Checking in on 14 Years of Obamacare: Part 3

Health and Gender Policy Brief #174 | By: Geoffrey Small | May 22, 2024

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March 2024 highlighted fourteen years since The ACA (Affordable Care Act) has been enacted. When it was passed more than a decade ago, there were three primary goals of the ACA, or more popularly referred to as Obamacare. According to, the first was to make affordable health insurance more available for the American public. The second goal was to encourage states to expand their Medicaid coverage to all individuals whose income is significantly below the federal poverty level. Finally, the ACA would provide federal support to “innovative medical care delivery methods designed to lower the costs of health care generally.” This part in the series will analyze the ACA’s impact on innovative medical care, and the delivery methods designed to save the American public money.

Policy Analysis

When the Affordable Care Act was first administered, a conference held by the Board on Health Sciences Policy, Board on Health Care Services, and the Institute of Medicine published a presentation  Leveraging the Affordable Care Act and Information Technology to Innovate. The presentation’s primary focus was using the ACA to enable a better disaster response. The consensus from expert speakers concluded a “Social-Health” information exchange must include community-based service organizations, where health care providers focus on the person as a whole. This includes housing, shelter, and other social needs, along with acute medical care. Using data analytics to engage in preventative health care can help reduce costly medical disasters. Also, hospitals could meet the ACA community benefit requirement by engaging in a health information exchange with their local community. Telemedicine was another big factor on sharing expertise remotely and extending medical care workforce capacity. Finally, educating  the community on new healthcare technologies must be administered in a user-friendly capacity, so it’s easier to learn and use.

Despite expert opinions on creating a road map for innovative affordable healthcare, a recent Washington Post article concluded that the ACA efforts still haven’t found “the magic pot of money.” Pilot projects in preventative care run by the Center for Medicare and Medicaid Innovation, after the ACA was administered,  were projected to save 2.8 billion according to the Congressional Budget Office. However, it ended up costing the government 5.4 billion within the first decade. This was due to the fact that medical care providers needed to treat a lot of minor issues to prevent a serious health crisis.

Estimating cost projections in the healthcare industry is extremely complicated. Especially in the U.S. where healthcare is not universal. Strictly mandating lower medication costs can lead to companies abandoning accessible medicines for Americans. Average U.S. physician salaries are approximately twice as much compared to their European colleagues. However, enforcing lower salaries can create a political quagmire for a healthcare system that is already overwhelmed with staffing issues. Telemedicine has thrived in post-pandemic society, but the impact of COVID-19 has reduced the cost-saving-projections that we’re initially estimated.

Overall, the ACA has helped the American public navigate the costly healthcare system. The United States is the only post-industrial country that does not have universal healthcare. The evidence presented in this three-part series makes it abundantly clear that the ACA, although helpful, should be a stepping stone to affordable universal healthcare.

This is the third part in a series. For Part 2 of the Obamacare series, click here. For the rest of the series, click here

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