":\"Article\",\"@id\":\"https:\/\/www.shortform.com\/blog\/affordable-healthcare-act\/#article\",\"isPartOf\":{\"@id\":\"https:\/\/www.shortform.com\/blog\/affordable-healthcare-act\/\"},\"author\":{\"name\":\"Darya Sinusoid\",\"@id\":\"https:\/\/www.shortform.com\/blog\/#\/schema\/person\/0421cce75bc249b11e2517b3a91f9c46\"},\"headline\":\"Affordable Healthcare Act: Achievements and Pitfalls\",\"datePublished\":\"2021-06-08T12:24:00+00:00\",\"dateModified\":\"2021-06-18T15:08:16+00:00\",\"mainEntityOfPage\":{\"@id\":\"https:\/\/www.shortform.com\/blog\/affordable-healthcare-act\/\"},\"wordCount\":453,\"commentCount\":1,\"publisher\":{\"@id\":\"https:\/\/www.shortform.com\/blog\/#organization\"},\"image\":{\"@id\":\"https:\/\/www.shortform.com\/blog\/affordable-healthcare-act\/#primaryimage\"},\"thumbnailUrl\":\"https:\/\/www.shortform.com\/blog\/wp-content\/uploads\/2021\/05\/barack-obama-photo.png\",\"keywords\":[\"An American Sickness\"],\"articleSection\":[\"Health\",\"History\",\"Politics\"],\"inLanguage\":\"en-US\",\"potentialAction\":[{\"@type\":\"CommentAction\",\"name\":\"Comment\",\"target\":[\"https:\/\/www.shortform.com\/blog\/affordable-healthcare-act\/#respond\"]}]},{\"@type\":\"WebPage\",\"@id\":\"https:\/\/www.shortform.com\/blog\/affordable-healthcare-act\/\",\"url\":\"https:\/\/www.shortform.com\/blog\/affordable-healthcare-act\/\",\"name\":\"Affordable Healthcare Act: Achievements and Pitfalls - Shortform Books\",\"isPartOf\":{\"@id\":\"https:\/\/www.shortform.com\/blog\/#website\"},\"primaryImageOfPage\":{\"@id\":\"https:\/\/www.shortform.com\/blog\/affordable-healthcare-act\/#primaryimage\"},\"image\":{\"@id\":\"https:\/\/www.shortform.com\/blog\/affordable-healthcare-act\/#primaryimage\"},\"thumbnailUrl\":\"https:\/\/www.shortform.com\/blog\/wp-content\/uploads\/2021\/05\/barack-obama-photo.png\",\"datePublished\":\"2021-06-08T12:24:00+00:00\",\"dateModified\":\"2021-06-18T15:08:16+00:00\",\"description\":\"One of Obama\u2019s hallmark achievements was passing the Affordable Healthcare Act. 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